Silly question . . . how do you learn to be an intern?

[Fabio]

I'm back . . . and fully recovered from Match.

I know that seems like a really broad question - but it seems like year after year, all kinds of good advice gets passed down in pieces to the upcoming intern classes, and some of us never have the privilege of knowing it. Especially if no one at our future program is from our med school.

Where do you learn how to plan your first schedule, how to organize your call nights, what to carry in your white coats, how to handle that first difficult patient encounter, whether or not to use a PDA and how to stay organized, what you should be reading in your free time, how to budget your income, how to stay healthy, how to resuscitate your clinical skills after a month or two away from medicine during the 4th year, in general . . . how to be a good intern???

Is anyone else as nervous about starting residency as I am?

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[The White Coat Investor]

Good interns work hard and are very anal. No one expects you to know a lot, but they do expect you to be very detail oriented and not drop the ball. You're allowed to make every mistake once, but don't make it twice.

The best training is to pay attention during your third year of med school.

Nothing prepares you to be an intern.

 

[dr.smurf]

desperado is right on. i think the main thing is to be or become organized and KNOW your pts. the worst thing is an intern who doesnt know a question asked about his/her pt from an attending or senior resident. i have seen it as a sub-i and the intern looks like a real idiot. i mean you should know when your pts going to cath, having his/her endoscopy, know if the Hgb has dropped in two days not just what the value is at the moment.

you should definitely read up on high yield things like fluid management, writing orders, etc. i dont know what specialty u are going into, but read up on things you will encounter most often. i know i did this alot as a student...i read up on everything i encountered. i had a pt with intestinal lymphoma one time..i didnt know anything about it...didnt know the incidence, how it presented, etc. so i read up on it. so next time ill know.

hope this helps! good luck

 

[Whisker Barrel Cortex]

You learn on the job and very quickly. If you are at a good program, you should have a decent amount of oversight from an upper level or attending early on. Much of your work as an intern relies not on clinical acumen but keeping things organized and making sure all of the work gets done. That is something you just learn. You start out slow and become an expert at it by the end of the year.

 

[DrIng]

Have just finishd 2 months as an intern (in Australia so job might be slightly different). It seems to all come quite naturally. You seniors will tell you what they need you to do and certainly here everything is a natural progrssion. My advice is write everything down and make up your own system for keeping track of patients, I use a ward list with different coloured pens with a different colour for results, things to chase/organise etc.
The other pain piece of advice I would give is start each shift with a full stomach and an empty bladder and remember that there is no law against writing a script or letter with a cup of coffee in the other hand. Also, I've found ebign able to type quickly very useful and a real time saver.

 

[beyond all hope]

1) Be diligent - care for your patients no matter what the obstacles (and there are many)
2) Be organized - carry notecards with pt info, or use your PDA, something to make sure you don't forget anything that needs doing
3) Don't talk back too much - you may at times know better than your resident or attending, but don't spit it out during rounds
4) Suck it up. Don't complain about your call schedule/too many patients/not enough backup/whatever. Just troop along. Being an intern is like being a private in the military, except they expect much better performance out of you.

Everything else should fall into place. A lot of medicine is repetative, but when you're first starting out everything is new, exciting and terrifying. If you work hard, your seniors will see it and try to help you with any problems you have.

 

[Winged Scapula]

Originally posted by beyond all hope

4) Suck it up. Don't complain about your call schedule/too many patients/not enough backup/whatever. Just troop along. Being an intern is like being a private in the military, except they expect much better performance out of you.

I like this part. I'm sure I've been guilty of the same, but its hard sometimes watching people complain about the hours they work, how few days they have off, etc. when EVERYONE senior to them has done it all, and probably (given these days of work hour restrictions) done more of it.

Its one thing to complain amongst yourself but its pretty poor form to do it in front of your seniors. Besides, the way I've seen it - no one really gets shafted all the time on the call schedule, it usually evens out somewhere along the line.

 

[beezar]

Don't worry too much about not knowing things. You will learn very quickly.

Internship really isn't that tough... you're basically a glorified secretary.

 

[Freeeedom!]

Expect to make mistakes and likely a lot of them. But when you do make the mistake, learn from them.
Practice practice practice. When an opportunity arises for a procedure, go in head first. If you flub it up, you aren't the first, you won't be the last, and keep on keepin on.

Take every call and complaint seriously.

Don't bitch.

Eat when you can, sleep when you can, crap when you can.

 

[Apollyon]

If you have to ask, the answer is yes (does the patient need cardiac enzymes drawn? Should I order the Lasix? Do I need help on this one?).

I originally realized this with child abuse cases (if you even consider it, your answer is yes, it is), but came to know that it spilled over into many things, especially cardiac ischemia.

 

[Blade28]

Same way you learn how to be a third-year, I'd assume...just kinda stumble around until you figure it out. That, and get advice from friendly uppers.