Intern year is truly a rollercoaster ride. Each July brings in a new wave of freshly minted doctors. Relief from being finished with the rat race of medical school coupled with trepidation of residency and responsibilities can lead to a jumble of emotions for new interns. With having recently completed my own intern year and having made it out alive (some might even say happy and healthy), allow my reflections to guide and comfort you throughout the year. Buckle up!
Rely on the nurses
Intern year starts roughly for just about everyone. I started out as a solo intern on a complicated inpatient oncology ward. With no senior resident to turn to, I relied heavily on the nurses’ expertise for these highly specialized patients. I frequently would discuss cases with nurses fueled by questions such as “How is this normally handled?” or “Does this plan sound reasonable?” Additionally, I learned early on to get to the heart of questions brought forth from nurses. Questions such as, “Why is this issue being brought up?” and “Is the patient concerned or are you?” and even “Is this an FYI or a request for help?” helped sift through different communication styles among staff. These distinctions allow young interns to learn from clinical experiences of seasoned nurses. It instilled a sense of teamwork between me and the other medical professionals. They became my lifeline. Nurses truly are the vital signs of a hospital floor and should be used for the wealth of knowledge and aid that they can offer.
Support your peers
Medicine is unique in that the progression in career is step-wise and fairly simultaneous amongst physicians as they transition from medical school to residency to attending level. The PGY-1 year allows interns to step back from a go-go-go and goal-orientation mentality that permeates medical school. Likely, this is simply because it is hard to maintain this mentality when all efforts of interns are centered around trying not to drown. With this new mentality, lean into your peers. You’re in a profession which occurs in waves, so everyone feels just as nervous and unprepared as you. Turn to your colleagues. Intern year can be difficult emotionally; don’t silently drown. It is brave to ask for help when you need it. Allow your peers to lend a helping hand.
Trust your seniors and attending
Around the halfway mark of your first year, you may feel like you’ve hit your stride. You have managed most major conditions resulting in hospitalization. It’s easy to develop a confidence, which is a well-deserved respite from the first few months of struggle. Interns surface and think, “Hey, I’ve got this! I can do this and remember to breathe!” This is a wonderful sense of accomplishment—protect yourself from this turning into arrogance. While it is important to develop your own style of management and sense of ownership and confidence in yourself, don’t let this prevent you from listening to your seniors and attending. Continue to learn from those who are more experienced than you.
Use your strength as a novice
Long hours on the wards hunched in front of a computer and responding to the ever-present beeping pager can wear down even the most positive person. Interns are lucky in that with everything still being relatively fresh and new, hopefully any sense of jadedness has yet to settle in. Use this to your benefit. Be the fresh pair of eyes on the patient who has been admitted eight times in the past year. Be the fresh set of ears for a chronic complaint from patients. This fresh perspective can help lend fresh solutions. For personal burnout prevention, I do recommend all of the stereotypical tips (i.e. eat healthy, exercise, sleep). But at the hospital, days get long. My best protection against burnout was maintaining curiosity. Pick one new thing about each patient encounter to learn from (and if you’re really good, write it down). For example, this might be an odd comorbidity that isn’t commonly seen in patients with heart failure. Read a brief article about it. Maybe it’s a drug you rarely see on a med rec–look at its side effects. Maybe the family has wacky interpersonal dynamics and you get some interesting human behavior insight. As cheesy and cliché as it is, every moment truly can be a learning experience if you let it. Remain curious.
Intern year is a year of mountains and valleys, full of failure, forgetting, and dreariness followed quickly by success, learning, and elation. Wallow in its instability and allow it to let you grow into a wonderfully dynamic physician. I promise you’ll get to the other side glad you tackled the ride.