How do I get the most out of it?
Spent the last decade trying to find balance between “medicine as a passion” and “medicine as a profession.”
MD general medicine on my way to the UK.
As an intern there is a world of information, clinical materials and skills that are out there for you to learn. It can be daunting and downright terrifying for you to approach this ginormous list of things. I mean, after all, you are now treated as full fledged doctors who are supposed to know everything, so how can you possibly admit to not knowing so many things?
But before I tell you about what to do during your medicine posting as an intern and how to gain the most out of it, let me tell you a few things about internship. When I was an intern, I did not know these things. I was an idiot. More likely than not, you will also be an idiot. But here are some things you should know which will make you less of an idiot.
It’s okay to be an idiot.
You can’t possibly know everything. Not now. Not fifty years down the line. If you ever meet a doctor who tells you he knows everything then you have my permission to punch him in the face. Telepathically, of course.
Your biggest task as an intern is to accept that you don’t know a lot of stuff. Once you accept that, learning those things becomes easy. You’ve already come past some of your toughest years in this profession. So things will mostly go uphill from here. Mostly.
Being at the bottom of the food chain sucks.
When I became an intern and put on my stethoscope and white coat and went to the wards on my first day, I had this inflated feeling that I was going to go in and change lives. I didn’t even uncap my pen that day. I just pushed wheelchairs, took samples from one end of the hospital to the other and escorted some VIP patient to the rest room. It was terrible.
But you gotta start somewhere. And the bottom is where you learn the most. Interns understand the inner workings of the hospital better than anyone else. Trust me. Your unit chief couldn’t run a urine sample in twenty minutes if his life depended on it, but I bet you could. You have your own super powers. To you, they may not be very significant or life changing, but trust me, you’re making a difference.
You don’t believe me? Call up your residents right now and tell them you’re going to be taking a break for just a couple of days. I promise you they’ll tell you how much they need you. Or they’ll threaten you. Residents can be ruthless sometimes.
Accept that your time is not yours.
I am sure that this is not going to be a popular point, but just hear me out. A hospital runs on autopilot 99% of the time. All the workings are necessary but it's boring and mundane. It's during that 1% that all the interesting stuff happens. Fights break out in wards. Patients crash. Relatives create a ruckus. These are the things that you don’t want to miss.
During your major postings, do yourself a favour and try to spend as much time in the wards as possible. I promise, you’ll get to experience, or at the very least, witness, some incredible things.
And when you’re called at ungodly hours by your residents, please don’t be rude about not coming. Yeah if you have a legitimate reason to not show up, it's cool. But most residents are not sadistic people who wanna just call you and make your life hell. They wanna leave and have some time to themselves too.
Yeah that’s it. These 3 things, if you can internalise and practice, will make your internship feel exciting and not just chore. Now onto medicine!
Medicine is huge. And interns in medicine are indispensable. Some of my worst weeks as a resident were the weeks when I had no interns to help me with my work. Conversely, some of my best weeks were weeks when I had interns who shared my passion for the field.
So, as an intern, the best way to squeeze everything out of your posting, is just to be present. If you’re just willing to be around your designated resident and volunteer to work, I promise you, you’ll learn a ton. The commitment and initiative go a long way.
And I know that doctors love lists, so I’m going to give you a list of things that you can do.
On admission days, stay as late as possible. In some hospitals, it’s normal to be expected to stay 24 hours. These are the days that you will learn the most.
When a new patient comes, volunteer to see the patient and try and come up with your own diagnosis before your resident sees them. Or go and see the patient with your resident and discuss the case with them. You’ve learned a lot of theory, but putting it into a real clinical situation and interpreting a cluster of signs and symptoms is a whole different ball game.
It you have to leave medicine posting with a single skill - learn how to establish IV access and draw blood. Its empowering.
Theory is good for discussions but your postings are about practicals. If you want to study something during your posting while you’re waiting around in the wards - study ECG and Xray interpretation. Confidently reading an Xray or ECG in front of your peers is a whole different high on its own.
You want to do procedures? You have to be willing to stay after hours and get uncomfortable. Procedures happen when things have settled during the day and so if you want to do them or even watch them, you have to wait for the bustle of the morning to settle.
Talk to patients and their relatives. Sometimes work load gets overwhelming and patients become little more than pages in the files we have to fill. But medicine is about the stories. You see just a tiny bit of the ice berg. Listen to them and understand the troubles that plague your patients. It’ll teach you empathy (arguably the most important trait for a doctor.) Even one patient a day makes a world of difference.
Learn to communicate. Communicate with your peers, your seniors, your faculty and your unit chief. There is a different way to approach every kind of person you will meet in your life, and the only way you’ll learn how to go about it, is actually by doing and failing and learning. Don’t shy away from people. Medicine is a team sport. You cannot do anything by yourself, so learn to work well in a team.
That’s it. If you can do these seven things in varying degrees on a daily basis then I promise you that your internship in medicine will be super fulfilling. And honestly, I think the same holds true for other departments as well. Try your best to be a good addition to the team.
Before I leave you, I just want to touch on something small but significant. What if you don’t like the subject? Like, what if you just don’t like medicine? How can you enjoy medicine internship then? In these cases, I urge you to forget your biases and just drown yourself in your work. Most of our biases are coloured in by our experience with theory and terrible class room teaching. Real practice is far from that. Give yourself a chance to be a part of that experience. Don’t sabotage your own future with preconceived notions.
Internship is a beautiful year of your life. You get exposed to the whole human body and the whole hospital. This is the last time in your life that you’ll get that kind of freedom. After this, you’ll be confined to one speciality or subspecialty. This power to go anywhere and be at home there is short lived. It's your hidden talent. Cherish it and gain the most out of it.
Comentarios