Junior Resident

Timeline

Note: if you are coming from a three-year residency program, shift everything back by one year. For instance, the recommended preparation in the PGY3 year in this table would apply to you as a PGY2, and the recommended preparation in the PGY2 year would apply to you as a PGY1. In this scenario, much of the administrative project work and publication will likely spill heavily into the senior (PGY3) year.

Early PGY1 Year

Focus on being an intern. It's hard enough without worrying about careers and life goals! From a quality assurance/improvement perspective, make a list of the most common workarounds that you or your nursing teammates practice daily.

Middle of PGY1 Year

Join some national interest groups for administration, quality, patient safety, or operations. Some will have listservs that periodically send out projects or articles. Start to get a feel for the trending topics in emergency department (ED) administration. 

• SAEM
• American Society for Healthcare Risk Management
• Becker's Hospital Review
• American Academy of Emergency Medicine Operations Podcast
• Healthcare Data and Analytics
• American Health Quality Association

End of PGY1 Year

• Start Getting Involved with Administration at Your Institution: Identify several possible mentors in this area and set up time to meet with them. Be prepared to ask questions, be intent on what you hope to learn from them, and ask about opportunities to learn alongside them or participate in ongoing projects.
• Be Proactive and Volunteer to Assist with Quality Improvement Projects in your ED: Don't be turned off if you're doing a lot of chart review or spreadsheet analysis. Remember that you're paying it forward by earning the trust of ED administrative leaders, and you need this trust to open up opportunities to participate at a higher level in the future.
• Join Committees: Participate in ED or hospital committees focusing on patient safety, quality, operations, or general administration.

Early PGY2 Year

You should have a pretty good idea during your PGY2 year of whether you want to pursue administration further. Keep in mind that individual institutions can have vastly different management structures, so if you don't feel that your own institution is a good fit, explore elsewhere (or at the national level) before you write off administration completely as a potential career pathway.

During PGY2 Year

• Identify Your Mentor(s): By the middle of residency, you should be familiar with the core ED administration faculty at your institution. Select one or two faculty members who are doing work that you find interesting and whose leadership style you admire. Approach them with your interest in ED administration and ask to assist with their projects or start your own under their mentorship. Be direct and emphasize that you are considering ED administration as a career, as this will improve your chances of getting the best opportunities for project involvement.
• Position Yourself for Leadership: Time is your most precious commodity in residency, so choose your involvement strategically. Choose projects that align with your passions or when you feel you can meaningfully contribute. Show up to committee meetings where resident representation is valuable or appreciated. Volunteer to take on additional responsibility when appropriate. If you consistently show up, deliver on tasks, and maintain good working relationships, you will naturally fall into leadership roles. You could also identify an interesting operational problem or challenge at your institution and take the initiative to help solve it. When appropriate, start discussions with ED administrative leaders and offer to create an order set, go to a committee meeting, or draft a policy.