It is almost July! For me, that means that I am finally entering my last year of residency (kind of – we’ll count chief year as a separate entity). For fourth year medical students across the country, it means the first day of their new job – DOCTOR. This is the time of year that you get to transition from “Hi, I’m Emily. The medical student who will be a part of your team.” to “Hi, I’m Dr. Hayes. I’ll be one of the doctors on the team caring for you this admission”. Only a little less formal. The July Effect (read the wiki page here and then do a little more research if you’re an overachiever) is a well known but not statistically proven phenomenon in medicine. Most programs have plenty of checks in place to make sure that errors are caught before they affect a patient. However, here are a few tips to surviving the start of intern year.
You all have already heard me say several times that I wouldn’t survive residency without my friends. Becoming friends with the other members of your class is vital to surviving intern year. They are the only people who will understand what you are going through. Each residency and each program in that residency is different. These are the people who will comfort you when you are having a bad day, stick up for you when you need it and commiserate with you after work. Make it a priority to get to know everyone in your year and to spend time with each other outside of the hospital. I asked several of my co-residents for tips and this was on every single list.
Be Nice to Nurses
Nurses can be your best friends or your worst enemy. And they will hold a grudge if it is the latter. It’s up to you on how it will all play out. It’s not hard to get them on your side. Care about your patients and don’t treat them (nurses) like second class citizens. After all, they likely know more than you for at least half of residency, if not more. Yes, it really is that simple.
Be a Team Player
The only thing worse than your nurses hating you is your team hating you. Remember the golden rule from kindergarten? Do unto others as you would have then do unto you? Don’t leave your team members with things to do for your patients after sign out. Don’t refuse new admissions. Don’t take a day off that would screw the rest of your team over. The list goes on an on. Basically, just be a nice person to work with.
Organize, Organize, Organize
Organize your life inside and outside of the hospital. Often, your residency will have templates that you can use to stay organized in the hospital. If these don’t work for you, make your own! As an intern, I had a template for H&Ps from my residency, a template for my daily rounds that I made and a template for my to do list that was in my planner. I also found this clipboard/notepad and this planner really helped me to stay organized.
Get a Life
Seriously. Have a life outside of the hospital. Its hard to move to a new city and start a new job. That being said, try to establish a life outside of the hospital. Join a gym, meet up with your co-interns for happy hour, go to local trivia nights, etc. Don’t let your entire life revolve around the hospital. Do things that are important to you, even if you are tired. Chances are, you are going to be varying levels of tired throughout residency. Learn to power through.
Don’t be Afraid to Make Mistakes
Everyone will make mistakes. The important part is to learn from your mistakes. I recently completed a medication reconciliation (the bane of all residents’ existence) and continued a patient’s medication at 5x their home dose. Unfortunately, since it was still appropriately dosed based on weight, we did not discover this error until almost 2 weeks into their hospital stay. Needless to say, I felt horrible. After apologizing to the family and taking the appropriate steps to rectify the situation, I decided to find a way to learn from my mistake. I continue to check and double check the medications that I am less familiar with and will call pharmacy if I have any questions. As P would say, that’s why its called practicing medicine.
You will hear this a million times during residency. As a physician, you truly are a life-long learner. In Pediatrics, we have a weekly clinic reading, journal club and TBL readings. Whatever your program’s curriculum is, try to complete the “assigned” readings. Also learn what resources work for you (expect a post on this in the near future) and learn how to search medical databases. At the same time, remember that you have 3+ years to learn what you need to know to practice in your field. It gets easier, I promise.
I manage to always get hungry around 10 AM, approximately 30 minutes into rounding. Therefore, I always have snacks hidden in my pockets. Know when the cafeteria opens and closes and always have access to food. Don’t get hangry.
I hope that these 8 tips help you survive the start of the year. For non-interns, remember what your first day was like and cut them some slack. I remember starting on nights and wandering into the 12th floor conference room check-out in a trance that can only be described as pure terror. You will survive! And to steal a piece of advice from my program, “never go down alone”. Good luck to all the interns and those that will be helping with the transition! Let me know if you have any more advice you would add to this list or any big concerns about the upcoming year below!