You’ve made it. After years of grinding through residency and fellowship, you finally have the title you’ve been working toward: attending physician! But let’s be honest: attaining this title isn’t the end of the marathon—it’s the beginning of a whole new leg. In this column, we offer 5 real-world tips to help you navigate those first weeks with confidence and build a reputation you’ll be proud of.
1. The First Week
Think of week 1 as a chance to learn the system and set yourself up for success with a few simple, intentional actions. First, learn every team member’s name and preferred communication style. Spend some time observing a seasoned tech or scheduler to better understand the clinic and OR flow. Similarly, familiarize yourself with how referrals, surgical scheduling, and electronic medical record messaging work. Prepare simple scripts for introducing yourself to patients. Finally, ask your administrators: “What’s one thing you wish every new attending here knew?”
2. Time Management Tips
Learning to manage and protect your time is key. Dr. Jesse Berry, chief of ophthalmology and director of the ocular oncology and retinoblastoma programs at Children’s Hospital in Los Angeles, encourages new attendings to take more time in the beginning. “The push is always to see more patients,” she says, “but make sure you have time for administrative tasks, and make sure you’re realistic about your limitations.”
Choose a designated day per week to review labs and messages, follow up with patients, and prep surgical charts. Use scheduling templates or blocks for common appointment types (such as new patients or post-ops) to avoid overbooking. You might notice inefficiencies, but don’t try to make changes right away—observe the workflow first so you understand the reasoning behind the current system.
3. Setting Boundaries Without Seeming Difficult
You may be asked to do more, so setting boundaries without alienating your team is important. Using a script can be helpful. For example: “I’d love to help, but I want to make sure I’m giving my patients the care they deserve.”
When it comes to negotiating your contract, Dr. Alanna James, glaucoma specialist at The Glaucoma Center, PC, in Maryland, recommends that you do this in advance. “Everything should be outlined in your contract, including how many days you agree to work and what locations you will be at,” she says. “If they are asking you to work outside that and you are willing to take on the extra work, discuss extra compensation.
4. Building Trust with your team
Your team makes your clinic run. Be prepared and respectful—review charts beforehand; know your patients; and be considerate of everyone’s time. Ask your team for feedback: “Is there anything I do that makes your job easier or harder?” Also, get to know each member of your team. “The biggest currency you have is time,” says Dr. Berry. “Investing your time makes people feel valued.”
5. Finding Mentors and Allies Early
You don’t need to navigate your new role alone, and you shouldn’t. Find your mentors—a clinical mentor, a career mentor, and a peer confidante.
“Many of your mentors may come from your training,” says Dr. Berry. “Beyond that, you can ask about mentorship in your job interview process.”
Formal programs are helpful, but mentorship often starts informally, sometimes with one quick conversation. Lean on your community. Resources like the RWO podcast can fill in gaps and offer honest perspectives on early-career challenges.
Conclusion
Your first 90 days as an attending aren’t about proving you’re flawless; they’re about laying a foundation. No one expects you to know everything, but they do expect you to show up, listen, and lead with integrity. Give yourself grace and remember that you’re not alone. OM
Looking for more advice from physicians who have been in your shoes? Join us at the RWO Signature Virtual Meeting Sept. 27. Details at RealWorldOphthalmology.com.
