It is the start of a new year with new students, interns, residents (and chief residents!), fellows, and faculty! We are so excited for the changes that this year will bring, and hope that you will all be an integral part of this program. To alleviate some of the stress associated with every July 1st, here is an excerpt from Dr. Christine Garcia to help get through the first day:
In the first few weeks, you won’t be expected to crack cases like Dr. House. Your biggest challenge initially is getting organized. You must be able to handle a massive amount of data on many patients. Use whatever system works for you, whether it’s your own handwritten notes or premade spreadsheets.
Checklists are a must! While sometimes tedious, lists assure you that things will get done. Make 2 boxes for every patient order to make sure you place the order, then check off the second box when you review the results. Figure out your own system to make sure you don’t miss anything.
Ask for Help When You Need It
There are 2 kinds of interns: those who ask, and those who do not. I’ve been warned by senior residents to worry more about the interns who don’t ask questions, whether it’s out of fear of looking stupid or personal pride. So, if you don’t know something, just ask. Chances are, your senior resident has had a similar experience and can help guide you through it.
If you don’t know something, don’t lie. As an intern, you aren’t expected to know everything. You won’t get into trouble for not doing something, but you will get into trouble for lying about doing something. If you don’t know the answer, don’t try to “BS” your way through.
Show Respect for the Nurses
Nurses can be your best resource or your worst enemy. They have seen new interns come and go, year after year (and they generally dread July 1). Put your ego aside and realize that at this point, they know more than you do. They aren’t bothering you just to be a nuisance. If they are concerned about a patient, you should be, too.
This time of the year is terrifying for nurses because people in charge of placing orders for their patients may not know what they are doing. You have to learn how to crawl before you walk, and in these first few weeks of residency, you might be barely crawling and need all the help you can get. Stay humble.
Be Nice to Everyone
This may be misconstrued as “kissing up,” but being a genuinely nice person goes a long way. Don’t throw people under the bus. Although you may not get along with everyone, don’t let patient care suffer because of petty stuff. You are all on the same team. If you see someone struggling and you have time, help out. Take the time to get to know the people you work with inside and outside of the hospital. These people will become your local support system.
Come In Early
This seems obvious, but it is especially important in the first few weeks. You will be slow and inefficient, especially if you are new to the computer system at your hospital. Accept that, come in early, and get to work. In time, you will become more efficient at learning to place orders and write notes, and you’ll be able to come in later.
Own Up to Your Decisions
Take ownership of your patients. Make sure that you know why you are doing something; don’t just follow along. This goes back to an earlier point — if you don’t know why you are doing something, ask. You are expected to be learning on the job. Understand the reasoning for every action, especially because you may have to explain to nurses and families why you are doing things.
I was told by my chief residents during orientation week, “The less you know, the better you should dress.” Many of your patients will be older and will expect a doctor who doesn’t look like a kid. A friend of mine was mistaken for a volunteer on his first day of internship and was directed to the volunteer office. Although you may not have all the knowledge of a seasoned doctor, you can at least look the part. Don’t come to work looking like the mess your life might actually be. Make sure your white coat remains white for both appearance and infection control purposes.
Learn From Your Patients
This is an important time to learn. Push yourself to read up and stay current. There is a vast amount of literature coming out on a daily basis from hundreds of journals. Focus on what might be the most pertinent to your patients. You simply do not have time to read everything, so take advantage of Websites that provide quick email summaries (like Medscape).
Make Sure You Have a Life Outside of the Hospital
Take advantage of your days off! This is especially important when you are on hard rotations — and at the beginning, they will all seem hard. You may feel inclined to stay in bed all day, but fight that urge and do something fun if you aren’t totally sleep-deprived. Watch a movie, go for a hike, go to the beach, bake cookies, or go to happy hour with friends.
Although it’s good to be committed and dedicated, you need to take time for yourself. It will help put things into perspective. Intern year and spending this much time in the hospital is consuming. Hang out with nonresidency people, and make it a point to not talk about work!
Get Control of Your Finances
Many of you will be entering intern year with a frightening amount of debt, and that grace period will be ending far sooner than you think. There are many options, including income-based repayment plans, that can be a lifesaver for most people. Don’t ignore your loan emails!
Call Your Friends and Family
They will worry about you. Unfortunately, even though the work hours in residency have improved, you will still miss out on many social events — weddings, birthdays, and holidays. Residency comes with a lot of sacrifice. Make it a point to be in contact with your friends and family. My family has a biweekly Google Hangout just to catch up with everyone.
Take Care of Yourself
You will be dishing out lifestyle advice for your patients, whether it’s at the bedside or in the clinic. Practice what you preach, and make sure you are taking care of yourself. Exercise. Sleep. Stay hydrated, and make sure you eat. Pack healthy snacks in your white coat if necessary. Don’t become a “do as I say, not as I do” kind of doctor.
Don’t Forget Why You Chose Medicine
Remind yourself every day! Think back to your first few days of medical school, or even when you were first applying. For many of us, that first day of internship represents a childhood dream coming to fruition. We are among the few to have this incredible honor of taking care of people during the most vulnerable times in their lives. This is an amazing, gratifying profession unlike any other.