Anyone out there?
Well, for those of you who may be reading…hi! My name is Priyanka and I’m a soon-to-be third-year internal medicine resident who decided it was about time I take all my thoughts about medicine, pop culture, how to lose weight, life in general, and put it to paper. Oops – put it to a webpage. Sorry I forgot we’re much more advanced now than those Neanderthals.
Good question, guys. There’s lots of reasons:
- The things you see and hear in a hospital are too good to be true.
- Shared experiences.
- To inspire and be inspired.
- I gotta study for boards. And what better way to study than to bounce ideas off one another?
Now that we’ve gotten the pesky intro stuff out of the way: Welcome.
I wanted to take today and welcome not just whoever may be reading this, but those thousands of people who will be elevated from mere medical students to INTERNS on July 1st.
Welcome to the world of residency, my friends.
Welcome to the world of motivation, inspiration and altruism. Where you wake up every day knowing this was what you were meant to do.
And welcome to the world of the hungry, the tired, the poor. And I’m not talking about the patients.
Wait, what? Hold the phones. Did she just say this was a world of hungry, tired and poor people? And if she’s not talking about the patients, then she can only mean us – the brand new interns?! WHAT DID WE GET OURSELVES INTO???
Hold on, everyone. Before a worldwide Code Brown happens, let me explain.
You’ve worked hard all your life. Did well in high school, college, got accepted to medical school. You stayed the extra hour at the hospital or did 100 more questions in Uworld than you needed to but you got the golden ticket. In March, you received an email saying Congratulations you have matched! All your dreams came true and July 1st, you know you’re going to walk into Podunk Hospital as the best damn intern there ever was, ready to save the world with one touch of your Littman stethoscope.
Well, you’re wrong.
This is a photo of my co-residents and I at the annual intern welcome party with our program director. There I am, cheesing hard in the gray on the bottom R (L to you non-medical people – I tell you, doing medicine has screwed up my L and R more than you know).
Each one of us thought we were going to walk into work on July 1st with all the answers, just like the rest of you. I mean, come on, we were DOCTORS now. We ruled the world – no one could stop us. We quickly learned, some sooner than others, this was the farthest thing from the truth.
As medical students, our duties were limited. We were solely there to learn, to observe, to absorb. It was enough to come into the hospital at 7 AM and leave at 4 PM knowing you had seen your 2 patients for the day, written satisfactory notes and presented just well enough so your residents didn’t have to add anything extra and not too well so the residents didn’t start singling you out for extra work. As medical students, your responsibility was to yourself. Let’s be honest – you’re all paying for your education, whether it’s now or years down the road as loan repayments. But if you didn’t want to get anything out of your time as a medical student, then that was a choice you made. It was enough to know the patient’s labs and symptoms but not know what to do with it. As a medical student, it was enough to be passive. Because, really, the only person you were making a difference with was you.
As an intern, this all changes. It’s not all about you anymore. Now you’re responsible for another human life. At times, you may be responsible for another 80 human lives. Point is, you become the least important person.
So when I say:
Welcome to the world of the hungry – you don’t eat so your patient can get the medications he/she needs
Welcome to the world of the tired – you don’t sleep so your patient can get the proper discharge planning
Welcome to the world of the poor – you don’t wallow in luxury so your patients can get the benefit of the time and energy you put into their care
As an intern, you are hungry, tired and poor because of the very thing that made you want to be a physician in the first place. That desire to help another person, to do right by your fellow men and women is still there.
And don’t get me wrong, it will be difficult. Your sense of altruism will be tested now more than ever. But this is when those who cannot help themselves need you the most. Even at your hungriest, your most fatigued and your poorest, you can still offer your patients what they cannot give themselves. Hope, empathy and a chance to feel better.
Come July 1st, I can guarantee no one is going to walk into Podunk Hospital and BE the best damn intern the world ever saw. But what I can also guarantee by the end of your residency training is a ton of self-reflection, intellectual growth and hopefully you walking out of Podunk Hospital as the best damn physician the world ever saw.
So, now you’re all sitting there, saying ‘Well she explained herself but that still makes me want to shit my pants’.
It’s okay, we’ve all done it. And to keep any more unsuspecting interns from having these unfortunate accidents, I’ve compiled a list of tips, tricks and advice that helped me survive my first day as an intern and residency since then. I promise – they’ll help you too.
- Be excited. This is what you wanted to do, right? You will be tested day in and day out but it’s important to remember why you’re here in the first place.
- Smile. The last thing a sick patient wants to see is your irritated face at having to get up at 5 AM or to hear about all the extra work you have to do, when all they really want is to feel better. Plus the nurses will be less likely to throw out your coffee.
- Be prepared. Remember when I talked about responsibility? Well this is what I meant. Knowing your patient’s symptoms, what their Creatinine was or how they sounded on exam in order to impress your residents and attending was enough when you were a medical student. Now, it actually matters, because you knowing whether or not your patient has AKI could easily become a life-or-death situation.
- Budget yourself. Internship and residency is really a time where you learn a lot about yourself and how you operate. Your intern year is going to be demanding so why not make it easier on yourself? If you know you’re a little slower, wake up half-hour earlier. If you know you’ll finish your work too quickly, bring a copy of Washington Manual with you and brush up.
- Orders first, notes second. This is pretty self-explanatory. You can write a beautiful note but if you haven’t given the orders to make that note a reality, none of it matters.
- Listen. As doctors, we love to talk. Well maybe not if you’re a surgeon…or a pathologist. But for those of who do like the spoken word, talking is great. Listening is better. Your patients will provide you with valuable information if you just listen. Plus some of them have very unique stories to tell. And it’s not just your patients, it’s your colleagues, your support staff. We all come from different walks of life and those shared experiences are what makes us better people.
- Lean on each other. It’s okay to struggle. You’re not the only one. And when it gets too much to handle? There is help available. Don’t be shy, use them. No one is meant to do this alone.
- You want action? Go to the frontline. The best way to learn is getting your hands dirty. Need I say more?
- Ask questions. Remember, this is about your education too. How else are you going to expand your knowledge base? Yes, dumb questions do exist. But there is no such thing as a useless question. And trust me, that dumb question you just asked? All twenty of your co-interns were thinking the exact same thing. Some of the residents, too.
- Read something every day. This is probably going to be the hardest part of your job. After working for twelve hours, who wants to open a book, much less lift their own pinky finger? The only thing you think about is whether to eat or sleep or do both. I get it. I’m not asking you to open up Harrison’s and read a chapter every night. An attending once told me ‘read for 15 minutes a day and you’ll do fine’. It’s true. Spend fifteen minutes on UpToDate or Washington Manual reading on the conditions you dealt with during the day. You’ll become a better clinician.
- Don’t forget about yourself. Yeah yeah I know I gave you guys such a long spiel on putting your patients’ needs before your own. It’s a fact of life you’re going to experience those things as an intern – there have been multiple instances where I wouldn’t have eaten for over 12 hours because I was so busy. But that doesn’t mean you don’t take care of yourself. You are important as well. Take that day off to recharge. Stay active. Just because you only get time to eat a small bite, make that small bite count.
- Have fun. July 1st marks the beginning of the rest of your life. Walk into Podunk Hospital with your Littman stethoscope and while you won’t BE the best damn intern there ever was, you’re going to BECOME the best damn physician the world ever saw.
Thanks for tuning in, everyone! See ya on the flip side 🙂