When are interns expected to be running at full capacity?

[sprawl2]

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It's been a month and a half here and I still feel inadequate ...... that I'm not running at full capacity.
Is that a normal feeling for you guys, my fellow interns?

I feel that there are still some area I can do better (ie. today, I assessed a new patient and I thought for sure that she had drug-induced psychosis but it turned out that she's been having some very vague worries over the past month <--- possible prodrome, when I asked about how she felt BEFORE the episode of psychosis over the weekend, she said she was fine... enjoying her job blah blah blah, until she smoked a couple joints *more so than usual* at a party on Sat but when the attending asks her, she was like ya I've been anxious on and off, worried about strangers, etc blah blah) I mean, it's not like I didn't ask her but I guess I didn't ask her in a way that she would answer me the same way she answered my attending.
I don't know. I can do most interviews adequately and can tease out most info but there are still times I miss a point or two. And of course, my psychopharm is still weak and the attending still has to add a line or two at the end of my note because I forget to mention stuff like the specific disposition (which center, etc)

When are interns expected to be working like a senior resident?
I'm definitely not there yet and I feel sad.

 

[nitemagi]

You're expected to operate like a senior resident when you're a senior resident.

You're 1.5 mos into it. Even the ACGME won't let you work unsupervised yet. For a reason.

There is no point when you're done improving. Learn from every patient. That's enough.

Chill out.

 

[deleted452516]

Another piece is that each time the patient is seen they have a chance to rehearse their story and think through their answers.

Med student asks first- gets one answer. Resident goes next- gets another slightly more thought out answer. Finally the attending goes in, not only are they the best equipped to ask the right questions, but the patient has already been worked over and has prepared answers to a lot of the surface level stuff so it's easier to delve deeper.

 

[vistaril]

It's been a month and a half here and I still feel inadequate ...... that I'm not running at full capacity.
Is that a normal feeling for you guys, my fellow interns?

I feel that there are still some area I can do better (ie. today, I assessed a new patient and I thought for sure that she had drug-induced psychosis but it turned out that she's been having some very vague worries over the past month <--- possible prodrome, when I asked about how she felt BEFORE the episode of psychosis over the weekend, she said she was fine... enjoying her job blah blah blah, until she smoked a couple joints *more so than usual* at a party on Sat but when the attending asks her, she was like ya I've been anxious on and off, worried about strangers, etc blah blah) I mean, it's not like I didn't ask her but I guess I didn't ask her in a way that she would answer me the same way she answered my attending.
I don't know. I can do most interviews adequately and can tease out most info but there are still times I miss a point or two. And of course, my psychopharm is still weak and the attending still has to add a line or two at the end of my note because I forget to mention stuff like the specific disposition (which center, etc)

When are interns expected to be working like a senior resident?
I'm definitely not there yet and I feel sad.

you're worrying about a lot of stuff that doesnt really matter.....

as for where you "should be" after a month and a half, dont worry about it.....honestly after 6 months I was positive I was better than some bc psychiatrists.....by the end of my pgy2 year I was positive I was better than 75%ish of them...maybe 80something percent

 

[OldPsychDoc]

You're expected to operate like a senior resident when you're a senior resident....
Chill out.

This.

(Unless you're vistaril, in which case we all have MUCH higher expectations. 🙄)

 

[SteinUmStein]

you're worrying about a lot of stuff that doesnt really matter.....

as for where you "should be" after a month and a half, dont worry about it.....honestly after 6 months I was positive I was better than some bc psychiatrists.....by the end of my pgy2 year I was positive I was better than 75%ish of them...maybe 80something percent

Isn't there something else you'd rather be doing right now? Go for a run or something.

 

[Scorcher31]

It's been a month and a half here and I still feel inadequate ...... that I'm not running at full capacity.
Is that a normal feeling for you guys, my fellow interns?

I feel that there are still some area I can do better (ie. today, I assessed a new patient and I thought for sure that she had drug-induced psychosis but it turned out that she's been having some very vague worries over the past month <--- possible prodrome, when I asked about how she felt BEFORE the episode of psychosis over the weekend, she said she was fine... enjoying her job blah blah blah, until she smoked a couple joints *more so than usual* at a party on Sat but when the attending asks her, she was like ya I've been anxious on and off, worried about strangers, etc blah blah) I mean, it's not like I didn't ask her but I guess I didn't ask her in a way that she would answer me the same way she answered my attending.
I don't know. I can do most interviews adequately and can tease out most info but there are still times I miss a point or two. And of course, my psychopharm is still weak and the attending still has to add a line or two at the end of my note because I forget to mention stuff like the specific disposition (which center, etc)

When are interns expected to be working like a senior resident?
I'm definitely not there yet and I feel sad.

As was said, you never stop learning. There is never a good enough end point. With that said you are a first year most programs have absolutely no expectations and you all are coming in at different levels. They expect you to work like a senior resident when you are a senior resident. Also believe me 3 attendings could see the same patient and come up with 3 different dx.

Just because your attending doesn't think it is substance induced psychosis doesn't mean it is not. Heck your attending may even think it is, but code it as something else just for billing. There is a lot of grey in this field and in the end as long as the patient gets better that's what matters. If it was my pt, THC has to be stopped first for months then we will see how psychotic they are unless there is a clear hx of psychosis prior. Until then it's psychotic D/O NOS (Substance induced vs x vs y vs z)

 

[surftheiop]

Isn't there something else you'd rather be doing right now? Go for a run or something.

You mean you didn't see vistaril medal in both the 100m sprint and 10k in London? The human interest story mentioned he was also better than most NBA players at basketball, but he didn't feel like putting in the hours playing a full season so he just picked up running and only trains a couple hours a day.