Help with new interns

[Leucovorin]

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I just completed my internship and am now supervising new interns. I can't imagine that I came off this way from the very beginning, or that any of my fellow interns did either, but we have a couple of interns who already act like they know it all. I'm not just talking about medical stuff, but the administrative paperwork that goes along with getting things done--like referrals, radiology requests, etc. You know, check this box if you want that done, if you don't fill this section out we won't get paid, and so on. They haven't had the occasion to even fill out half of this stuff and they're telling upper level residents how do it! These aren't people who went to medical school at the same program, so I know they didn't pick this stuff up in 3rd and 4th year.

They also act very disinterested and jaded, as if they don't have anything to learn from the patients they're seeing. One upper level resident has already approached them and suggested they work on interest and enthusiasm and being less argumentative, which hasn't helped at all. I am dreading working with these people this year considering the poor attitudes they're already displaying. Any advice on how to be a good example and inspire new interns to be hard-working and less bossy? I have no problem being direct and assertive, but I don't want to come across as malignant. Help!

 

[Annette]

My evil side wants to recommend that you let them sink. Nothing like experience as a teacher!

You might approach your chief, maybe suggest some team building exercises. Or maybe try some boot camp techniques.

Nah, let 'em sink

 

[GenSurg]

This is part of the problem with our system. Fourth year medical students think they are as smart as the interns, interns think they're as smart as the 2nd years, and so on....

I don't think people realize how much they learn during internship. There is a huge learning curve, and there is the experience factor. New interns generally don't have the experience to either take care of difficult patient problems. In surgery, interns generally don't have the experience to perform many operations they feel they should be able to do.

These interns will probably figure it out for themselves eventually, but I would let your chief take care of things. A talk and a poor evaluation can quickly change someone's attitude.

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[Doczilla]

Maybe your pimp questions aren't hard enough.

 

[MD'05]

Oh ****! This is probably me. I do feel like I know alot about the administrative stuff and paperwork and I just want to do a good job and be proactive. Some of this stuff is rather routine and boring, but I will work on my fake enthusiasm and fake smile.

I don't know why second years feel threatened by us lowly interns. If we were slacking and acting like ******s, they would still be slamming us.

I thought I left this backbiting **** behind in med school.

 

[Gauss]

one thing you may want to consider: are these prelims/transitionals? Frankly I just wanna get through internship and move on (literally move to another state) Thus my enthusiasm is zero and my interest is barely palpable, so my apathy never inspires me to argue about anything and I never claim to know anything about administrative stuff. So I usually get along fine with the seniors.

 

[supercut]

I think part of the problem stems from the upcoming generation of kids who have an entitlement mentality. These kids have never been corrected their entire lives. Their parents have insulated them from any difficulty in life, and they have no grasp of reality. They think higher of themselves than they should. They were probably the med students who after the exams, complained loudly about not getting A's and fought hard to get enough questions thrown out so that they could raise their grade to A

Where is your faculty? I'm not sure that residents can solve the problem, becuase the interns probably see other residents as peers (even upper levels)

Personally, I'd warn them once then let them learn for themselves what the consequences of this behaviour is.

 

[Teufelhunden]

Whoa! What's with the whole "these kids today..." rant? The age difference between residents and interns is only a few years. I hardly think you can make an arguement that this is some sort of generational gap.

 

[Leucovorin]

Actually, faculty has given some of them some constructive feedback, most of which was met with excuses. One of them outright told another upper level resident, "I don't care what people think of me. I'm not going to change." I guess there are usually a couple at each level of residency who aren't going to play nice, and these folks have now declared themselves.

With most of the people I supervise, whether it's an intern or medical student, I try to help them out as much as I possibly can--giving answers to anticipated pimp questions, how to handle nurses, attendings' quirks and preferences, etc. I've resigned myself to not helping this handful of interns and letting them figure it out themselves or get burned. I hate to do that because I'm usually a great team player, but I don't think I have a choice. This is part of the learning process for me as an upper level resident--I'm figuring all this out as I go along.

The remainder of the interns are great--hard working, proactive, eager to learn, positive attitude, etc. There's probably not a lot I can do to fix the ones who aren't. And honestly, some of the issues I'm experiencing may be the age difference between me and the interns--I'm about 10 years older that they are, and I'm sure I was a young punk with an attitude at some point in my life! Hopefully they'll figure it out the same way I did. I only have two more years to put up with them if they don't. As someone else said, a couple of bad evaluations from upper level residents and attendings may help.

Thanks for the input!

 

[Furrball2]

Actually, faculty has given some of them some constructive feedback, most of which was met with excuses. One of them outright told another upper level resident, "I don't care what people think of me. I'm not going to change." I guess there are usually a couple at each level of residency who aren't going to play nice, and these folks have now declared themselves.

!

One of the prelims in my year was fomally written up on her first night of call. She told a patient, GI liver failure type, to "suck it up" and refused to Rx any pain meds. Then she talks back and routinely insults the GI fellow on her team. It's all rather spectacular.