No one is meant to truly enjoy intern year. It is meant to transition you from the honestly "cush" life of a 4th year medical student and teach you how to work up, evaluate, and treat a patient. More than that, you should be able to learn how to manage significant cardiovascular and pulmonary disease so that when faced with cases filled with bad medical disease, you don't balk and beg for consultants.
Learn to manage heart failure and recognize when a patient is and isn't optimized. A patient like I had today with Grade 3 diastolic failure with recent admission after GI bleed causing ADHF, 100 pack year smoking history, SSS, poor functional status, AFib who presented for her sternal wound debridement and flap after nonunion from CABG 2 years prior. There's lots in that case to look for. To make sure the patient can undergo surgery. Was she optimized? Yes. Baseline home oxygen, on lasix, no signs of volume overload, hemodynamics stable etc, pulm at baseline. I took her and she did well.
Understand medical disease and how to manage it. That is the BEST thing you can obtain from intern year.
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