Intern year with no admissions

[igottaquestion]

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There are medicine residencies out there in which the upper-levels do all the admissions (up to putting in initial orders) and the intern just manages the patients on the floors. Does this make for an easier or less educational intern year, or does it not make a big difference?

 

[Smurfette]

I don't know if it really makes things easier as you'd still need to review the chart and see the patient and all that in order to get yourself up to speed with the new admission. Doing the admit yourself is the best way to know the patient well.

Personally, I think it's not a good thing if interns never do admissions. Knowing what initial orders to put in, getting to know the patient well and doing the H&P are crucial to your education. Especially when there is a senior person around to back the intern up and review things and confirm orders; otherwise once you're senior, and you've never done admits before, how are you going to manage a patient?

If it's a program that has seniors do all admits only on certain rotations, that's fine, but if they ALWAYS do them, that is a problem.

 

[Buzz Me]

You actually want to be able to do admissions - working on the assessment and plan is the most important part!

 

[95439]

Yeah you need to do admits as an intern. It's my least favorite part of patient care (especially trying to fight for the chart in the ER...ugggghhhh), but I don't think that's something you should wait to learn until your 2nd or 3rd year. ADCVAANDISML!

 

[2012mdc]

I don't know if it really makes things easier as you'd still need to review the chart and see the patient and all that in order to get yourself up to speed with the new admission. Doing the admit yourself is the best way to know the patient well.

Personally, I think it's not a good thing if interns never do admissions. Knowing what initial orders to put in, getting to know the patient well and doing the H&P are crucial to your education. Especially when there is a senior person around to back the intern up and review things and confirm orders; otherwise once you're senior, and you've never done admits before, how are you going to manage a patient?

If it's a program that has seniors do all admits only on certain rotations, that's fine, but if they ALWAYS do them, that is a problem.

Does it hurt you if you are a prelim matched into a subspecialty?

 

[Buzz Me]

Yeah you need to do admits as an intern. It's my least favorite part of patient care (especially trying to fight for the chart in the ER...ugggghhhh), but I don't think that's something you should wait to learn until your 2nd or 3rd year. ADCVAANDISML!

I use ADCVAANDIMLS myself. 🙂

 

[gutonc]

I use ADCVAANDIMLS myself. 🙂

I use the template in my EMR.

 

[Buzz Me]

I use the template in my EMR.

Well, I don't hand-write admission/transfer orders anymore. But I used to!

 

[guillanbarre]

Does it hurt you if you are a prelim matched into a subspecialty?

I was a prelim at such a program, it felt like a blessing at the time but when second year came around, although I was in a different subspecialty, I found it a little unnerving when I had to do them by myself. And it took longer.

I would advise you to be proactive and ask your resident if you could help them out in the ER. It may not always be easy when you're trying to get the scutwork done, but it will help you learn how to formulate the assessment and plan.

In any case your learning curve when you are a PGY2 in your subspecialty will be very steep. You will learn how to do admissions along with other things.

 

[2012mdc]

I was a prelim at such a program, it felt like a blessing at the time but when second year came around, although I was in a different subspecialty, I found it a little unnerving when I had to do them by myself. And it took longer.

I would advise you to be proactive and ask your resident if you could help them out in the ER. It may not always be easy when you're trying to get the scutwork done, but it will help you learn how to formulate the assessment and plan.

In any case your learning curve when you are a PGY2 in your subspecialty will be very steep. You will learn how to do admissions along with other things.

Does your answer change if that subspecialty is radiology?