Family Medicine Residency: How to Finish Strong in Your Final Year

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September 30, 2022
Time flies, it seems, and you’ve made it to the last year of your family medicine residency! With less than a year before your graduation, this is your chance to learn as much as you can under supervision before entering the world as an attending physician. Take advantage of these tips to ensure a successful year of training and a smooth transition into attending-hood.

Complete your ABFM portfolio

At this point, you should be aware of your American Board of Family Medicine (ABFM) profile. This is the same organization that administers your board exam and provides you with your board certification. In order to graduate from an accredited family medicine residency program, you need to have 50 certification points. You can obtain certification points either by completing Knowledge Self-Assessment (KSA) topics or performance improvement activities. Some of these are longitudinal projects with hourly requirements that take weeks or months to complete, so do not delay. Login to your ABFM portfolio and start accruing points well before you are set to graduate.  

Teach incoming interns

Joseph Joubert once said, “to teach is to learn twice.” Use your final year as an opportunity to teach. As a senior in your program and a veteran of your hospitals and clinics, you have a lot of knowledge and experience to impart. The incoming interns and even the seasoned second years have you to look up to. When you are comfortable enough to teach a topic, you can teach your colleagues while also reinforcing it for yourself. Third year is your opportunity to make an impact on those around you during residency, so don’t be afraid to teach. You may even find a new passion.

Decide whether you’d like to pursue a fellowship

Family medicine offers various opportunities for fellowship, if you are interested in pursuing this path. From palliative medicine and geriatrics to sports medicine and obstetrics, there is a wide variety of specialties available to family medicine residents.

It is important to decide whether you’d like to pursue a subspecialty early on in your third year so you have time to apply for fellowship programs. Ideally, you would have discovered this passion even sooner so you can make the necessary preparations such as letters of recommendation and elective time.

Discuss fellowship opportunities with graduated residents or classmates who experienced fellowship training. Make sure to reach out to your program director, who can guide you through elective rotations and even put you in touch with directors for your fellowship of choice.  

Prepare for the board exam

First, decide when to take your boards. This depends on a few factors, including your graduation date and if you plan to work after graduation. Does your job require board certification, and if so, when will you need it by? After answering these questions, then you can decide if you are taking the family medicine boards in November or April prior to (or even after) graduation.

Once you’ve set a date, start your ABFM board review! Creating your study plan will likely be your last major event before graduation, so it can be something you look forward to. There are various family medicine board prep Qbanks and resources out there to choose from.

Learn all about the ABFM Certification Exam with the ABFM Quickstart Guide.
Studying for the ABFM certification exam in 2023? Download the FREE ABFM Quickstart Guide to learn all about the exam format, topics, and more!

If you’re stuck on how to start your study plan, you may want to check out this post on “How to Increase Your ABFM Family Medicine Certification Exam Score by 100 Points” or the video below from the Rosh Peak Performance course to get you started.

Of note, most programs still require their PGY-3 residents to take an In-Training exam (ITE). Study for it and take your PGY-3 ITE seriously as the score reflects your future performance on the board exam. Failing the PGY-3 ITE may force your program director to consider a course for remediation. 

Find a job

Interview season seems to come around so often in the medical field. First, you interviewed for college. Then, you interviewed for medical school. Next, you explored the country (perhaps virtually) interviewing for residency. Now, it’s time to interview again.

Recruiters will reach out to you often so your first step is to determine what kind of career you want. Are you interested in private practice, public service, academia, or something else? Do you want to work full-time or part-time, inpatient or outpatient? Once you narrow down what you are looking for, reply to the recruiters with specifics of what you want. From there, they will help you find a good fit.

Remember to keep in mind things that go beyond compensation such as continuing medical education (CME) opportunities, vacation days, and work culture. Talk with former program graduates and your program director for more insight. Furthermore, consider hiring a contract attorney to review your employment contract prior to signing. 

Enjoy your last year (but don’t check out too early!)

It can be tempting to feel done and ready for the next phase of your life during your third year. You’ve learned a lot in the last two years, which will continue as medicine is a career of lifelong learning. The important thing to remember is that you are now setting an example for underclassmen. Stay involved and in touch with your colleagues, and stay motivated as that energy will help carry you through your final year. Lastly, take the opportunity to keep learning and caring for patients with the same enthusiasm you did as a newly minted intern. 


Rosh Review is a board review company providing Qbanks that boost your confidence for your boards and beyond. Get started with a Rosh Review free trial to the Qbank of your choice (no credit card required!) and gain access to board-style practice questions, detailed explanations, beautiful medical images, and more.

By Mike Ren, MD


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