Senior Resident

As a senior resident, you should focus your time and energy on:

• Billing and Coding: Learn and ask questions of attendings and administrators regarding details necessary for good billing, whether that be including diagnosis codes (including chronic issues), MDM writing, documenting detailed procedures, providing interpretations of tests, etc. This is especially important if you plan to start at a site that utilizes relative value units (RVUs).
• Develop Efficiency: Find ways of maximizing efficiency and practice techniques that may help charting skills (develop dotphrases), history-taking (interview techniques), switching/group tasks, identifying pain points (consults/imaging), anticipating phone calls, or delegating tasks to your interdisciplinary team as able. It is often helpful to replicate skills or patterns you see in other residents and attendings that you admire.
• Legal: Shore up your legal knowledge, which can include reading online blogs, speaking with attendings, and even discussions with your training hospital's legal services. It can be helpful, particularly if you are moving to a new state from where you trained in residency, to review local laws. Important topics include malpractice, legal holds, and pregnancy laws.
• Identify Gaps: Make effort to see patients you are less comfortable with. You should also make a list of problems, presentations, or diagnoses you want to have a better grasp on before finishing residency and being on your own. Try to practice thinking through management decisions with different resources than the ones immediately available. Practice managing larger patient volumes without significant assistance.

Once you've signed a contract, know what resources will and won't be available at your future job and start thinking about how you'll treat patients with that change in resource availability.