Preparing Medical Students for the Transition to Residency: A Qualitative Study of New Pediatric Interns.

Background: The medical school to residency transition remains challenging for learners and educators. Within pediatrics, the effectiveness of medical school activities intended to ease this transition remains unclear, and little is known about the intern perspective. We sought to (1) describe new pediatric interns' perspectives on areas they felt least and most prepared for and (2) elucidate the educational interventions interns found valuable during the transition. Methods: From 2/2024 to 4/2025, we conducted a qualitative study consisting of 1:1 semi-structured interviews with pediatric interns from an academic, tertiary-care medical center guided by a phenomenological approach. We utilized self-determination theory to develop our interview guide and reflexive thematic analysis to analyze transcripts. Results: Sixteen interviews were conducted with interns from 14 unique medical schools. Four themes were identified: (1) Interns felt most comfortable with medical knowledge and patient presentations, yet struggled with autonomy and counseling families in the outpatient setting; (2) Undergraduate Medical Education (UME) experiences e.g., sub-internships and Transition To Residency (TTR) courses that were pediatric specific were most valuable; (3) Early Graduate Medical Education (GME) programming should prioritize teaching institution-specific skills e.g., Electronic Medical Record (EMR) best practices; (4) A supportive environment with close peer mentoring best fosters intern growth through clinical learning. Themes informed a novel conceptual model with actionable recommendations for medical school and residency educators. Conclusions: By interviewing interns who graduated from multiple medical schools, we benefited from learners with diverse experiences. Our model should guide educators in facilitating a smoother transition to pediatric residency through programming aligned with intern needs.