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Acad Med. 2018 Feb 6. doi: 10.1097/ACM.0000000000002150. [Epub ahead of print]

What to Do About the Transition to Residency? Exploring Problems and Solutions From Three Perspectives.

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B.C. O'Brien is associate professor, Department of Medicine, and educational researcher, Center for Faculty Educators, University of California, San Francisco, San Francisco, California; ORCID:


Transitions are both a blessing and a curse for learning and professional development. While transitions can afford valuable opportunities for growth, they can also burden learners in ways that stymie performance and development. In this Commentary, the author focuses on the transition to residency-a transition that many believe has tipped too far toward burden. The Commentary explores three ways of problematizing the transition to residency: as a transaction problem, as a transfer problem, and as a trajectory problem. The author also describes current efforts aligned with each framing of the problem and discusses potential gaps in these efforts that might be addressed through an overarching framing of transitions in medical education as transformative processes. This framing may help the medical educational community think more holistically about the problems and solutions with transitions.

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