starting as icu, night float, backup intern

[inositide]

given the choice between starting intern year in the ICU vs night float intern vs backup intern, which would you choose?

when intern schedules are made, are "home grown" med students often started off in the icu or night float or backup because they are already familiar with the system or is intern schedule assignment completely random?

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[P Diddy]

given the choice between starting intern year in the ICU vs night float intern vs backup intern, which would you choose?

when intern schedules are made, are "home grown" med students often started off in the icu or night float or backup because they are already familiar with the system or is intern schedule assignment completely random?

i started my internship on call in the ICU. during my first presentation post call I decided to apply the little knowledge I had acquired and present some other options. before i could get to the second clause of my first sentence i was getting shot down so badly i felt like Ralph Fiennes in the English Patient. Luckily the ICU fellow came to my rescue and told everyone to stop interrupting me with these consoling words: 'Let him finish. I know, it's painful, but let him finish.'

my co interns were sihtting their pants at this point.

despite this unauspicious start, i loved starting in the ICU and would choose it again (not that i had a choice). it's a controlled environment, you learn to take care of critically ill patients, and there's great supervision (theoretically. i had a lazy surgery resident for 3 weeks so I got to do all of the procedures).

i was not home grown. the assignments were done alphabetically and none of my cointerns had rotated at the ICU in question. would not want to start on night float as there is less supervision and you're not entirely sure if that extra tylenol for a temp of 38.0125 C will tip the patient into liver failure.

p diddy

 

[inositide]

any more thoughts?

 

[tec]

My MICU rotation as a fourth year was the one place I felt most equal with the interns because it is a sheltered environment where the upper level residents, fellows, and attendings make sure you learn a lot (at least at my school, where I am staying to do my prelim year). I think this is because most of the interns hav not has that type of experience before. By the time I left the rotation, I felt very comfortable managing complicated patients with multiple organ systems affected. When I did another sub-I later that year, I was much more comfortable managing the patients independently, which I attribute to my MICU experience. Thus, I think the ICU is a great place to start.

 

[Blade28]

In what field?

As someone in surgery, I'd rather start off my surgery residency with regular call than being in the ICU.

 

[inositide]

Internal Medicine.

If your chief resident gave you the choice of starting with icu, night float, or backup, which is best?

Night float sounds intriguing but...

 

[Blade28]

What's "backup intern"? Who are you backing up?

 

[inositide]

backup intern for this program is more like filling in for another intern on any service in case of sickness or whatever.

 

[MM9]

If this choice is really yours to make, I vote for the ICU. Always good to start out with a difficult rotation as you won't really appreciate an 'easy' one until the fall. Besides, ICU's can be fun as there is (hopefully) a good amount of supervision and you learn a lot.

Night Float: 2nd choice to the ICU. Wouldn't be terrible to get it out of the way but, like someone commented, there isn’t as much supervision. Also, it might be good to gain some experience and efficiency before tackling the night time.

Backup Intern: This would be my absolute last choice. You don't know the ropes as it is, do you really want to be thrown from department to department everyday?? Depending on your program, this sounds like it might be a nice block, if you know what you’re doing.

Good luck.

 

[ears]

I also vote for ICU. It's a great place to learn one of the critical intern skills for almost any field: how to recognize the really sick patients. It comes in handy for almost anything else you do (wards, night float, ER, etc.).

 

[HDMTX]

ICU... you might as well dive right in... get all those procedures under your belt!!