Finishing up PGY1 with one more block of inpatient service. Currently working on my weaknesses.
Other than what the ACP has for tips for PGY2 year, what other tips do you guys have?
I'm particularly interested in teaching so I am drafting a syllabus for the incoming interns and med students for the wards.
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Ignoring your syllabus, have a couple of teaching topics that you can pull out at the drop of a hat. For mine, it was inpatient diabetes management and code status, with potentially ESLD acute management as a third if people had already worked with me before.
Learn to prioritize. You can not check every order. Well, I suppose you can. But I would suggest, given that you're finishing intern year, to really internalize that knowledge of what the
crucial and
urgent orders are so that you can help your new interns understand why, for example, that antibiotic order is really the first thing they should do before they get back from rounds and not calling the ID consult to figure out if we need to rule out TB. Helping interns understand why we do what we do is hard, and focusing in on that reasoning is important.
Learn to let go. You can be detail oriented, but there's really no need to check over every detail in your intern's note or rigorously double check really tiny details that don't make a difference to the patient's care. Some of that needs to be learned by your intern.
Learn when to ask for help. This is an important part of intern year, but big decisions as a senior resident should be discussed with your attending. You may already have a plan, and your plan may be awesome, but getting another opinion is hugely important. Your attending may know less than you about the disease process you're managing, but still, getting that second opinion when you're working through a new problem is priceless. I've had attendings go with my suggestions even though they were going to suggest something completely different, and that's been an awesome experience. But if you don't discuss big problems with them early, you run the risk of doing something your attending might know
more about than you do.
Learn to delegate, both to yourself and to others, and how to communicate that delegation in a productive way. You can make your interns' life a lot easier if you tell them, "Hey, I'm going to take care of Ms. Johnson's antibiotic order because I want to make sure it's done. Could you double check it for me?" This allows your intern to build more autonomy while also feeling like they have control over their patient's care; they are the primary provider and should feel that way. Similarly, if you have a medical student, your interns may be bad at finding tasks for them. If there's a history item missing, a med rec that's not done, or some other patient task that needs to be done, help your interns delegate: "Sandy, would you mind talking to Ms. Johnson and verifying her medications and allergies for us? We can go through her med rec together and I can watch you do it in the EMR when you're done." It will help your medical students both gain experience with clinical tasks and feel as if they're actually part of the team.
That's all I've got for now.
