Probably depends on the program; also what you mean by new program. Do you mean a new program like integrated IR or integrated CT surgery, or a newly established program in a field that already has programs (e.g., a program at New Hope in general surgery). My experience is with the former. I'm one month into a new program as "first and only intern", and it's definately a great experience, but one that probably isn't for everyone.
First, you have to have a high tolerance for being the guiney pig. Someone sat down and made up a program, but no one has really been through it before. So, while it might seem like a great idea that the IR integrated resident do two months of vascular surgery as an intern, in practice being the vascular intern probably just means holding pressure on arteries and being a good scut monkey. My program is so far so good in this department, but the IR integrated resident who started in another program had this sort of thing happen a lot.
On the other hand, your program has the advantage of being something someone sat down at thought about. Someone figured that a future cardiac surgeon should have time with the cardiologists, and built that in, rather than thinking "hey, bariatric surgery is getting busy, I need another resident on the service, so tag you're it."
The there's the inevitable "no one thought of that". For instance, who buys your white coat? The department or the division? The department that gets your labor for a year as an intern, or your home department? What inservice exam do you take? [e.g. for CT integrated programs, do you take the ABSITE or the thoracic surgery inservice?] You're going to feel silly if you have to bring up every single thing like this to your program director.
As far as expectations, I've found the expectations of me to be much higher than for the residents most closely related to me (different program, but same department). Maybe other programs are different. I've found this to be motivating rather than problematic. I'm expected to know a lot about the specific subject matter of my integrated track (even though I'm 'just' the intern). As a result, if I don't know, I'm careful to look it up.
Finally, you're going to have to spend a lot of time explaining what your program is, exactly. I have my schedule for the next several years memorized because I get asked about it so often.
The most important thing about being the first intern is that the program director is committed to the program (and to you personally). You need to be able to approach him or her about problems you are having, because there will be a lot of them. Also, you have to believe in the program. You're taking a big risk by signing up; you have to believe that you will get a better training by taking the risk; an equivalent training really isn't good enough.
Hope that helps!
AJ
