Intern year went by so fast! But I only say that because it’s over now. Hindsight is very different than the day to day struggle. While it was happening, it felt like it would never end. It was such a struggle to do the work well, read everyday, still take care of myself, call my family, entertain relationships, explore my new city, exercise, etc.! Hence why I fell completely off of the blogging ship. Sorry guys, I’m not perfect. During the second half of intern year I was unloading in different ways and not turning to writing like I used do. I was still doing YouTube but then I even fell off with that. I lost interest. My time was getting so stretched, and even on the days when I had the free time, I spent it with people or I just wanted to binge Tiger King or Dead To Me. I’m back now, and intern year has taught me a TON, medical and non-medical. I’m going to share some of those lessons with you all! Honestly, just the tip of the iceberg.
1. You are a learner
You have 3 (or 4-7) years of residency to make mistakes, ask questions, get things wrong, look stupid, etc. before you are the boss and people are looking at you to have it all figured out. At the end of the day, we are here to learn. You shouldn’t feel bad for not knowing something, or not being as efficient as another resident. You should take it as a challenge to get better. I notice the difference in the caliber of upper level residents who take advantage of learning opportunities, and push themselves to read about their patients, compared to those who decide to take chill pills all year. Those geniuses didn’t get so smart overnight, and they aren’t any different than you and me. We just have to put the work in as learners. This lesson came to me later in the year as I was watching all the senior residents land jobs and prepare for their careers. After residency, that’s it! No more excuses. So I have to take advantage of this time to sharpen up and learn as much as I can.
2. Better to be confidently wrong than quietly right
In both inpatient and outpatient settings, whether you are one-on-one with your attending or in a team, you have to be comfortable with your voice. Which means you have to find it first. And then you need to get comfortable with correction and redirection. Residency isn’t like medical school when you can fly under the radar and just study and take your tests. Patients are at stake. If your attending poses a question to you, you should at least take a stab at it (unless you honestly have no clue). If you’re wrong, it’s not the end of the world. You’ll even learn more from the teaching you get afterwards. Maybe it’s just me, but I realized that I was learning more the more I spoke up and expressed my thought process out loud. Trust me though, I know when to keep quiet haha.
3. No one knows the work you’re putting in if you don’t tell anyone
I got this from one of my attendings. Actually I think 2 different ones told me this in feedback during inpatient rotations. They would say I’m sure you’re reading at home because you’re thoughtful in your plans, but you need to share that more explicitly with the team on rounds so that I know specifically what extra work you’re putting in. During rounds it’s so important to slip in things like the evidence behind a certain therapy, or the protocol that another big hospital uses for treatment, etc. it shows that you are critically thinking about your patients, and it’s educational for your team. One of the pillars that we are assessed on is evidence based medicine, so you have to make it clear that you are applying that to your clinical decisions. Don’t expect your attendings to assume you’re reading at home, and they of course won’t record evaluations based on assumptions.
4. Stress isn’t going anywhere, you have to learn how to deal with it
If you thought medical school was stressful, residency is coming to give you a run for your money. Intern year was just back to back onslaught. Mine was at least. We only have one outpatient month out of 12 rotations. For the most part, it’s 4-5 days off a month; vacation scattered around if it’s properly planned for. When you’re in the thick of it, especially when your efficiency hasn’t built up yet, it is stressful. You have to have an outlet for it. Whether it’s family waiting on you at home, or exercise, or getting drinks with a friend, reading, shopping, building stuff, something! My outlets changed throughout the year. The gym was huge until they all closed. I ran outside until it got too cold/hot to. I’d go out with friends until everything closed (now slowly opening up!). Then came along a new relationship, so I relieve stress by talking to bae. I went on small shopping sprees buying stuff for my place after a rotation. If a particular week was stressful I would take a bubble bath. When 2020 started I got a membership at a massage/facial place and have monthly appointments there (paid for with my HSA!). Most recently I started jumping rope, which requires so much concentration it takes my mind off everything. So I’ve done different things to give my brain a break and take care of myself. I wouldn’t survive if I didn’t put my sanity first.
5. Teamwork makes the dream work
You are not alone. In clinic you have nurses, social work, pharmacists (we have our own pharmacy in my clinic), other residents, and more who you can turn to in addition to your preceptor to help you take care of you patient. On the wards you have nurses, physical therapy, respiratory therapy, nutrition, speech therapy, case managers, and more to help you! Not to mention your team of residents, pharmacist, and attending. It can be daunting and often you feel like alone, but I had to constantly remind myself that I was not!
Bonus: Everyone has their own style
You learn this lesson very quickly intern year. Every attending has a different way of doing things. Different teaching styles, different ways they want you to present or write your notes, different style of practice, etc. Some are conservative, others are liberal. Some are evidence based, others more anecdotal or cutting edge. It’s important as an intern not to get sucked into each person’s way. You can do what they want sure, but in your mind you should be cherry picking those traits and clinical styles that you like and slowly creating your own style of practice. I’m working on that a lot now.
Alright, that’s all I got. I have a 24h shift tomorrow on our Mom/Baby service, so I’ll be looking up the patients on the list before heading to bed. Second year is off to a busy start! Wishing you all the best. Stay safe and wear your mask!