Bridging the gap: UK’s Transition to Residency prepares medical students for intern year

LEXINGTON, Ky. (April 24, 2025) — Springtime in higher education is a season of excitement and celebration, especially for fourth-year medical students — from Match Day, when they learn where they will complete their residencies, to graduation day, where friends and family join in the celebrations as they officially become new physicians. 

What many don’t see is the intense period in between Match Day and their residencies. During these weeks, students are not only celebrating, but also preparing for the reality of becoming doctors. Soon, they will be responsible for patients’ lives, facing both the excitement and pressure of this transition. 

The University of Kentucky’s Transition to Residency course serves as a crucial bridge between medical school and residency.  

Designed as a four-week capstone, it begins after Match Day and concludes before graduation. It offers students hands-on training in patient communication, emergency scenarios and simulations tailored to their future specialties. 

Kristen Fletcher, M.D., co-course director and an associate professor in the UK College of Medicine’s Department of Internal Medicine, described the course as the beginning of intern-year orientation. Over the years, the program has evolved from lecture-heavy instruction to an interactive format with workshops and case-based learning, with the goal of ensuring that students feel like they are stepping into the role of an intern. 

Students participate in simulation exercises that expose them to high-stakes situations. Fletcher said she sees students transform through the program, from their first hour in the simulation lab to their 10th.  Many experience mild panic initially, but by the end, they develop the confidence and presence needed to take charge. 

“Hour 10 is entering that room with their ‘doctor voice,’ and you can just see the confidence change,” Fletcher said. 

For Ethan Glaser, a fourth-year medical student in the M.D./Ph.D. program, the course has been an essential step before starting his neurology residency.  

He recently participated in airway management workshops and operating room simulations, where he learned to recognize when to call for help in critical situations. 

The simulations provided insight into gaps in his knowledge, particularly in managing acute respiratory issues.  

“I consistently struggled to address patients’ respiratory needs quickly enough. This was a recurring self-critique as well as feedback from my preceptor and attending,” Glaser said. “I learned that was a specific skill I needed to sharpen.” 

Jonathan Bronner, M.D., UK HealthCare medical director for simulation-based education and an associate professor of Emergency Medicine, said simulation education provides an avenue to practice clinical skills in a psychologically safe environment. 

Fletcher said one of the goals of the program is to create a “brave space” for students where they feel confident in their decisions while recognizing when to seek guidance.  

“Each case begins with reminding learners of our basic assumption that they are all intelligent, want to be excellent resident physicians and do the right thing for their patients, which allows them as well as the facilitators to be comfortable making mistakes and understanding where we can all consistently improve,” Bronner said. 

Tom McLarney, M.D., co-course director and professor in the Department of Anesthesiology Perioperative, Critical Care and Pain Medicine, emphasized the importance of self-assessment in the training process. The course encourages students to reflect on their decisions and improve in real time. 

“They need to self-assess, continue what they’re doing well and change what needs improvement,” McLarney said. “I want both students and facilitators to embrace this process, as our goal is self-reflection, self-assessment and self-improvement,”  

The program has also expanded to include UK College of Medicine regional campuses in Bowling Green, Northern Kentucky and Morehead, each with its own simulation center.