I can still remember making the decision to attend the interview at a newly established residency program. Being born and raised in the Chicago suburbs, and having completed both my undergraduate and medical school education in the Midwest, no Midwesterner would turn down an opportunity to escape the freezing winter for a weekend trip down to sunny Miami Beach. I framed it as an excuse to get some warmth and sun and, at that same time, visit a residency program that would be a backup on my rank list.

When I arrived at the hospital, Dr Rosen, the program director, greeted me at the foyer with a warm smile and a firm handshake. We embarked on a walk-and-talk tour of the hospital that contrasted starkly with the typical 15-minute, speed-dating–esque interview format. Dr Rosen spoke frankly and earnestly about his aspirations for the new residency program, and what he was seeking in his inaugural class of residents: people who were hardworking and willing to go the extra mile for the betterment of the team, able to get along with the surgeons, and likeable, dedicated, all-around energetic go-getters. We then met with Dr Wittels, the department chair, an imposing bearded man with a similar warm smile and an even firmer handshake. The 2 physicians took turns firing off probing, yet friendly, questions, which sent a signal that there was more substance to this new program than simply a good location. After my interview ended, I phoned my parents from Miami International Airport.

“Mom, Dad, I really have this strong feeling in my gut that this is the place for me,” I told them excitedly.

Naturally, my parents raised concerns about a new program. “Very risky,” they said.

I understood that they meant well, as I had already interviewed at several well-established programs where I thought I had a decent chance to “match.” However, none of the other programs evoked the same gut feeling that I got from this new program.

On Match Day, I opened my envelope and felt a mixture of delight and relief as I read the name of the newly established program.

On the first day of residency, Drs Rosen and Wittels wasted no time informing our inaugural class of 3 residents about the importance of our behavior.

“You must set a good tone for the program from today onward,” they said during the first week, “it will be your job to take this program from its infancy and build a brand-new training program.”

Their words were both an inspiration and a burden. I channeled that added pressure into a sense of pride: this new program wanted me to set a standard, and I ranked the program first for a reason. I was not only an anesthesiology resident, but also our new program's flag-bearer in everything I did. During my second year of residency, as I got ready to venture to Miami Children's Hospital as our program's first representative, Dr Wittels pulled me aside and reminded me that I was a reflection of him and our new program, and jokingly told me to not “mess up.” I took my chair's comments in stride and set the tone that residents from our program show up on time, work hard, and make a good impression. This theme recurred on my obstetric anesthesiology rotation, as I was once again selected to be our inaugural class representative.

My residency classmates and I discovered early on an amazing aspect of being at a brand-new program. Because there were no classes above or below us, we had the unique learning opportunity to have substantial 1-on-1 time with attending anesthesiologists. Here I was, in July during my first month of anesthesiology residency, and my department chair spent the entire day in the operating room with me, teaching me the basics. When it came time to ask Dr Wittels to write a letter of recommendation for my fellowship application, I was certain that the letter would be extremely personal and high quality, as he could attest to our close relationship in and out of the operating room. Of note, I have spoken with resident colleagues at other programs who rarely have the opportunity to work with their department chair.

The excitement of a close, collegial working environment is something that I have treasured from the start. My attending physicians have stated on numerous occasions their appreciation for having their own residents to teach and educate, whose successes and failures are felt as if they are their own. Our attendings and residents are encouraged to offer suggestions for how to improve and shape our malleable, fledgling training program. For example, I suggested that the following class have a chronic pain rotation during their intern year to expose them to another facet of how anesthesiologists treat complicated patients; my program director agreed and immediately implemented that change for the following year. Another example of my program being open to change was to have a weekly hour of protected time for the residents to meet and run through practice questions together, with a subsequent discussion. It was something that I felt would be great for the residents to do as a group, with us as the senior residents running the weekly discussion. Our program leadership immediately put this into effect.

An additional suggestion that many of the attendings made focused on our interview days and resident recruitment. They thought it was imperative that there be built-in time during the interview day for the medical students to have the opportunity to speak to the current residents alone, without the presence of the faculty, which would provide them with a less intimidating environment where they could feel free to ask questions they may otherwise be hesitant to ask. This suggestion was accepted for the next interview day and has been in place ever since. The growth and development of our program over the past 3 years are accomplishments that all of us have contributed to and appreciate, from our chair and program director to our interns.

Now, looking back, it is hard to believe how fast these last 2-plus years have gone, and I am well into my final year of residency. We now are at the full complement of 9 residents, and I was fortunate to be given the opportunity to be chief resident. I truly feel a sense of pride in having a direct hand in the molding of our training program.

I recently completed the process of applying for a fellowship position, and my pride in my program pervaded my interviews. I was fortunate to match at my top choice for interventional pain medicine. I attribute this accomplishment to my residency program and my attendings who have supported me from day 1. I love telling medical students how much this program has given me, and I am excited to see the positive changes that will come to this program in the next few years as it continues to grow and graduate residents every year. I know there are many times when you have a gut feeling but your mind convinces you not to follow that feeling. Following that gut feeling and coming to this new residency program was one of the best decisions of my life, and I could not be happier and more proud to represent my residency program.