Advice for Surgical Intern Year?

[NecrotizingFasciitis]

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I matched into an integrated interventional radiology program with an attached surgical intern year, and I have no idea what to expect.

Just looking for tips, how to prepare, what to expect, etc. Kinda nervous to start.

Any insights welcome.

-NF

 

[longhaul3]

There's not much you can do to prepare for a surgical intern year. You should expect to feel incompetent, overwhelmed, tired, and useless. You can't really do anything about it. The important thing to know is that this is normal for intern year, so try to keep reminding yourself that throughout the year.

As a prelim you have the benefit of not having to care too much what they think of you because it's not your residency program and you already have an advanced position. But on the flip side you are expendable and the program won't be interested in investing much in your education or well being.

 

[LucidSplash]

There's not much you can do to prepare for a surgical intern year. You should expect to feel incompetent, overwhelmed, tired, and useless. You can't really do anything about it. The important thing to know is that this is normal for intern year, so try to keep reminding yourself that throughout the year.

As a prelim you have the benefit of not having to care too much what they think of you because it's not your residency program and you already have an advanced position. But on the flip side you are expendable and the program won't be interested in investing much in your education or well being.

While I won’t deny that some programs out there are like this, this is certainly not the norm anymore. I’m sorry you had such a poor experience, as I will assume this post comes from a place of personal experience and not just what you think it might be like. But that is no reason to give such an unhelpful response to an earnest question.

OP, in terms of texts, for a prelim going into another specialty, the best/easiest to get is probably the Fiser ABSITE review. It will have useful chunks of info in a readable format you can carry in your pocket and will have something to say on most basic Gen surg scenarios.

If your program offers the ACS Fundamentals of Surgery course beforehand (not all do) then definitely go through those scenarios. I found that helpful as a pre-intern.

General precepts: Show up on time, if you finish rounding early offer to help other teams, if you are concerned that a patient is “sick or dying” then load the boat early by calling your senior.

You can’t do much right now to prepare except order Fiser. But you can do things like get your dental checkup, have a physical if you need one, figure out how to make some healthy meals that you can meal prep ahead of time for when you are actually an intern.

Good luck!

 

[NecrotizingFasciitis]

While I won’t deny that some programs out there are like this, this is certainly not the norm anymore. I’m sorry you had such a poor experience, as I will assume this post comes from a place of personal experience and not just what you think it might be like. But that is no reason to give such an unhelpful response to an earnest question.

OP, in terms of texts, for a prelim going into another specialty, the best/easiest to get is probably the Fiser ABSITE review. It will have useful chunks of info in a readable format you can carry in your pocket and will have something to say on most basic Gen surg scenarios.

If your program offers the ACS Fundamentals of Surgery course beforehand (not all do) then definitely go through those scenarios. I found that helpful as a pre-intern.

General precepts: Show up on time, if you finish rounding early offer to help other teams, if you are concerned that a patient is “sick or dying” then load the boat early by calling your senior.

You can’t do much right now to prepare except order Fiser. But you can do things like get your dental checkup, have a physical if you need one, figure out how to make some healthy meals that you can meal prep ahead of time for when you are actually an intern.

Good luck!

Thank you!

Is this the correct Fiser book here?

The ABSITE Review Amazon product ASIN 1975121155

 

[LucidSplash]

Thank you!

Is this the correct Fiser book here?

The ABSITE Review Amazon product ASIN 1975121155

Looks like it! Mine was blue but I bought it in... 2010 😵

 

[longhaul3]

While I won’t deny that some programs out there are like this, this is certainly not the norm anymore. I’m sorry you had such a poor experience, as I will assume this post comes from a place of personal experience and not just what you think it might be like. But that is no reason to give such an unhelpful response to an earnest question.

I really didn't mean this in a negative way. I enjoyed my intern year and had a great experience. Nevertheless, I felt incompetent, overwhelmed, tired and useless at times.

I don't even think it was an unhelpful response. I think it's important to have the perspective that intern year is difficult, it's normal to feel that way, and there's really nothing we can do except embrace and acknowledge it. For me that advice would have been more useful than buying a specific book or watching YouTube videos about knot tying.

 

[ACSurgeon]

Looks like it! Mine was blue but I bought it in... 2010 😵

You’re sooo old. I bought my blue fiser in 2011 😎

 

[ACSurgeon]

I really didn't mean this in a negative way. I enjoyed my intern year and had a great experience. Nevertheless, I felt incompetent, overwhelmed, tired and useless at times.

I don't even think it was an unhelpful response. I think it's important to have the perspective that intern year is difficult, it's normal to feel that way, and there's really nothing we can do except embrace and acknowledge it. For me that advice would have been more useful than buying a specific book or watching YouTube videos about knot tying.

My experience with prelims destined to advanced positions was they had it better than the categoricals. If they did a good job, people were impressed that the radiology/anesthesia/ophthalmology bound kid was so sharp and on top of things. If they did a bad job, people didn’t care so much because they’ll leave the program in a few months...

The goal of intern year is to learn basics of how to be a doctor. Operative time is a huge bonus so if you don’t get much as a prelim don’t be heartbroken, that’s not why you’re there.

 

[LucidSplash]

You’re sooo old. I bought my blue fiser in 2011 😎

Young-in 😉

 

[TypeADissection]

I'm clearly less old because the Fiser book when I bought it in 2013 was black. I think.

Back to OPs post. You are going to feel overwhelmed and that's okay. Don't be afraid to bump things up the chain. What you lack in knowledge and overall hospital savvy can be overcome with a couple of things that are completely independent of that:

- Punctuality: This may sound weird, but it isn't. If you can show up on time for sign out if you're the incoming night person or show up early for pre-rounds in the AM; this goes a long way in just being a good intern. You will be surprised how many people show up chronically late.
- Attitude: Just be affable and eager to learn. People will go to bat for you and want to help and teach if you're an easy person to work with. You'd be surprised at how many people show up with a bad attitude and that just sucks for everyone.
- Details: This is where the devil is. Efficiency is learned and planned. Nobody stumbles into efficiency. So over the course of your first three months you're going to have to find a system that works for you to keep a lot of information organized. For example: Are they on antibiotics? If so, how many days? Are they on anticoagulation? If so, which one? Pertinent past surgical and medical history.

I've worked with a lot of interns who were on their way to Uro, ENT, Ortho, and IR; and a lot of them were just awesome to work with because even though they knew they weren't going to be general surgeons, they were still professional enough to show up and kick ass everyday at work. Don't let clothes or dressings come between you and a diagnosis. I've had people tell me so-and-so had an AAA repair and I'll ask if it was done open or endo and they just stare at me. Uh...is there a big ass incision on his belly? And no one looked. It's little things like that. It doesn't require you to have a massive fund of knowledge, just a desire to be thorough. In the end, you'll get out of it what you put into it and hopefully be better for it. Cheers.

 

[LucidSplash]

I'm clearly less old because the Fiser book when I bought it in 2013 was black. I think.

I have that one too. It is the “Advanced” Fiser.