How should I prepare?

[DocP]

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So - six months away from the dreaded PGY1 ... how can I start preparing? I will (*crossed fingers*) be starting my prelim internal med year this July. Start reading Harrison's IM or Robbins' Path chapter by chapter?

Any suggestions would be much appreciated 😀.

 

[dragonfly99]

Harrison's is OK...kind of a big book though.

Take an ICU rotation if at all possible.

Take a radiology rotation and/or study up on radiology (? Felson's radiology).

 

[Winged Scapula]

Relax and enjoy 4th year (and read the multiple threads on this topic which say the same thing).

The learning curve is steep, any reading you do now will not significantly affect your performance as a resident.

 

[mules05]

I've been asking the same question. The one suggestion I got that seemed really useful was to come up with ideas for quick 5-10 min teaching ideas so you have them ready when you have med students.

 

[Bubb Rubb]

Relax and enjoy 4th year (and read the multiple threads on this topic which say the same thing).

The learning curve is steep, any reading you do now will not significantly affect your performance as a resident.

ditto. sleep as much as you can -- hibernate all winter like a bear, if you will.

 

[BlondeDocteur]

I feel the same anxiety-- I want to prepare as much as possible-- but I think this question is *exactly* the same as the pre-meds asking what to study the summer before med school starts. It's so impossible to get anything but a minute leg up on the material (particularly the 'learning by doing' bits) that it's just not worth your time, anxiety and wasted opportunities.

 

[dragonfly99]

Hmmm...I don't really agree. I agree it doesn't do to stress needlessly and try to read the entire Harrison's prior to intern year. However, if you think you're going to have much time to read as an intern you are WRONG, unless you do some cush transitional year. So I think that reading up on a few common IM topics won't hurt.

I really think that doing rotations in ICU and radiology could help a future medicine or surgery intern a ton. I mean, the ICU is just a different world, and if you get to internship never having spent time there as a med student, you'll be behind the 8-ball vs. other interns who have.

As far as radiology goes, being able to read chest and abdominal radiographs is just important for all those nights on call...

No matter what, though, you'll find a way to suck it up as an intern when you have to, assuming you have it in you (I'm assuming you all do!).

 

[yumita]

I'll be 2 years out of med school this summer when I start my PGY1 and I plan to brush up on some pharmacology the month before starting. Maybe review some work up stuff that I was never so great at (anemia, clotting factors...). The rest is conceptual and will be easy to fall back into (I hope).

 

[DocP]

Thanks for all the suggestions! I'll have been a year out when I start, that is why I am particularly concerned. I've had plenty of time to relax 😉. I like the idea of 5-10 min teaching lessons - something new. LOL, I guess I know what I have to do - brush up on all those radiographs!

 

[DrB]

I am trying to prepare by creating my own H&P form that I will be able to use quickly for Admissions. I have also tried to gather patient handouts and education for the clinic. I think I will also create a SOAP note page complete with sections for labs, meds, ins/outs, calculations etc.

Sleep sounds like a nice idea... I wish I had the time in my 4th year 🙂

-

 

[Bigpwn]

You really can't prepare for intern year. Intern year is about knowing the computer system, who to call for this test, and how to get along with other people around the hospital. Your upper level will tell you what to order, and you will learn on the fly. I am not saying that reading is worthless. Reading is always good in our field, but when you are going to be working 80 hours with 2-3 weeks of vacation you really should enjoy the time you have now.

I was in the same shoe and considered doing SICU and all that as MS4. I made a good decision by just doing nothing.

Being a good intern is about 1. not being lazy and 2. stay positive. You don't need to study for those. Hope this helps and good luck.

 

[dragonfly99]

Getting a good evaluation as an intern is about doing what people tell you, doing it fast and fairly well, and getting people to like you.

Knowing what to do with a patient as an upper level resident, and hopefully as an intern, requires a good knowledge base, and for that I think that reading is very helpful, at least in my field (internal medicine). And I think that just knowing how things work in an ICU is helpful. Knowing how to read chest and abdominal films, and noncontrast head CT's (at least a little for the latter) is helpful if you are going to do IM, and I'd imagine for surgery as well. But there are definitely varying opinions about what to do during 4th year, and either way (if you slack or work hard during 4th year) you'll probably make it in the end.

 

[Howser]

Probably going to be rough no matter how you prepare

 

[dragonfly99]

In case this makes anyone feel better, I thought 3rd year of med school was worse than intern year. At least as an intern you have a little money coming in, so that lowers your stress (at least it did mine). There were a couple of months of intern year that were neck and neck with most of 3rd year, in terms of general heinousness, but I felt like in general the increased respect from patients, their families and attendings plus coworkers made intern year better than being a 3rd year medical student. And at least they were paying me to get abused, as opposed to the situation in the clinical years of med school...LOL!

 

[Samoa]

For me, intern year was all about figuring out what I could and could not do without permission from my senior. The answer's easy as a student: everything requires permission.

In residency, those boundaries are constantly changing. I found that a good rule of thumb was: PGY of supervisor = length of your decision-making leash.

But I agree with dragonfly: there are certain things you want to be exposed to before internship. As an intern in the ICU, what matters is that you can present patients and write notes in ICU format. It's painful to try and learn that on the job, trust me. Radiology is a bit less helpful. Mainly you want to be able to recognize a normal film. The radiology residents are happy to review a film with you if there's something funny about it. You learn a lot that way. But I imagine it would irritate them to get 20 calls a day to go over obviously normal films.