Student Experiences Learning in Specialty Cohorts During a Transition to Residency Course: Context, Safety and...

Transition to residency (TTR) courses, aimed at preparing graduating medical students for residency, are increasing in prevalence. Although specialty-specific just-in-time training is nationally recommended, many courses still deliver generalised, non-specialty-specific content. The learning benefits of a specialty-specific teaching approach remain unclear.

Guided by the communities of practice framework, we developed a 4-week TTR course with specialty-specific context for seven medical specialties: anaesthesiology, emergency medicine, family medicine, internal medicine, obstetrics and gynaecology, paediatrics and surgery. The course used identical topics contextualised to each specialty. Students self-selected cohorts aligned with their planned residency and learned from specialty-specific instructors. To explore students' educational experiences, we conducted five semi-structured focus groups with 33 of 183 graduating students selected via block randomisation. Interviews explored two domains: (1) overall learning experience and (2) influences of specialty-specific instruction, context and cohort structure. Transcripts were analysed using an inductive, thematic approach.

Three themes were identified: Learning experience: enriched by specialty-specific content, contextual relevance and faculty expertise. Learning environment: shaped by psychological safety fostered through stable cohorts and a non-competitive post-match setting Connection: promoted by specialty alignment, shared experiences and relational learning within cohorts.

Specialty-specific content, context and instructors enhanced learner engagement through authentic, meaningful experiences. The post-match timing and cohort structure fostered psychological safety. Specialty-aligned social environments supported interpersonal connection and emerging professional identity. Our findings suggest that increasing specialty-specific content and structuring learning in specialty-specific cohorts may enhance engagement, emotional safety and professional identity development.