I Will Be an Intern In A Few Months But I Feel Like I Know Nothing

[JackD]

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I have been thinking about this a lot lately. In just a few months I am going to be a doctor, working in a hospital but I feel like I know nothing. I've done well in all of my classes, passed the tests, the practicals, I have diagnosed and treated real problems but I still feel like I don't remember 1/10th of what I was taught in school. I have a massive, 2000 page file on my computer that is just my notes from my various clinical courses (not including radiology) and during this break I have been trying to review some of that information but I just constantly find myself thinking "god, i have forgotten all about this stuff!".

It is kind of scary. I feel like I need another 15 years of med school before I really know what I am doing. Is it normal to feel like you are about to be pushed into the deep end as soon as you leave school?

 

[link2swim06]

Kinda of the point of residency, no?

 

[GoSpursGo]

Yep.

The important thing to realize is that you aren't just "pushed into the deep end." As an intern, they know you were a medical student a day ago, so you always have your upper levels and fellows and attendings around to help you. As you learn more throughout residency they will give you more autonomy, but they aren't going to just let you drown in your first month either.

And if you ever doubt that you have learned something over the last 4 years, go and hang out and do some mentoring to the first years (teach physical exam things, tutor anatomy, etc..) and you will see just how far you have in fact come 😀

 

[mimelim]

I have been thinking about this a lot lately. In just a few months I am going to be a doctor, working in a hospital but I feel like I know nothing. I've done well in all of my classes, passed the tests, the practicals, I have diagnosed and treated real problems but I still feel like I don't remember 1/10th of what I was taught in school. I have a massive, 2000 page file on my computer that is just my notes from my various clinical courses (not including radiology) and during this break I have been trying to review some of that information but I just constantly find myself thinking "god, i have forgotten all about this stuff!".

It is kind of scary. I feel like I need another 15 years of med school before I really know what I am doing. Is it normal to feel like you are about to be pushed into the deep end as soon as you leave school?

You know a lot more than you think. You also realize very quickly how irrelevant 90% of the content of pre-clinical curriculum is to the practice of medicine.

 

[JackD]

And if you ever doubt that you have learned something over the last 4 years, go and hang out and do some mentoring to the first years (teach physical exam things, tutor anatomy, etc..) and you will see just how far you have in fact come

Good point. Just this summer I helped out in a second semester course and I had to sit in on some of the lectures. The information presented seemed to basic; it almost felt like a middle school health class but the students seemed to be really challenged by it and of course when i was in that class, I was challenged by it too.

Kind of the same thing when I was studying for board exams. I remember neuro anatomy being insanely difficult. It was the single hardest thing I have ever had to get through. Then when i went back through my notes while studying for boards, it seemed like kid stuff.

I guess I just need to trust that these programs are designed the way they are for a reason and that if you stay focused and work hard, it all comes together in the end.

 

[JackD]

You also realize very quickly how irrelevant 90% of the content of pre-clinical curriculum is to the practice of medicine.

I did realize that a few months back. When i was done with the basic sciences, I kept all of my notes neatly organized in a file cabinet next to my desk. I was thinking that I would have to go back and reference physiology, biochemistry, or pathology notes all of the time and that i would have them there anytime i would need them. You know, for all of those times you have to draw out the steps in glycolysis when you are treating a patient.

Then a few weeks ago I was cleaning my apartment and I am looking through my file cabinet thinking "why the hell am i saving all of this?". So all of that ended up with that week's recycling bin.

 

[username456789]

I did realize that a few months back. When i was done with the basic sciences, I kept all of my notes neatly organized in a file cabinet next to my desk. I was thinking that I would have to go back and reference physiology, biochemistry, or pathology notes all of the time and that i would have them there anytime i would need them. You know, for all of those times you have to draw out the steps in glycolysis when you are treating a patient.

Then a few weeks ago I was cleaning my apartment and I am looking through my file cabinet thinking "why the hell am i saving all of this?". So all of that ended up with that week's recycling bin.

Conversely (and just for argument's sake), as a PGY-2 first year Derm resident, I'm starting to realize just how much of the preclinical (and, specifically, M1) stuff is needed. More specifically, the molecular bio/biochem stuff. Not that I would've kept all those notes to look back at or anything, but I'm damn glad I studied hard to do well in those courses and the stuff really stuck with me.

As an intern, though, none of that stuff matters. No one is going to ask you what a zinc finger is, or demand that you illustrate the MAP Kinase pathway.

