Expectation level?

[thecalccobra]

As a new intern, what exactly is expected of you? Are you given a few weeks to get used to things or are you given 10 patients the 2nd day to work-up?

---

Members don't see this ad.

 

[ShyRem]

Depends on the program. Generally though you are expected to fulfill the rotation requirements. You may have some extra time in the beginning (i.e. rounds may start a little later in the beginning), or you may be expected to just get with the program and jump in. On an ambulatory clinic rotation there may have extra time scheduled for patients with an intern. No one expects an intern to be as efficient as an attending or senior resident. If you have a senior resident with you, one of the senior's jobs is to help you out and teach you how to be more efficient.

It is nerve-wracking in the beginning, but it gets easier.

 

[DOk1ng]

What abt Medical knowledge?

 

[modelslashactor]

at least at my program, new interns eased in as their schedule provided. if you started on a tough rotation, you were thrown to the wolves. if you started on an easy rotation, you got a break and had some breathing room. you'll be surprised how quickly you warm up to it and how little the easier rotations prepare you for the hard ones - my first tough month wasn't until october and it was still horrible and although the prior months helped a bit, it wasn't enough to make it totally smooth. in any case you make it work, there's really not too much you can screw up as a new intern as long as your seniors are competent and help you out.

regarding knowledge, i don't think anyone really expects you to know anything, but if you know nothing they expect you to at least try to make gains and read. at least at transitional programs, as long as you show up and get the work done everyone will be happy and if you actually make some progress so much the better.

 

[ShyRem]

You have been in medical school for four years and passed at least two levels of boards. You are expected to have a minimum of some kind of medical knowledge.

Now, do we expect you to be able to manage an ICU patient by yourself? Heck, no. You are expected to gather data well, put together a good H&P, start formulating a plan that your senior will help you flesh out, and most of all you are expected to realize when you have no idea what to do (or just want to confirm what to do) and call for help. Your seniors will expect a LOT of calls from interns in July, on everything from "how do I dictate" to "where are the bathrooms" and "how do I replace potassium". And for the love of everything, please call your seniors immediately if you notice your patient has a blood pressure of 52 systolic or is tachycardic at 150, or a respiratory rate of 6 not intubated, or for critical labs unless they are expected (expected: a calcium of 6.5 in someone with an albumin of 1.6; NOT expected: potassium of 11).

Relax. You're not expected to be at an attending level. You're expected to be just above an average medical student. But you are expected to read, take control of your education, be a team player, and work hard.

Honestly, I enjoyed my intern year. I laugh when I think of all the stupid things I did, but I am such a better person for it now. You will continue learning every day... you will always run across stuff you have no idea what is going on, new ways to treat problems, etc. Just be willing to work hard and learn. That's all that is expected. Work hard, be willing to learn, be a team player.

 

[adagio]

You have been in medical school for four years and passed at least two levels of boards. You are expected to have a minimum of some kind of medical knowledge.

Now, do we expect you to be able to manage an ICU patient by yourself? Heck, no. You are expected to gather data well, put together a good H&P, start formulating a plan that your senior will help you flesh out, and most of all you are expected to realize when you have no idea what to do (or just want to confirm what to do) and call for help. Your seniors will expect a LOT of calls from interns in July, on everything from "how do I dictate" to "where are the bathrooms" and "how do I replace potassium". And for the love of everything, please call your seniors immediately if you notice your patient has a blood pressure of 52 systolic or is tachycardic at 150, or a respiratory rate of 6 not intubated, or for critical labs unless they are expected (expected: a calcium of 6.5 in someone with an albumin of 1.6; NOT expected: potassium of 11).

Relax. You're not expected to be at an attending level. You're expected to be just above an average medical student. But you are expected to read, take control of your education, be a team player, and work hard.

