What makes a good/bad intern?

[turkish]

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You guys have had time this year to think about what makes a good intern. You've probably run across some people and thought either "I hope I'm like that person," or "I hope I'm nothing like that when I'm an intern".

Care to share some of your suggestions on how to be a great intern? I'm in the position now between friend and teacher. I want to pass on my "wisdom" without being condescending, and I want to be able to motivate people without draining their desire to work hard and learn. I know a lot of people might be thinking "easy, don't make me do your scut". I'm looking for suggestions a little deeper than that, we all know scut sucks.

Some examples- do you like your intern to call you on your day off and tell you about any new people so you don't feel lost when you come in the next day? Do you like the little "here's how I do it" bits we give you sometimes? Do you just want us to shut up and let you work and go home?

Maybe you can look back on this thread someday and see how you really turned out...anyhow, I'm interested to hear some opinions.

 

[gschl1234]

Very interesting thread! Well, as a third year, I found that my definition of a "good intern" has changed. When I started out, I didn't know anything about the hospital (that notes don't mean anything is going to be done unless an order is written, how to use the computer system, what an MAR was/how to find out what meds your patient is on, what all the abbreviations were, the sections of an H&P etc...) and my interns (in surgery) didn't really bother explaining these things but somehow expected us to know how to do everything. At that point, a really great intern would have been someone who bothers explaining things like this, gives pointers on notes/presentation b4 rounds etc....

After catching on to hospital culture, it's difficult to describe an intern that EVERYONE would like. Some students really like getting taught. Others like being left alone to manage, make mistakes and learn on their own from mistakes.

I guess the best intern/resident team I had was back in IM because they made us really feel like a team. They took the first step by acknowledging that students need lots of time to study/read and always sent us home a little early if we were let out a little late the previous day whether or not they were swamped with work. Since they were unselfish, I really wanted to repay the favor and help them get out earlier too. We all gelled as a team pretty quickly and soon, I didn't mind staying a little later b/c I genuinely wanted to help them. I have to say, I did not like when the intern only gave me 1 task at a time b/c you have to keep looking for her to get the next task or to be let home. I started asking her to give me lists and that was much more efficient. I liked being left alone to do H&Ps so that I can come up w/ the DDx and w/u plan independently. Even if they disagreed or wanted to add things, I felt more responsibility toward the patient and learned a lot from going through the thought process.

The other side of the coid would be "bad" interns. The obvious stuff aside, I don't like interns who want you to follow them around and do menial tasks here and there as they think of them. It's a waste of everyone's time but it makes the intern's job as mini-manager easier since there's no planning on their part. If there's really nothing a student can do, then at least offer to let them leave.

 

[deleted109597]

Some examples- do you like your intern to call you on your day off and tell you about any new people so you don't feel lost when you come in the next day?

God no

Do you like the little "here's how I do it" bits we give you sometimes?

These actually help, especially during procedures.

Do you just want us to shut up and let you work and go home?

Depends on what you're talking about. If you're just going to make me follow you around all day writing orders and answering pages, then just let me go home. If you're teaching me about each admit, then talk away.
Oh, and constructive criticism of note writing is important. I hated getting dinged on something I did the same way from beginning to end because nobody told me that "we don't like it that way."

 

[Mayhem]

Some examples- do you like your intern to call you on your day off and tell you about any new people so you don't feel lost when you come in the next day? Do you like the little "here's how I do it" bits we give you sometimes? Do you just want us to shut up and let you work and go home?

Maybe you can look back on this thread someday and see how you really turned out...anyhow, I'm interested to hear some opinions.

.

Off days? What luxury hospital is this? No but seriously those things are nice but all I really need is for the intern to let me know when new patients come in. And you don't even have to call me as it happens or anything but it would be nice if you'd let me know that you admitted 5 people while I was off during your scut. I had an IM intern that used to keep the admissions like a state secret and everytime we had attending rounds I'd get chewed out cause I thought we had 15 patients on the ward when we really had 16 or some crap like that. Man I hated that.

 

[justwondering]

its nice to hear someone looking for "feedback" from us med students

the best teams i have been on have been the ones where we all get along like peers while the students still respected the knowledge differential btwn us and the residents. ie we'd talk about normal (non hospital) stuff at times, etc. it definitely makes me more likely to volunteer to help with scut, etc (which YOU do need help with at times, right?).

as for calling on an off day... PLEASE dont do that. my off day is the day for me to not think about the hospital. if u think there's something that would be helpful, tell ur students, u'll email them (with no expectation for a response). then if there's anything important (ie like we admitted 6 pts, they know to come early...or u can tell em their pt had some issue that's not written in the notes) for them to know, they can see it before pre-rounding the day they get back.

teaching is good, i appreciate when my residents take time to teach in a nice way. also important is letting us go (home or to the library) when there's nothing to do for a while.

 

[QuinnB]

A few things that make incredible interns...really they all kind of feed into each other (my two cents):

1) Teaching - interns who teach even when they are crazy exhausted with 6 admits on call night and getting pages q 5 minutes for cross cover stuff are really solid

2) Patient advocate - you know that people who are strong advocates for their patients during intern year, which is nothing short of hell, will probably be patient advocates for the rest of their careers; too many people get bitter during this time (understandable, it breaks a lot of people) if they aren't already and it is really easy to focus on shipping that gomer out the door

3) Patient loads - speaking with chief residents (at least at my very small sample size program), they said that they love interns who are willing to take on any patient load, even at 5 am when 2 new admits show up and you have to have the note up by 7

4) Strong knowledge base - saves time, improves patient care, inspires med students, people learn a lot from them

5) Fun people - you have to be able to talk with them and they have to be able to let go everyone now and then

6) Efficient - you can't waste time on call, but definitely not post-call

 

[DebDynamite]

yo turkish,
What an amazing question. I've found the best interns at my institution are the ones who graduated here, for the most part. It's as if they understand that the bulk of our grade for these rotations is coming from quizzes and the NBME shelf exam, and that we therefore need some time to study. Thus, they do not have us following them around watching them answer pages etc. Instead they make sure that we do help out with H&P's (please no more than 1-2/shift...after that it becomes scut in my opinion) etc and then they cut us to go study. If it is an in-house call, they only page us for a REAL learning experience, and they say, "go read and I'll page you when you can learn something". Or, "do X,Y & Z, then go read (or, go home if it's not in house) and I'll page you if you can learn something". They also keep teaching as long as the students are around. Or, they let us do things like admit orders, writing Rx's etc. Then they go over them with us as a learning experience. Thus, the best interns are the ones that make sure we do pertinent work while learning and then cut us to go study, etc...

If I really want to be paged on my day off, I'll tell the intern ahead of time. Otherwise, honestly, I just would not answer my pager. Nothing personal, but it is my day off, and as a student I would not even consider answering a page on my day off. But, if it's a field I might want to go into, I'll make it a point to let the right interns/residents know to page me. Otherwise I don't even know where my pager is when I'm off.

Your question reflects a certain amount of insight and awareness that I wish every intern had- obviously you are not worried about contract renewal. It's the interns that think that they "need" their med students( in order to look better than someone else) that scare me.

 

[turkish]

Excellent responses, so far, very insightful. Keep em coming!