 

[JackD]

Do you guys think there is any point in going through and reviewing old clinical information? Like today, I spent a bunch of time relearning about conditions of the eyes. It was all stuff that we went over in my EENT course. Is it smart to review like that or should i just take breaks when I can get them and just do what I am told, when I am told to do it?

 

[link2swim06]

Are you starting residency at a weird time or are you just gearing up for july 1st?

I am thinking my AI during 4th year will help prepare me a little more with the process of putting orders in the computer and little bit more responsibility.

 

[Kahreek]

i cant bring myself to review my own notes, when there is a world full of medical publications to be explored.

 

[ChiDO]

Everyone feels dumb in July. Don't worry about it. Go enjoy life.

Besides, u'll learn quickly on the fly as most of the things you probably are going to see are: CP, CHF, COPD, DM as an intern.

 

[DrBowtie]

If you can put in skeleton admission orders, know how to replete K and order pain/sleep meds, you'll coast through the first month.

 

[JackD]

Everyone feels dumb in July. Don't worry about it. Go enjoy life.

Besides, u'll learn quickly on the fly as most of the things you probably are going to see are: CP, CHF, COPD, DM as an intern.

My uncle, who is an MD, said something very similar to me awhile ago. He said if you are a doctor, you spend about 90% of your time treating ear infections, sinus infections, and high blood pressure. The path we have chosen is truly full of wonders.

 

[Arkangeloid]

As an intern, though, none of that stuff matters. No one is going to ask you what a zinc finger is, or demand that you illustrate the MAP Kinase pathway.

My professor told us specifically to ignore this material.

Just an aside.

 

[username456789]

My professor told us specifically to ignore this material.

Just an aside.

There are some anti-cancer therapies that target this pathway.

 

[mimelim]

There are some anti-cancer therapies that target this pathway.

That don't need to be understood at all to effectively give the medication. Knowing which pathways are targeted, yes important, but clinically most of those details are irrelevant.

 

[username456789]

That don't need to be understood at all to effectively give the medication. Knowing which pathways are targeted, yes important, but clinically most of those details are irrelevant.

I'm not talking about clinically. I'm talking about as a resident studying for boards. In Derm, just like in many fields I'm sure, those kinds of non-important facts are exactly what show up regularly on licensing examinations.

 

[airplanes]

July is literally 10 months away. Don't you have other things to be freaking out about right now?

 

[Bacchus]

If you can put in skeleton admission orders, know how to replete K and order pain/sleep meds, you'll coast through the first month.

👍

We also have iForms so you pick the med/surg admitting iform and it literally has everything on there besides, I believe, the diet you want for the patient. If you want funky labs/films, you have to order those separately but otherwise it has everything. It even has a risk algorithm where you click boxes for DVT prophylaxis. Whatever number is spewed out tells you if you use nothing, boots, or a medication.

It's pretty much idiot proof as long as you have "some" knowledge.

 

[Doctor Bob]

You know, for all of those times you have to draw out the steps in glycolysis when you are treating a patient.

Then a few weeks ago I was cleaning my apartment and I am looking through my file cabinet thinking "why the hell am i saving all of this?". So all of that ended up with that week's recycling bin.

"Nurse, this patient has an acute alpha-ketoglutarate deficiency! Page whoever is on call for the KrebsCycle Consult Service immediately!"

 

[prometheus09]

I have been thinking about this a lot lately. In just a few months I am going to be a doctor, working in a hospital but I feel like I know nothing. I've done well in all of my classes, passed the tests, the practicals, I have diagnosed and treated real problems but I still feel like I don't remember 1/10th of what I was taught in school. I have a massive, 2000 page file on my computer that is just my notes from my various clinical courses (not including radiology) and during this break I have been trying to review some of that information but I just constantly find myself thinking "god, i have forgotten all about this stuff!".

It is kind of scary. I feel like I need another 15 years of med school before I really know what I am doing. Is it normal to feel like you are about to be pushed into the deep end as soon as you leave school?

you'll be ok OP! 🙂 I feel the same way... so many notes, bookmarked resources, journals.... and hardly any time (or energy) to review any of it! It seems overwhelming. My main consolation is "dumber people have made it through this," and I start feeling a bit better. 😎

 

[Bacchus]

"Nurse, this patient has an acute alpha-ketoglutarate deficiency! Page whoever is on call for the KrebsCycle Consult Service immediately!"

This might be fun to do just for the hell of it.