Now in my final year of residency in pediatrics, there will be a lot of “lasts.” Since the time we are kids, we often remember our different “lasts,” especially when it comes to school.

During the back-to-school rush at our primary care clinic, I had the opportunity to talk with several rising senior high school students who will be starting their “last first-day of high school” this week. I vividly remember my last first day of a new year of medical school and my last first day of residency. As I have matriculated through college, medical school, and now residency, the excitement of a last first-day or last call is still present, but I now reminisce more on how I arrived there and what I have learned.

As a senior pediatric resident, I just had the elation of completing my last PICU (pediatric intensive care unit) call just recently. From this point forward, there will be no more 24+ hour calls in the PICU for me. While I look forward towards the upcoming and final rotations of my last year of residency and the excitement and uncertainty of opening a solo practice after graduating, I take solace in knowing that my training in the Miami Children’s Hospital PICU has prepared me as a soon-to-be general pediatrician to identify children who are in need of or at risk for requiring critical care.

While my practice will undoubtedly have more horses (commonly seen medical conditions) than zebras (uncommon, rare conditions), having the opportunity to diagnose and manage both “animals” and their many variations during my residency is reassuring as I move closer towards completing my residency and moving into practice. Realizing that I have not and will never see it all, the trepidation that the current patient may be harboring a zebra drives me to read more, looking to expand my knowledge of pediatric care each day.

I am certainly in the minority of pediatric residents (and all medical residents) who will choose to open a practice following residency. There have been many colleagues, old and young alike, who shudder at the idea of opening a practice in the current state of our healthcare system. I see this not as a hindrance, but rather an opportunity to get in on the ground floor and have the flexibility to change with the times, always putting the health of my patients and their families first and foremost.

I look forward to the summer of 2014 when I will begin to care for my patients as their primary pediatrician, using the skills that I have been taught in medical school and residency along with new technologies to best serve and advocate for my patients.

Chad Rudnick is a pediatric resident and the author of The Ultimate Guidebook For Getting Into Medical School. He blogs at All things pediatric.