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Transition to practice: “You’re welcome, future self!”

Here’s how to ensure your transition from residency to practice sets you up for future success

So, you’re almost finished your medical training. Congratulations! It’s been a long road, full of ups and downs, lefts and rights, and now you find yourself on the verge of starting a professional medical career. The leap from residency to practicing as a physician is a big one, and you won’t be surprised to learn there’s a lot you’ll need to do to get yourself safely to the other side. Which should be no problem at all, since you have so much free time between all your research, exams, ongoing education, and clinical responsibilities—right? 
Maybe not. But while it might seem daunting, being proactive about your transition into practice will save you from costly last-minute delays (and a whole lot of stress and anxiety). Your future self will thank you. 
There are many important steps to take before you start your practice, from applications and certifications, to legal and financial arrangements—not to mention the most important decision of all: what kind of practice are you going to undertake? It’s a lot to wrap your head around, but we’ll help you get started. Here’s an overview of some of the big tasks, both practical and emotional, that you’ll have to tackle as you launch yourself into the world of professional medicine.  

Last Things First: Start Your Job Search

Your final year of residency is the time to start thinking about – and planning for – your job search (and if you’re in a particularly competitive specialty, you might want to start doing this even earlier). You may already have a solid idea of what kind of practice you want to establish, but, if you’re still unsure, there are lots of resources available to help you weigh your options.   
Throughout your residency, you’ve met a ton of people and made some important connections, and all these interactions should help you shape your vision of the future. Don’t be afraid to reach out to your peers and colleagues to learn as much as you can about what their personal and professional lives are like—and whether or not you value the same things. In this sense. Your residency is almost like one big job interview, so be curious, clear, confident, and, most important of all, be yourself. 
Oh, and don’t forget to start updating your CV—odds are that you haven’t even looked at it since your CaRMS application, and just think of all the cool stuff you’ve done since then.
When you’re about 6-9 months away from the end of your residency, it’s time to start sending out applications. This will give you time to consider the opportunities that are available to you, and to set the stage for the important steps in your transition that come next. 

Get a Little Advice from the Other Professionals

Finance. Law. Insurance. Three industries that are almost as complicated as medicine. And guess what? You’re going to have to learn all about them, too. 
But don’t worry: the same way a patient comes to you with questions about their health, you can (and should) seek out expert advice. Think about your financial advisor like your family physician; they get to know you, assess your needs, and call in specialists when necessary.
Speaking with a financial advisor throughout your residency will help you plan for the costs of setting up your practice, figure out how to manage your student loans and lines of credit now that you’re no longer a resident, and come up with strategies to start investing your income while repaying your debts. They can also help you set up your professional team…
…because, yes, you’re going to need a professional team! A financial advisor can connect you with accountants and lawyers who are familiar with the unique issues medical professionals face. They’ll help you crunch the numbers, set up your business, negotiate contracts, buy insurance, and cover all the legal and financial obligations you’re undertaking by establishing a practice. 
One vital thing you’ll have to take care of right away is malpractice insurance, which is provided by the Canadian Medical Protective Association (CMPA). Many residents have their CMPA dues fully or partially paid by their employers, but once you graduate, it’s your responsibility to arrange your own coverage, which has to be in place the second you begin practicing as a physician. You can set this up by calling the CMPA about 4-5 weeks before completing your residency to let them know your completion date, so they can change your work code. 

Apply, Apply, Apply (Then Apply Some More)

After applying to medical school, then applying for residency, then applying for jobs, you probably thought you were finished filling out application forms. Well…you aren’t. Better tune up your keyboard, because you’re going to have a busy few months. Here’s a list of just some of the things you’ll have to apply for in the final year of your residency. 
Application for Hospital Privileges
Application for Fellowship in the RCPSC
Application for the Maintenance of Certification (MOC) Program
Application for Certification in the College of Family Physicians of Canada (CFPC)
Application for Licensure in Your Province/Territory
Application to Provincial/Territorial Medical Association
Application for a Billing Number
Requirements also differ from province to province, so be sure to check with your provincial governing body as well.

And, Finally: Enjoy Your Last Days of Being a Resident 

You’re probably super excited that your days of being a resident are almost behind you. But when you complete your residency, that means you’re no longer considered a student. And the truth is, there are a lot of perks and privileges you’ve been enjoying that aren’t going to be available to you for much longer. Like, for example, the student rates you’ve been getting on all those journal subscriptions (better renew quick before it gets too pricey). 
As your residency comes to an end, you might also be doing some travelling, whether to check out different practice opportunities, take your certifying exams, or even just to enjoy a vacation before jumping feet-first into a lifelong career. So, make sure to book your flights and accommodations while you’re still a student to take advantage of discounted fares. Because a resident is considered a full-time student, you’re eligible to obtain an International Student Identity Card (ISIC) and can book travel through TravelCuts (known as Voyages Campus in Quebec).
The end of your residency is a time of reflection, too. Life won’t be the same after this. In a lot of ways, it’ll be better—but there are also going to be a lot of things that you miss. So, make a list of everything you’re grateful for in your current life as an all-star resident, and take the time to celebrate them.   

What should I do next?

If you have any questions about how to manage your transition from residency to practice – like, say, how to develop a solid financial plan that will help you cover the costs of setting up a business, or how to get through those first few months when income is scarce – our team of MD experts is always available to help.
You can also check out our Transition Timeline Tool to get a comprehensive view of everything you’ll have to do as you transition into practice.