July is a time for transitions. Students are transitioning to clinical training in clerkships and into autonomous practice in internship. Graduating residents and fellows are transitioning into independent practice as attending physicians. For those in the autumn of their careers, there are perhaps transitions to non-clinical roles, or better yet, retirement.
Several theories of transition have been described in the literature. Atherley et al. described three conceptual perspectives to illustrate a learner’s transitions through the medical education continuum. These are: educational, social, and developmental. Unsurprisingly, each of these conceptual perspectives has associated with it feelings of struggle, difficulty, anxiety, and stress. These tensions can arise when there is no shared mental model of expected performance between trainees, supervising faculty, and governing bodies.