Honestly, I enjoyed my intern year. I laugh when I think of all the stupid things I did, but I am such a better person for it now. You will continue learning every day... you will always run across stuff you have no idea what is going on, new ways to treat problems, etc. Just be willing to work hard and learn. That's all that is expected. Work hard, be willing to learn, be a team player.

very helpful posts. thank you very much

 

[gutonc]

You have been in medical school for four years and passed at least two levels of boards. You are expected to have a minimum of some kind of medical knowledge.

Now, do we expect you to be able to manage an ICU patient by yourself? Heck, no. You are expected to gather data well, put together a good H&P, start formulating a plan that your senior will help you flesh out, and most of all you are expected to realize when you have no idea what to do (or just want to confirm what to do) and call for help. Your seniors will expect a LOT of calls from interns in July, on everything from "how do I dictate" to "where are the bathrooms" and "how do I replace potassium". And for the love of everything, please call your seniors immediately if you notice your patient has a blood pressure of 52 systolic or is tachycardic at 150, or a respiratory rate of 6 not intubated, or for critical labs unless they are expected (expected: a calcium of 6.5 in someone with an albumin of 1.6; NOT expected: potassium of 11).

Relax. You're not expected to be at an attending level. You're expected to be just above an average medical student. But you are expected to read, take control of your education, be a team player, and work hard.

A million times that bolded stuff. Especially the "start formulating a plan" thing. There is nothing more aggravating than getting a presentation (from anybody frankly, med student, intern, fellow/attending from another service consulting you) that is simply a list of lab/exam/imaging findings without any thought as to what might be going on and how to a) get to the bottom of it diagnostically and b) fix it.

It's OK to be wrong, it's not OK to not even make an effort.

 

[bambi]

And for the love of everything, please call your seniors immediately if you notice your patient has a blood pressure of 52 systolic or is tachycardic at 150, or a respiratory rate of 6 not intubated, or for critical labs unless they are expected (expected: a calcium of 6.5 in someone with an albumin of 1.6; NOT expected: potassium of 11).

You would be expected to call immediately for all that? Or after you had sorted it to let them know? Where I work we would be expected to be able to deal with that and only call if they weren't responding and maybe just to let them know the situation.

 

[Law2Doc]

...if you started on a tough rotation, you were thrown to the wolves. if you started on an easy rotation, you got a break and had some breathing room. ...

This. Someone is going to be on call one of the first couple of nights. Someone else is going to start off the year using up an easy elective (that you'd rather have later on).

 

[Seldon1985]

My first month (FIRST NIGHT) was solo night float. had to even start a code myself during the first week. very scary times...

 

[ShyRem]

There are programs like this. I personally avoided such programs, but I do realize not everyone asks whether they are on call by themselves as an intern, who the code team is, etc.

 

[Top Gun]

You would be expected to call immediately for all that? Or after you had sorted it to let them know? Where I work we would be expected to be able to deal with that and only call if they weren't responding and maybe just to let them know the situation.

You should begin measures to stabilize the patient, but you should also get your senior on board as soon as possible. When a patient begins to go south, you're going to want all the help you can get. As an intern, you'll have a better chance of saving the patient if you collaborate with a more experienced resident rather than if you try to go it alone.

 

[Dral]

I'm at a pretty benign program, but some of us had to start on rough rotations. The rough rotations at the beginning suck, but they give you such a head start into the next few.

I started on floors right off the bat. Not the worst, but not the best. It wasn't bad. You pick it up quick and for the most part at most programs, your upper levels and attendings are there to help you. Remember, if you screw up, it's partly on their butts, so they have a vested interest in helping you out.

Your notes and what not? Pretty much on your own other than feedback.

You'll screw up orders, say the wrong things in notes, suck at presentations (at the beginning at least). If you screw up, you will probably be told about it. Pour your efforts into improving that area while maintaining and improving all the other areas and you'll be fine.

There are so many levels of checks. Maybe because it's that I'm at a large program, but residents, fellows, attendings, nurses, pharmacists, and techs all caught things that I missed or didn't do correctly. Pretty much all of them small, but nonetheless important.

