The transition from medical student to physician is difficult for anyone. You will be thrown into the realm of caring for patients almost immediately, and it is not always what you expect. Here are some tips to help those of you starting out as interns in July.
1 | Congratulations!
First and foremost, congratulations! Matching is the culmination of a minimum of 20 years of schooling (18 if you did an integrated medical school program). Every morning when you wake up, try to remember that you worked hard for this spot, and that the match landed you here through a complex process of ensuring everyone got the spot they deserved most.
Your mentors, your colleagues, and your support system are all proud of you. Ahead of you lies an ocean of patients you have been dying to take care of your whole life. This is your chance to shine. Just because you are an intern does not mean you will be shuffling paperwork all year. You will have countless opportunities to make a difference in someone’s life. Relish it and start taking care of people as best as you can, starting day one.
2 | You Are Scared and That Is Normal
I was too. We all are. Walking in with the longer white coat on your first day in the ICU, booting up the PACS for the first time as an actual radiologist, or scrubbing into your first real case are moments that will paralyze you at first. There is a wall there, keeping you back, and it is your own fear. Fear of failing, fear of being a different kind of doctor than what you anticipated, and a fear that others will think you are not qualified.
Rest assured that every senior resident and attending had their own first day too. Those watching over you want you to succeed. We know you are just starting and will help you. Do not let the fear of failure keep you back. Embrace it and use it to stay sharp and prevent silly mistakes.
When the fear is heightened, be aware of it. Uncertainty is usually a sign that you should ask someone above you or look something up before jumping forward. Double-check your decisions and ensure that you are making good choices for your patients. For me, knowing that my interns can approach me with questions is paramount to success. Try to find someone you can approach when you are unsure and show them that you are a responsible physician. It is significantly easier to trust an intern who is comfortable asking stupid questions than one who you are always following to make sure they are not making poor clinical decisions. If you ever need guidance, MSI has excellent mentors who can help you.
3 | Trust Your Colleagues
I do not just mean the other residents, though you should use them as a resource as well. I mean the nurses, therapists, and ancillary staff who have been doing this far longer than you. In the beginning, the staff will often know the routine and can help guide you in the right direction. Do not be afraid to ask the nurses what to do, as they will often know the answer and will be happy to help guide you. They all know what July entails, as the budding young physicians flood the hospital. Seasoned nurses especially know the panicked look we all have the first time we are faced with a new clinical scenario. If approached, they will guide you towards success. Similarly, respiratory therapists will help you with ventilators, the operating room techs will hand you the right instruments if you are frozen, etc.
However, a key part of these interactions is to maintain a respectful and friendly environment with everyone you work with. If you turn into Dr. Jerk the first time you wear the badge that ends in MD and start bossing people around, they will be far less likely to help you when you are stuck. Medicine is first and foremost a team sport, and you will be wise to form strong bonds with your “teammates” early on.
4 | Managing Fatigue
You will never have been this tired before. Not during Step 1, rotations, or sub-internships. Your body will need time to adjust to both the rigors of a punishing schedule and the stress of advanced patient care. Set up a schedule and stick to it. If Mondays and Wednesdays are gym nights, do not try to cram a dinner and mowing the lawn in there too. Try to maintain a balanced schedule that includes components designed for wellness and glimpses of fun in between the necessary activities. If you have a rough day ahead on a new service, do not go partying the night before. Fatigue can steamroll out of control and you will not be used to it. All it takes is one truly sick patient when you are on call for the first time in the Cardiac Critical Care Unit and a late morning the next, followed by a noisy neighbor keeping you awake during your allotted sleep time of 10am and 2pm before you have lost track of your sleep cycle and are exhausted until you have break two weekends later.
Another key piece of advice is do not be afraid to speak out if you are nearing dangerous levels of tiredness. We recognize you are learning and new, and that things can get out of hand. If you think you are nearing dangerous levels of fatigue, let someone know. The last thing we want is a bad decision made or you to get into a car accident on the way home because you have not slept. There are mechanisms in place at every hospital and program to ensure that does not happen. Our hospital has a ride service to get you home if you are tired, and there are mechanisms to find coverage if you are too tired to care for others effectively. Do not be a martyr, the rules regarding logging hours are in place for a reason.
5 | Learn Every Day
I would urge every intern to forego research endeavors and other extracurricular hospital activities, and instead spend that time reading every night. A journal article, a few pages of the chapter that is due Friday, or even a brief review of an operation you did that day. Try to learn two new things daily – one in the hospital and one outside of it. Establishing a habit early on will help you fill those knowledge gaps quickly. You are a sponge and your practice patterns are malleable, and this is the perfect time to grow the right patient-care techniques. Eventually, you will learn to fit in research, committees, and other events around your schedule as needed.
Enjoy every moment. As I stated, you have all worked extremely hard for this spot, and earned it amongst the thousands of other applicants. Your patients will be waiting every morning for your help. Your intellect and book knowledge will guide you towards the right answers, but ultimately it is your compassion that you will be remembered for. Most people will not care that you are an intern, they just want to be treated with respect and kindness. Do not let the fatigue and rigors of intern year break you away from the kind of doctor you want to be and the kind of doctor your patients deserve. The steps you take towards being that person start day one.