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How can I be a good intern?

Discussion in 'Emergency Medicine' started by Hawk22, Mar 9, 2007.

  1. Hawk22

    Hawk22 Senior Member
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    So as most of us who are graduating this year are eagerly awaiting the results of the match, I wanted to post this question to current upper level residents and attendings. This thread pops up every year and I've found it to be helpful, but I wanted to get new insight and pearls of wisdom from those who have been there.

    1. So what can we do to be good interns?
    2. What makes a good or great intern in your opinion?
    3. What do you "know now" that you wish you had known before you started?
    4. What other insight would you like to give to those of us who are starting in July?

    The best advice I've gotten so far: Work hard, be honest, admit when you don't know something, and keep your relationships with family and friends as healthy as possible.

    Thanks so much!
     
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  2. The White Coat Investor

    The White Coat Investor Practicing Doc and Blogger
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    Nobody cares how smart you are, just how thorough you are. We need reliable interns, not intelligent ones. The knowledge will come naturally if you are anal about details.
     
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  3. GeneralVeers

    GeneralVeers Globus Hystericus
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    Also, listen to your senior residents, and do as they tell you. Occasionally your senior will be wrong, but more often than not they will be right due to their better experience. If you don't listen to your seniors you'll rapidly develop a bad reputation which will make it back to your faculty and PD.
     
  4. joeG

    joeG Member
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    work, work, work

    you are the work-horse. A good intern works hard, is efficient, and gets things done. You'll know nothing when you start. Figure it out. Be nice to the nurses - they usually have the answers you are looking for.

    Don't get a bad name on your off-service rotations - you'll be seeing these people again.

    JoeG

    PS did I say you should work hard?
     
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  5. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner
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    Someone published something that is hanging up in at least 3 resident rooms across the SE. I saw it first at UF-Jax, and can't remember where else. Anyway, it is titled "So you're an intern" or something like that, and has a whole crapload of rules. Many of them are good, but some of them do offend you, just like intern year will offend you.

    But the gist is: Don't have an opinion unless asked, and then have an intelligent one. (Also, work hard).
     
  6. USAF MD '05

    USAF MD '05 Just another dumb ER doc.
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    These are in no particular order.

    1.No matter how much up to date lit you read, please for the love of GOD don't pimp your 2's and 3's. ( actually happened to me) Also, don't argue treatment plan with your seniors/staff in your 1st month in the ED out of med school. You will be put in your place, and generally thought of as a cocky A$$.
    2. Have fun, see lots of patients and be complete. Have a plan in mind when you present. Don't wait for me to feed it to you, though we may revise it together. A medical student can generate an H and P - we have to know what to do with it.
    3. Show your nurses and medics love. Seriously.
    4. Be on time.
    5. Good turnovers at shift change. Don't turn over procedures, especially gross ones. Call your consultant before you leave if the dispo is definite. I hate telling people about someone I've barely met.
    6.At rounds, remember that this is not IM. Short, sweet and to the point. We can go deeper if the staff or senior wants. Present the complaint, pertinant positives/negs, studies and plan. Easy cheesy.
    7. Again- have fun. We have the best job in the hospital. You'll see when you are in you career affirming off-service months.

    Steve
     
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  7. NinerNiner999

    NinerNiner999 Senior Member
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    Know when you are out of your "comfort zone" and ask for help when needed. Caveat - don't ask for help at 3am when the floor nurse wants to give tylenol.

    Study at your own pace but be sure to learn from your patients.

    Become an "expert" in one specific area when you are on your off-service rotations. I.E. The workup and differential for PE, the HCG level and ultrasound findings for ectopic, etc. Caveat - don't volunteer this information, just be a rock star when you are pimped.

    Don't pick up 10 charts at the beginning of your shift and move the meat - pick up one chart and learn 10 things...
     
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  8. BadVB750

    BadVB750 Senior Member
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    Thanks for all the good advice.
     
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  9. JBlue

    JBlue Member
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    So what constitutes "pimping" your resident? I ask my residents a TON of questions mostly if I don't understand why something is done (not that I have any idea of what else could be done instead) or because I want to make sure they are doing something for the reasons I think they are. Basically, I am trying to understand the care we are providing so that when I am a resident I can know WHY I am doing something. Is this pimping? If so, then how are we suppose to learn?
     
  10. BadVB750

    BadVB750 Senior Member
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    I think it is all in how you ask it.
     
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  11. NinerNiner999

    NinerNiner999 Senior Member
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    Def. PIMPING (pimp-ing) - (1) Asking a knowledge-based question to those whom you suspect may not have the correct answer, (2) Asking a clinical question to those in a similar or lesser clinical level of training when you suspect you may have the correct answer, (3) a clinical question posed in an arrogant, dominant, or demeaning manner, (4) cohercing, advertising, ordering, or demanding more income from your ho's. Syn: quizzing, testing, insulting, degrading, balling.

    Definitely - don't pimp ANY residents. You can ask questions for your knowledge base, but I wouldn't even hint that I'm testing someone else...
     
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  12. OP
    OP
    Hawk22

    Hawk22 Senior Member
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    Thanks to all who responded! Great advice all around.
     
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  13. Febrifuge

    Febrifuge Grizzled Old Newcomer
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    From the tech point of view: even more than techs, Interns should have no ego. And I mean that in a Zen sense; you cannot possibly protect yourself from other people's predjudices, assumptions, and biases. Be prepared for people to assume the worst about you, and at the same time leave room for people to see through to the decent, hardworking, smart, competent doc we all know you're turning into.
     
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  14. IntheDraft6

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    Just a little more advice.

    1. In case you missed it, work hard. Bring your A game every day.

    2. Know how to tactfully ask questions. As others have said, your seniors are an invaluble asset. Ask them questions, but know how to do it without giving the impression you are pimping them. Also learn when you have asked too many questions and it is time to get back to work.

    3. Become best friends with the nurses. They are the ones that will prevent you from killing a patient. They are they ones that will remind you what you should be doing when you have no idea what to do.

    4. DO NOT sign out procedures. Always have a clear plan for any pt that you do sign out.

    5. Do not make any off color jokes early on. No matter how innocent they seem, they will cause you grief. Wait until you have been there a while so that people are comfortable with you. I had an intern who made a few jokes that, coming from a senior that everyone knew would have been funny. Coming from someone that no one knew well, people began to wonder if he/she had some sort of psych issues.
     
  15. AR1776

    AR1776 Flying through
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    So yesterday I matched and I was very excited that I never again have to apply for something and suck-up for years to get it! My husband asked if I still have to suck up to the PD.
    I was just wondering if you can get kicked out of a program. Has it ever been done? I would think it's possible but something they hate to do since they want the funding of the filled spot.
     
  16. NinerNiner999

    NinerNiner999 Senior Member
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    Yes, it is difficult to get kicked out of residency for personality issues but, in the long term scheme of things, working with people is a skill you should master during residency. If you hold a grudge for your entire training, it will show and you won't have a job outside of residency for long...
     
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  17. AR1776

    AR1776 Flying through
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    Yeah, I don't plan on being a problem. Just a side thought of being excited that I don't have to go through any process like applying to college, med school, or residency again. This whole thing has been like a cheerleading try-out complete with everyone pushing eachother to look at the final "who made it" list. Finding a job doesn't seem to be like this - or so I hope.
     
  18. Aloha Kid

    Aloha Kid Senior Member
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    Be yourself.
     

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