Podcast Summary: The OB/GYN Resident Survival Guide

Episode #15: Lessons From My First Year as an OB/GYN Attending (and passing oral boards)
Host: Dr. KC Miller
Date: January 12, 2026

Episode Overview

In this reflective solo episode, Dr. KC Miller shares candid insights from her first year as an attending OB/GYN, fresh off passing the challenging ABOG Oral Boards. Her mission: to demystify the transition from residency to attending life, normalize common struggles, and encourage OB/GYN residents and new attendings during this phase of their journey. She covers the unexpected learning curve of new independence, finding one’s personal identity after residency, the exhaustive process of board certification, and the highly relatable new realities around physician income.

Key Discussion Points & Insights

1. The Challenge of Clinic as a New Attending

• Realizations about Training & Competency

  • Dr. Miller admits the transition is “a total whirlwind, mostly in a good way,” but the learning curve remains steep.
  • Despite extensive residency exposure (“200 vaginal deliveries and 145 C-sections”), new attendings won’t have encountered the full spectrum of gynecologic issues ([02:00]).

• Getting Comfortable With “I Don’t Know”

  • Residency is insufficient to prepare for every problem.
  • She describes regularly needing to say to patients, “I don’t know, but I’m going to work with you to figure out what’s going on.” ([02:53])
  • Dr. Miller underscores the importance of collaborating with colleagues and ongoing research:

    “The learning never stops in this field and the more you do it, the easier it gets…” ([05:30])

2. Rediscovering Identity After Residency

• Residency’s Toll on Personal Identity

  • Dr. Miller shares her vulnerability:

    “Halfway through residency I had a bit of a quarter life crisis ... I didn’t know who I was anymore outside of work.” ([06:12])

  • She describes emotional exhaustion and the surprising “anticlimax” after graduation.

• Time and Patience Are Key

  • “About three months after graduating, that mostly changed.”
  • Emphasizes recovery from “sleep debt” and reconnecting with family and friends.
  • Urges residents:

    “If you feel the way I did the summer after graduation, that’s OK. It’s not going to last forever. You can find yourself again. You just have to be patient with yourself.” ([10:18])

3. Preparing for Oral Boards: “Worse than the Exam Itself”

• Procrastination and Unexpected Time Commitment

  • The oral exam (Part 2 of ABOG) requires case lists for Obstetrics, Gynecology, and Office patients—an intensive process she underestimated.
  • “I thought this would be plenty of time. But when I say I was cramming … I am not lying, this took me a couple of weeks spending hours a day…” ([13:02])

• Advice for Residents

  • Strongly recommends taking boards early:

    “This might be the smartest you’ll ever be.” ([15:48])

  • Her regret: leaving the case list until the last minute—“Don’t make the same mistake I did.”
  • Notes the case list prep was “way worse than the exam itself.”

4. The Financial Reality of Being an Attending

• Positive Change: Financial Freedom
  • Dr. Miller concedes,

    “Having money makes a big difference ... It is very motivating and exciting to look forward to when you’re stuck in the dredges of residency.” ([17:32])

  • Enjoys being able to choose how and where to spend, though still mindful about financial decisions.
• Surprise at Physician Taxation
  • Unexpected downside:

    “Nothing can prepare you for the shock that comes when you jump tax brackets ... you still end up owing the government money.” ([18:26])

  • Jokes about the misconception of always receiving a tax refund as a doctor.

5. Final Reflections and Encouragement

• Reaffirmation of Career Choice

  • “I love what I do and who I get to work with every day … I am able to have an amazing lifestyle ... I can choose how I practice.”
  • Credits the flexibility and reward of OB/GYN practice.

• Words of Hope for Residents and New Attendings

  • Emphasizes that residency is called “Survival Guide” for a reason.
  • “At least in my experience, I really think it is [worth it]. So keep chugging along, keep hanging in there.” ([21:20])

Notable Quotes & Memorable Moments

• On Uncertainty:

  “Sometimes the answer just has to be, ‘I don’t know, but I’m going to work with you to figure out what’s going on.’” – Dr. KC Miller ([02:53])

• On Post-Residency Blues:

  “All I could feel was tired. I was just so, so tired ... I thought I’d feel vibrant and vivacious and like my old pre-residency self. But all I could think about is how I should have hobbies and interests—but I just don’t.” ([08:24])

• On Clinical Independence:

  “You’re never going to see 100 to 200 of every different gynecologic disorder in residency.” ([03:15])

• On Oral Board Preparation:

  “When I say I was cramming to get all of my patients on the list … it was a huge pain. But the preparation was way worse than the exam itself.” ([13:07])

• On Taxes:

  “You become a doctor, and even though your taxes have been deducted from your paycheck all year, somehow you still end up owing the government money. It is crazy.” ([18:39])

• On Hope for Residents:

  “If you feel the way I did the summer after graduation, that’s okay ... You will heal.” ([10:19])

Timestamps for Key Segments

• 00:00 – Welcome, board certification update, and setting up the episode
• 02:00 – The learning curve in clinic as a new attending
• 06:12 – The loss of personal identity and adjusting to life post-residency
• 10:18 – Reassurance for those feeling burned out after graduation
• 13:02 – Oral Board exam logistics, case list crunch, and lessons learned
• 17:32 – Financial realities and unexpected tax challenges
• 21:20 – Final reflections, encouragement, and closing remarks

Episode Tone and Style

Throughout, Dr. Miller’s delivery is honest, reassuring, empathetic, and laced with relatable humor—a balance of vulnerability and practical advice. She validates listener anxieties, offers permission to be imperfect, and closes with an uplifting affirmation that the journey, though demanding, is ultimately rewarding.

For future episode suggestions, Dr. Miller invites emails at info@drkcmiller.com.