5 Lessons from Intern Year
As medical professionals, we're often told that intern year is the most difficult year of medical training. And now that I'm on the other side of intern year, I can whole heartedly agree with that sentiment. Almost one year ago today, I began residency training at the University of Texas Southwestern Medical Center. Over the course of the year, I have grown tremendously in ways that I never thought possible. Intern year pushes you to your limits. You spend long hours in the hospital; you're subjected to the most menial administrative tasks (i.e. note writing and requesting outside hospital records); you may doubt yourself as you're constantly reminded by your seniors and attendings that you have so much more to learn. But despite all of this, I know that I have the best job in the world. I'm grateful for the opportunity to care for people during some of the most vulnerable and uncertain points in their lives. Intern year has its challenges, but with those challenges also comes rewards. Below, I highlight some of the most important lessons that I've learned from intern year. I hope that these insights will help you on your own journey through residency and beyond.
Lesson #1: Make Time for Friends and Family
Intern year is hard. You will absolutely DEPEND on your friends and family to help you through some of the most difficult and trying times of the year. Contrary to popular belief, you have more time than you think you do during intern year. If your residency program does block scheduling, be sure to take advantage of knowing your rotation schedule well ahead of time. Figure out when you have vacation time or free weekends. Take the time NOW, at the beginning of the year, to plan trips out of the state/country with family, friends, or significant others (a bit more difficult during 'rona, but still possible). Plan date nights well in advance if you have a partner or spouse. Take time to call your parents and best friends on a regular basis. For me, my friends and family kept me grounded and sane by talking about subjects outside of medicine: current news events, new musical artists, their own work and hobbies. Finding time to connect with your loved ones often motivates you to keep going during challenging points in the year.
Lesson #2: Find Ways to Keep Medicine Exciting
It's inevitable. You will get tired as the year progresses. You may also feel like the work you do goes unnoticed or goes unappreciated. As the intern--the man/woman behind the scenes--it's easy to feel like your role on the medical team is undervalued. In times like these, it becomes important to have outlets that keep you motivated and excited about medicine. For some people, this means teaching medical students. Many of my fellow co-interns and co-residents have an intense passion for medical education. If this sounds like you, take time to map out a few chalk talks that you can teach to medical students before or after rounds. Others are drawn to research. Think of a medical topic or medical question of interest, find a faculty member doing research in that area, and spend some of your free time or time during your elective working on a research project. For me personally, I enjoy spending time with patients after rounds. On non-call days, I make it a point to spend at least 10-15 minutes getting to know new patients and educating them on their disease processes. Patients are often very appreciative, and I find comfort in being able to provide them with education that enhances their health literacy, especially my patients from disadvantaged and minority backgrounds.
Lesson #3: Establish Routines
When you're operating with limited time, i.e. intern year, it's important to establish routines and consistency within your day to make sure that you get everything done that you need to. Below, I highlight some of the routines that comprise my day:
- Before Work
- Wake up 30 minutes before my actual alarm
- Drink at least 500 mL of water as soon as I wake up
- Meditate for 5-10 minutes
- Cook/eat a quick 10-15 minute breakfast
- Listen to a 5 minute flash/news briefing as I prepare for work
- During Work
- Have a consistent method for pre-rounding (whether with rounding cards or templated pre-rounding sheets)
- Get work done during rounds. This could mean placing orders or calling consults for your patients while your co-intern is rounding on one of his/her patients
- Post-rounds, have a priority system for how you complete daily patient care tasks
- Anything that is a pressing life or death concern (i.e. a code, stabilizing a patient with increasing O2 requirements or rapidly decreasing blood pressure)
- Matters that could hold up discharging a patient the same day
- Orders pertinent to patient's chief complaint/working diagnosis
- Daily maintenance requests from RNs (bowel regimens, foley placements, calls to family)
- After Work
- Work-out
- Eat dinner
- Make phone calls to loved ones, friends, significant other
- Wind down before bed (journal, read, drink tea, meditate)
Lesson #4: Find Your Tribe
This means finding your group of ride-or-dies (a.k.a. best buds) in the residency program. For me, this group of co-interns happens to be fellow underrepresented minority residents in the Internal Medicine program at my institution. Most of us met during the first week of orientation. Within a large Internal Medicine residency program such as my own, the reality is that you simply don't/can't form strong connections with everyone. That's why it's so important to have a core group of colleagues that you feel comfortable asking questions, soliciting advice, and having a good time with. As such, especially at the beginning of the year, it's important to mingle with your intern class. Go to events. Go to extracurricular meetings and opportunities within the residency program or GME department at your institution. Get a sense for the individuals that you naturally "click" with, and make those individuals your chosen family.
Lesson #5: Resist the Temptation to Compare
At the end of the day, every person in your residency program is intelligent, hard-working, and ambitious. Why else would they be pursuing medicine as a career? With so many of your fellow co-interns and co-residents coming from a variety of medical schools, social backgrounds, and even former careers, it's easy to want to compare yourself to others. Resist the urge to get wrapped up in who's doing research with whom; who wants to pursue which sub-specialty; who's gunning to be chief resident. Intern year is about focusing on how to take care of patients. Place this idea at the center of your first year of residency. When you do this, everything else falls into place. Do this by establishing goals for yourself before each rotation. Ask yourself, "What do I hope to improve upon or gain during this rotation?" Also be sure to ask your seniors and attendings what it is that they expect from you at the start of each rotation. By setting expectations early, it becomes easier to elicit feedback about your performance at the conclusion of your rotations. Make strides to grow in your confidence and management skills everyday. During your intern year, focus on competing with yourself, not with those around you.
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