Feeling unprepared to become an attending? Here’s how to overcome the anxiety
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Don’t expect perfection … give yourself some grace.
—@toooldbuthereanyway via Reddit
[I] leaned on the seasoned attendings to bounce stuff off of. They had my back and things got better.
—@Nomad556 via Reddit
Do you remember the moment residency ended and your safety net suddenly felt a lot thinner? Or maybe you’re close to becoming an attending and you’re feeling anxious, underprepared, and not quite ready to be the final answer in the room.
Residency trains physicians to make decisions under pressure, but it also trains them within a structured environment. There is usually someone above you—a senior resident, a fellow, or an attending—and a known escalation pathway. Even when supervision is light, the existence of backup changes the psychology of decision-making.
Then July arrives, the badge changes, and the pager feels different. The clinical knowledge may be there, the procedural logs may be complete, the evaluations may say “ready for independent practice.” But the emotional shift from “I think we should…” to “This is the plan” can feel enormous.
How do you overcome this anxiety? In a conversation in r/medicine, doctors offer their best tips.
Related: Ways to overcome physicians’ No. 1 fear1. Talk to a therapist or someone you trust
“You don’t have to have depression or GAD to benefit from therapy, CBT is literally helping people think through this stuff,” writes HCP and Reddit user @Eastern-Ad-3586.
You can also talk to your former coresidents or other mentors for support, according to HCP and Reddit user @crescentstrike.
“[I] leaned on the seasoned attendings to bounce stuff off of. They had my back and things got better,” writes HCP and Reddit user @Nomad556.
Related: How physicians can rethink happiness in an era of time famine2. Know that you’ll probably mess up—and that’s OK
“You’re not a god. It’s only a job. Don’t expect perfection … give yourself some grace,” writes retired family medicine physician and Reddit user @toooldbuthereanyway.
Similarly, @crescentstrike writes, “You’ll always run into someone you can’t please and that’s okay.”
Related: Is there a 'sweet spot' for physician happiness? New science says maybe3. Take up stress-relieving activities
“I am not an anxious person historically (‘pathologically chill’ said one med school classmate), but within 2 months of starting as an attending I was trembling by lunch every day. … I took up an intensive cardio regimen. … I also tried out some different meditation techniques,” writes family medicine physician and Reddit user @Countenance.
For urologist and Reddit user @Urojet, mindful meditation has been helpful to ground them in the moment, “rather than the past that is unchangeable and the future that is unknowable.”
Related: Off-the-wall ways for doctors to instantly destress4. Create a list of things you love about your job
“I have a literal list of things I love about my job, and people I have truly helped. It’s too easy to just remember the bad experiences and the tough people. I want to make sure I remember the good stuff too,” writes HCP and Reddit user @aiofeimmortal.
5. Know that you’re not alone—and things will get easier
“It will get better. … It took me a long time to not take everything home in my mind and go over it repeatedly. It’s a hard learning curve. Be assured a lot of people experience this anxiety,” writes HCP and Reddit user @Odd_Beginning536.