Improving the Medical School to Residency Transition: Narrative Experiences From First-Year Residents

•Few studies have asked learners what supports were needed before residency•This study assessed resident perspectives on their transition to residency•Residents felt unprepared to address bias, racism, and healthcare disparities•We enumerate areas for improvement in optimizing resources and support for learners•Medical educators can use this work to better support the transition to residency We sought to identify first-year obstetrics and gynecology residents’ perceptions of both support needed at the medical school to residency transition and readiness to address structural racism and bias at the start of residency training. Residents were recruited by email and social media for 1:1 interviews from March to June 2021. All interviews were completed by a first-year resident or fourth-year medical student using an interview guide created by the authorship team. Recorded interviews were anonymously transcribed and independently reviewed for themes by two authors. Virtual interviews on the Zoom platform. First-year obstetrics and gynecology residents. Interviews were performed with 26 residents, and six themes for support emerged from their narratives: 1) Establishing a residency program community; 2) Relocation resources; 3) Residency preparation content in medical school and residency; 4) Preparedness to address racism and bias; 5) Connecting with peers with similar lived experiences across institutions; and 6) More proactive intentional touchpoints from program leadership early in residency. Resident narratives described multiple crucial opportunities to improve learners’ transition to residency. These findings can help define a roadmap of resources and support that residency programs can provide for learners from Match Day through the first few months of residency.