First year resident expectations

[dj_smooth]

I am just curious as to what is expected of first year residents when they show up for the first day on the job?? I am doing my third year in England and see the first year doctors and what's expected of them; it's not too bad. What is expected out of a first year resident in the US?? I just worry that I will be behind the curve. Thoughts?

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[maxheadroom]

General response:

Interns are expected to be able to do a complete, relevant H&P, start an appropriate diagnostic workup, interpret standard lab values and radiology studies, and make basic clinical decisons regarding patient care (fluid management, pain management, electrolyte/blood replacement).

Interns in medicine and surgery should both be able to run a code (most interns do ACLS before starting). Surgery interns are usually ATLS-certified, so they should be able to run a trauma (although they rarely will without a senior).

Surgery interns should quickly learn how to get major vascular access (subclavian, IJ, femoral) and place arterial lines (radial and femoral).

That's a far from complete compilation . . .

 

[fourthyear]

Most days I think it's my organizational skills and attention to detail that are most in demand. You dont' make a whole lot of real decisions as a first year resident b/c if anything big goes on you're expected to report it to someone above you anyway - so your job is to be a good record keeper and reporter and learn what is relevant to report to your supervising residents.

You do have to make some basic decisions on call, but it's more about basic medications and starting basic workups for common complaints, all of which I seem to be picking up pretty quickly in the last few weeks since I started. Don't be afraid to ask questions at first - it's better than doing something wrong. But write things down somewhere you can have it for future reference, b/c people will get annoyed if you keep asking the same thing again and again. Write everything down, in fact, b/c you'll have so much going on you'll forget anything that's not written down.

You're not expected to know all of medicine on day one - you are only expected to work your tail off to do all the tasks you are given each day and keep your residents informed of changes that happen throughout the day and night.

Some days are tough, b/c no matter how hard I try, I can't do everything as well as I'd like, but it's a long process and every day I learn how to do something a little better tommorrow.