I was reading a blog post from attending who had been Intern of the Year at his program in residency. He gave a list of instructions on how to follow in his footsteps and be Intern of the Year. I'm not going to link to it here, because then you'll all read that post instead, but basically he said some things that were good ideas and other things that were borderline insane.
The thing is, many of us have no desire to be Intern of the Year. Especially those of us who are going into cushy sub-specialties. All we want is to go through the year without losing our mind or killing anyone. Therefore, I present:
How to NOT be Intern of the Year (yet not kill anyone)
1) When your work for the day is done, LEAVE. Don't wander around the hospital, looking for people who might be coding. Go home. Sleep. Smell flowers.
2) When there's a code on a patient, don't run to the code. Walk. Possibly in the opposite direction. No person's life was ever saved by an intern. Your presence in the back of the room, squished up against the wall, isn't helping anyone.
3) If a clinic patient turns out to need a procedure like an injection or a pap smear, schedule it for the next visit. Preferably after you've graduated.
4) Patients' families are like the plague. Avoid them or at least sequester them in a plastic bubble.
5) Whatever your patient wants, give it to them. Arguing with a patient who wants pain medication takes a lot longer than just giving them pain medication.
6) When it's lunchtime, eat lunch. When it's dinnertime, eat dinner.
7) Don't work-up chronic conditions on inpatients, no matter how "interesting" they are.
8) When starting a new rotation, do absolutely nothing to prepare for it. You'll figure it out eventually.
9) By the time rounds are over, you've seen your patient twice. Do not see your patient again for the rest of the day unless forced. And even then, try to get out of it.
10) Block consults with every fiber of your being.
I swear, many off-service interns on the OB service did just this... ;)
ReplyDeleteAs an intern who just started a surgical rotation, let me add one more:
ReplyDeleteNever volunteer any information more than absolutely necessary when rounding with an attending. That info will always earn you more work which will do absolutely nothing to better the patients prognosis.
I completely disaggree with n.5, all the rest are spot on!
ReplyDeleteLove your blog! I'm always on the lookout for good physician blogs - mind giving us the link now that we've all read your post? :)
ReplyDeleteActually, I originally wrote this 4-5 years ago. Your guess is as good as mine where that link is.
DeleteHere's the link: http://scalpelorsword.blogspot.com/2007/07/work-hard-succeed.html
DeleteGoogle is a pretty good guesser.
~Jasmine
Jasmine: I'm actually 99% sure that wasn't where I got it from, especially since I don't think I've ever seen that blog before. The one I used was a numerical list, which was why mine was a list.
DeleteI flew home to help advocate for my mother when she had a stroke that gave her speech difficulties. She was in a teaching hospital, no one (interns) would make eye contact with me, one neurologist walked around like he was God - then let the elevator door close on me right before I walked in. By the time she had moved to rehab - I despised every one of those doctors and those in training. However, I had a good relationship with every nurse and OT/PT there. They were the ones that truly helped my mom anyway. I witnessed the most boorish behavior (barging in while she had a sponge bath, etc.)from doctors - this post brought it all flooding back.
ReplyDeleteAmanda
I can see why it would bother you that I think interns should eat meals like actual human beings. Or leave at the end of the day.
DeleteThe truth is that most of the behavior that makes you "intern of the year" is just kiss up stuff that won't help your patients a bit and possibly encourages the behaviors that you found distasteful.
Loved this list! For #5 though - feeding the junkies will just make you more popular with them, and create more work for you.. It's better to give them a prescription for something they'll hate (a non-narcotic) then run away before they decipher your handwriting. ;) (Admittedly I'm a pharmacist, not a physician, but I think that would work as a get-away policy! )
ReplyDeleteAh, number 1 is outdated. Interns these days work shifts. When their work is done, they sit around looking at the clock, hoping the next admission doesn't come before 5. Some of them do wander around looking for stuff to do, which usually involves playing videogames with the patients (I'm in peds).
ReplyDeleteInterns in Canada still work the old school way. I would also add, from a Canadian perspective, when you're post call leave at the exact time the contract says you can, leaving a handover note in the next day's intern's locker if they're late.
ReplyDelete