I'm starting my medicine intern year in a couple of weeks, and I was wondering if anyone had tips on how to prepare. I did my sub-I last July and feel like I don't remember anything (i'm a prelim, just want to survive this next year).

I'm starting my medicine intern year in a couple of weeks, and I was wondering if anyone had tips on how to prepare. I did my sub-I last July and feel like I don't remember anything (i'm a prelim, just want to survive this next year).

Just a fellow incoming intern, categorical, but same boat. I'm looking forward to it (similar concerns as you expressed though) and will check here to see what others suggest.

I do think we should never forget that there are tons of us interns starting in programs all over the country (not sure when training starts in other countries) and that our programs are expecting us as we are. We're expected to know what we know, to likely be fuzzy on some stuff, and frighteningly, to make mistakes. The system we're entering is there to keep those we treat safe while we learn. We're in this together and with others there to help us.

Just couldn't help saying this, I leave it to others for real advice.

I don't think there is an upcoming intern arround who will honestly say they are somewhat scared of the year that lies before us. I absoluetly feel underprepared...nothing to do but wait at this point.

Here are a few suggestions:

1. Go through some clinical case scenarios. You can find some excellent CME activities online and you can practice treating patients in various settings (hospital to outpatient).

2. Review how you plan to keep track of all your patients in the hospital. What makes/breaks an intern is the way he/she stays organized throughout the day. You'll be expected to carry out a ton of tasks and you need to have a system that works for you.

3. Finally, get as much rest as you can now!

If you have an iphone, my husband and brother are making a really good application to track patients. It will be out by July. (first versions). If you are interested, PM me.

Get Pocket Medicine (small book/notebook with essential info).
Get Epocrates or another drug reference (I use Epocrates on my smartphone).
Start thinking about a system to organize your data/patient information.
Get plenty of sleep and relax.
Get a good IM textbook for reading at home (? Harrison's) but realize you can't read it all and it's more of a reference.
Get ready to kiss up/pucker up.

A system to organize patient information and data is something that's been an issue for me, as I'm sure it is for many.

I have had passing thoughts of an electronic method, but for day-to-day I'm gonna stick with paper. I've got decent-to-nice writing (which hopefully won't get worse:D), so that isn't the issue.

As a med student for in-patient months I would use the medfools printouts, which I like and will likely continue to use. But my concern is in terms of archives. Should I keep patient data? Should I have it to go back to? If so, then for how long? I'm thinking just their hospital stay, nothing beyond that, but I don't want to miss anything, especially when I'm starting as an intern.

Additionally, I know that I'll be using some sort of software or the like to track things like procedures and tabulate data on that type of stuff. What is a good way to approach that?
Is it markedly institution specific? I know some people on SDN mention spreadsheets, which I love, but how would I set it up?
Maybe this is one thing I should wait until I get going. I start in the ED (IM program), and then have two electives (my only two of the year), before any core IM months. I'd imagine I'll have time with the gradual introduction I got.

Any advice or thoughts are always welcome! Thanks, as always!

Get Pocket Medicine (small book/notebook with essential info).
Get Epocrates or another drug reference (I use Epocrates on my smartphone).
Start thinking about a system to organize your data/patient information.
Get plenty of sleep and relax.
Get a good IM textbook for reading at home (? Harrison's) but realize you can't read it all and it's more of a reference.
Get ready to kiss up/pucker up.

My first rotation as an inter will be at MICU...
any book recommendation?:confused:

My first rotation as an inter will be at MICU...
any book recommendation?:confused:

Everyone will say "The ICU Book" by Marino. That's all well and good but it's a lot to read in the next week or two. I started in the MICU as well. Didn't do an ICU rotation as a med student (other than half of my surgery rotation being based in the SICU), didn't read anything to prepare, showed up day 1 barely able to even find the ICU (to be fair...it moved to a new building that day) and did just fine.

Listen to your seniors, listen to your fellows, listen to your nurses, consider listening to your attendings. Be at the bedside as much as possible, you'll learn a lot from really sick people. Get your hands dirty...volunteer to do procedures. When consultants are at the bedside discussing your patients, you should be too. Learn to manage vents by talking to the fellows AND the RTs. The ICU puts Dog Lab to shame. You'll get to see the most basic tenets of human physiology in real time...pay attention.

After a month (5 weeks actually) in the MICU, I was beat and ready for just about anything.

As well as the pocket medicine, and drug reference, I personally found the Sandford guide very helpful. FYI.

Another piece of advice:
Think about 1 or 2 things that kinda stress you out, eg: codes/ACLS or "chest pain" or lumbar punctures...

Then, take a little bit of time to review those couple of areas to boost your confidence going in. Obviously, without the real-life experience, you can only do so much, but it may "take the edge off."

There is no way you can be completely prepared and you'll get overwhelmed if you try too much. But, reassuringly, it's amazing how fast you acquire knowledge/skills with on-the-job-training :-)

Also - for the ICU:

take a couple evenings and review just a few of the landmark journal articles/protocols/consensus statements for critical care: surviving sepsis, low tidal volume/ARDS, ventilator/hospital acquired pneumonia, noninvasive ventilation, intensive insulin in SICU pts/NICE-sugar, etc etc.

Or at least print them out and then read them when you get a pertinent patient...

Read while you work. Easiest way to learn, absorb, and retain.

Realize that you know more than you think you know.

Realize that you know more than you think you know.

I sure hope so!! :scared:

Intern year is actually pretty easy if you remember these things:

1. Your number one priority is data collection and knowing your patients and helping your resident with the plan. Yes, you should come up with a tentative plan but ultimately that's the resident's job and your second priority. Remember: data collection and knowing the patient.

2. Learn through osmosis via your patients - every chief complaint look up, even if it's UTI or community acquired pneumonia. Read it so you don't miss anything and learn some new things. Quick things require Uptodate...detailed things require an NEJM review article.

3. Know where to get food. Know where to sleep. Know where to buy groceries, do your laundry, etc BEFORE intern year starts.

4. Don't do laundry on your day off. Do it your postcall day while you're sleeping.

5. Post call days take naps on the beach or somewhere nice...staying at home makes it depressing.

6. Bond with your interns. If there's anything...ANYTHING that you could have learned from House of God, it was to bond with your interns. My intern class went out 3-4 times a week and even post-call with each other. It kept my intern year manageable and happy. I had less than 5 bad days as an intern and I go to what is considered a "malignant" program, but isn't really. Even getting together for a 30 minute dinner makes a world of difference.

7. If you HAVE to read a book, go over pocket medicine and your housestaff manual. If you HAVE to read a real textbook - read the ICU Book. It's not ONLY ICU topics, it applies to everything in fundamentals of medicine - blood transfusions, basic science, nutrition, oxygenation, cardiac issues, code situations and management.

8. Realize that the most important medical knowledge you should have down cold by your 3rd/4th month is your code cards. Everything else you can look up (workup for rheum stuff, how to interpret tests, new and improved studies) but in a code situation it's not very practical to have to look doses and acute information up.