Intern year is bad, but mainly because of the drudgery, not because of a helpless feeling.

 

[Law2Doc]

I'm at a pretty benign program, but some of us had to start on rough rotations. The rough rotations at the beginning suck, but they give you such a head start into the next few...

I look at it not about getting a head start, but getting things out if the way early. Its going to be painful whenever you get there, so might as well get it over with quickly. The outlook for the year is a lot less bleak once your ICU and night float months are behind you. So in my view easing into the year is bad because that's an easy rotation you'd rather have in May.

 

[LouisianaDoctor]

Thank you for this thread. Like everyone, I'm concerned with looking and feeling stupid at first. I'm just reading up on everything I can, and am going to knock Step 3 out of the way so hopefully when I start in 4 months I'll be at the top of my game (well, up until that point..)

 

[gutonc]

I look at it not about getting a head start, but getting things out if the way early. Its going to be painful whenever you get there, so might as well get it over with quickly. The outlook for the year is a lot less bleak once your ICU and night float months are behind you. So in my view easing into the year is bad because that's an easy rotation you'd rather have in May.

And the expectations of a July intern in the ICU are much lower than they will be on the wards or a subspecialty consult rotation.

 

[UTMBMD2012]

Thank you for this thread. Like everyone, I'm concerned with looking and feeling stupid at first. I'm just reading up on everything I can, and am going to knock Step 3 out of the way so hopefully when I start in 4 months I'll be at the top of my game (well, up until that point..)

I asked about Step 3, you have to be graduated before you can apply to take the test.

 

[happygolucky1]

How much "should" a resident help out? There's a fine balance between babying the intern and the not helping out enough. How much are the residents helping out with admissions, writing signout, notes, and talking to families?

 

[TMP-SMX]

Seniors shouldn't be helping with sign out that is between interns. Seniors shouldn't be writing notes unless the intern is capped. (10 patients in my hospital). Usually seniors won't help with admissions but it depends on the senior and if things are getting delayed for whatever reason (seniors don't want to be dictating H&Ps right before it is time to round in the AM on a post-call day. Talking to families, ideally an intern would observe an attending and senior speaking to families at first so one can emulate what is right and not right to see what works well and what doesn't work well. After that point, the intern can take the lead.

 

[Roguelyn]

I don't have any advice that hasn't been said. Make sure you have a plan, any plan. Even a totally incorrect plan is better than nothing.
The new regulations require direct supervision for interns, so you won't be out there completely alone.

 

[Cerberus]

You have been in medical school for four years and passed at least two levels of boards. You are expected to have a minimum of some kind of medical knowledge.

Now, do we expect you to be able to manage an ICU patient by yourself? Heck, no. You are expected to gather data well, put together a good H&P, start formulating a plan that your senior will help you flesh out, and most of all you are expected to realize when you have no idea what to do (or just want to confirm what to do) and call for help. Your seniors will expect a LOT of calls from interns in July, on everything from "how do I dictate" to "where are the bathrooms" and "how do I replace potassium". And for the love of everything, please call your seniors immediately if you notice your patient has a blood pressure of 52 systolic or is tachycardic at 150, or a respiratory rate of 6 not intubated, or for critical labs unless they are expected (expected: a calcium of 6.5 in someone with an albumin of 1.6; NOT expected: potassium of 11).

Relax. You're not expected to be at an attending level. You're expected to be just above an average medical student. But you are expected to read, take control of your education, be a team player, and work hard.

Honestly, I enjoyed my intern year. I laugh when I think of all the stupid things I did, but I am such a better person for it now. You will continue learning every day... you will always run across stuff you have no idea what is going on, new ways to treat problems, etc. Just be willing to work hard and learn. That's all that is expected. Work hard, be willing to learn, be a team player.

All of this! Also, I am much more concerned by the arrogant intern than the "hey can you help me out with ______" intern.