Intern Year Learning Curve

[DoReMiFaSo]

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Starting IM residency in a few wks , wondering what the learning curve is like your pgy1 year... What was it like to start as a newly minted doc? How long did it take ya to get into a groove?

 

[skyuppercutt]

I felt the learning curve was a bit steep in the first 3 months or so. Really the best thing you can do in my opinion is reading up on an approach to... this is can be hyponatremia, hypercalcemia, chest pain, etc.
The only things you actually need to know on the spot is the ACLS algorithm for a code blue (I just kept the pocket card on me whenever I was on call). Absolutely everything else can be read up on.

Things really started to become easy for me 6 months in. I felt I actually knew **** and when I was back on a CTU block around block 8 or so, I'd be done seeing all my patients by like 11am and would just help out the medical students and the family med residents and do teaching or read up on stuff.

Honestly, I felt the transition between 2nd year and clerkship to be larger than the transition between med school and residency. Also felt amazing to be making some money and to start paying off my debt. Get excited! Residency is fun, but make sure you take care of yourself too so you don't get burned out.

Best of luck and cheers!

 

[lulu09]

I barely remember July of my intern year, but having worked with brand-new interns in the last 3 years first as seniors then now as a new attending, I'll tell you that for the first 3 months or so (until ~Labor Day) there's very little expected from interns. In the beginning the interns are literally just trying to keep their head above water and learning their way around the hospital (figuring out what to avoid from the cafeteria 😉).

The only thing that I really expect interns to do is to NOT do anything that can jeopardize a patient's safety. Although this sounds a bit daunting, there has only been two interns who I worked with where I actually needed to explicitly tell them that what they are doing is dangerous. You actually know more think (but, yes, at the same time, think you know more than you know 😉) Clinical medicine is highly, highly repetitive, and soon you will organize your thinking into "illness scripts" for the common conditions -- as time goes on these management algorithms get more and more refined, and you'll see that the vast majority of medicine patients are all just different flavors of the same 10-20 common illness pathways.

I tell everyone at the first week of July to ask lots of questions. If you don't know something and you feel odd about it, ASK someone (see above). We've all been there. Read while you can, but I don't think it's imperative to really do that much especially in the first half of intern year. Focus on getting out on time, getting enough sleep, exercising, and eating well first. You'll learn the medicine through seeing patients.

Once you've had about 2 blocks of inpatient floors, clinic, and ICU each you should be much more comfortable. By around Feb-March of intern year I was barely running my plans by the senior before presenting to the attending (they won't care anyways by that time as long as you do a good job 😛).

 

[Moko]

Literally everyone (nurses, residents, attendings, etc) will assume that you know nothing for the first few months. So the good news is that the bar is set real low. As long as you check your ego at the door and go in with a positive attitude and open mind, things will be fine. The most dangerous residents are those who are too afraid to ask for help, or worse still, those who think they know something that they're actually clueless on.. Try to dedicate 1/2 an hour to read every day (I would start with resources such as the MGH "White Book", etc), and you'll find that your clinical knowledge will start expanding exponentially. Also, don't forget to dedicate time to do things outside of medicine in what little spare time you'll have!