Confidence level and what is expected of new interns

[jf]

Hi,

I will be graduating med school in may and will be starting an EM 1-3 program at the end of June. I am just curious what the EM residents and EM grads on the forum felt before starting their residencies. How were your confidence levels at the start of residency and at what point in your training did you start feeling comfortable with your abilities? In addition, what was expected of you as far as knowledge and ability when you started your first year?

Any insight would be appreciated!

Thanks

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[Seaglass]

Well, being terribly overconfident I wasn't too worried about starting my residency. I think that what is expected is to be a) teachable, and b) meticulous. They can teach you the rest. Also, they know that they are going to get a bunch of people who have had different levels of training so they know some will have more to learn in some areas than others.

 

[roja]

I think you will find that this will be very program dependent. people going into EM come from all different kinds of experiences. At our program, we have a month of 'orientation' where there are lectures, procedure labs, badge getting and generalized fun as well as attending regular confrerence and doing 4 shifts or so to orient to the ER.

This works to get everyone in the EM thinking mode as its very different from everything you are taught in med school.

Expectations and comfort level depend on your program. It depends on how much ED time you have in your first year and what off services you do.

I was a little nervous starting as my first rotation was in the MICU. Comfort in the ED here is pretty normal in our interns in the first couple of months, but our residency is VERY heavy in EM months. (we do more ED time than many 4 year programs.)

As I am about to take on new interns as a third year, I expect my interns to be eager to learn, polite to consults and have a general desire to learn.

 

[beyond all hope]

You know almost as much information as you will at the end of your intern year. Intern year (and pretty much all of residency) is putting that information into use and getting confidence with your skills by repitition and experience.

I didn't feel like a doctor coming right out of medical school. It took me about halfway through my intern year to really FEEL like a doctor. You'll notice that instead of having to think through every DDx and treatment you'll just bark out orders. You'll become familiar with dosages of common meds and you won't have to look them up every time. You'll develop tricks in order to finish procedures.

Keep an open mind, be polite to everyone (especially nurses and patients) and use what you already know and you'll do fine.

 

[Sessamoid]

Most everybody starts residency feeling like something of a fraud, that somehow somebody must have screwed up and put a long coat on you by accident. That usually passes in the first month or two when you realize you're not the most clueless intern around. Nobody expects you to be a diagnositic god when you graduate from medical school. They do expect that you'll be eager to learn, work hard, show up on time, pay attention, and generally be nice to folks.

At what point did I start to feel comfortable in the ED? For myself and most of my class, probably near the end of the first year. Mind you, that's just starting to feel comfortable in the academic setting. It generally takes a quite while longer to feel comfortable as a solo practictioner.

 

[Aloha Kid]

I'm glad this post is here. The responses have been quite encouraging. I will be starting EM internship soon and really feel like a "Faker, Pretender, 6 cookies short of a dozen." Glad to know it gets better.

 

[jf]

Thank you all for the encouraging input. I totally agree with aloha kid!!

Best of luck to all!

 

[NinerNiner999]

Speaking from experience if you don't know how to slam in a central line, insert a chest tube, or perform a thoracotomy - the basics - you will be far behind the eight ball. That being said, medicine doses, IV to PO conversions, and floor orders should be old hat to you. Come on - you are going into ER right? You should know how to sedate and intubate like the pros.

Then again, if you really knew all of that stuff before residency you wouldn't need to train now would you? Honestly - the most important thing you should know going into residency is how to have FUN! It's easy to get caught up in the serious side of learning and academics but if you can't have fun doing it your training will fly by and you will feel like you have missed out. Everything you have to learn will be taught repeatedly and you will know it whether you force yourself to or not. Congrats on the match and start your career the fun way - stress free!!!

 

[anonymousEM]

i expect my interns to enjoy every minute of free time they have from now until july...the learning curve is straight up and there will be plenty of time for working hard and reading a lot when residency starts. Just like med school, know wehn to say I don't know but i'll find out, speak up when you do know and know when to ask for help....Best of luck!