Survival Tips for the Intern
By: Loan Trinh Kline, MD
You finally matched into residency, it is July 1st… and you’re the doctor. It’s a big responsibility, and you’re scared and clueless. Don’t worry! Take a deep breath — everyone goes through this. Here are the tips I’ve learned along the way to help me survive my intern year.
#1 – Ask. Simple as that. When you don’t know a medication dosage, where to go to get something, or how to do something, just ask! Ask your senior (they are there to help you) or an attending (if your senior is nowhere to be found). Ask a nurse, unit secretary or a colleague. They have been doing this for a long time and would rather have you do something right the first time. Plus, this shows you’re interested and makes things a lot easier.
#2 – Make lists. Have a list of phone numbers, or know where to find numbers of all your ancillary services or consults. Most of the time, the hospital will have a website where you can obtain these numbers. Know the number for the lab so that you can call them to ask what media/color tubes you need for your labs. Know the number to the pharmacy because, trust me, they would rather have you call them to ask the correct dosage of a medication, then page you to tell you that the dosage is wrong. On a related note, answer your pager as soon as you can. I know it took me a week to get used to dropping everything to answer my pages.
#3 – Own your patients. I think the best advice I was ever given as a medical student was to own my patients. This means you should know your patients. Know their history and their plan. Be thorough and complete. Update your patients and educate them. You are the primary doctor now. This may be daunting, but you are never alone. There is always a senior and an attending.
#4 – Know your limitations. If you don’t know something (i.e lab value, plan, etc.), admit that you don’t know. It’s okay if you don’t know the answer; we are all here to learn. Do not, I repeat, do not ever lie. Once you say something incorrect, your seniors, colleagues, attending and patients will find it hard to trust you again. I’ve found the best answer to give when you’re stumped is, “I don’t know the answer to that, but I will find out for you.” It’s gold. Use it, and follow through with it. Do what you say, and say what you do. Communication is key. Again, back to #1, ask someone who would know. Ask for help when you’re feeling overwhelmed. Ask your senior or a colleague for help. They are all there to provide the best patient care as a team. Finally, be a team player and help your colleagues out.
#5 – Take care of yourself. I know we hear it all the time, but seriously, sit when you can sit, eat when you can eat and sleep when you can sleep. In the first two weeks of residency, I lost seven pounds because I wasn’t eating. I remember falling asleep shaking because I was hypoglycemic. You cannot take care of patients if you are a patient yourself. Also, use the bathroom. I know it sounds ridiculous, but I’ve met residents who have had UTIs because they didn’t have time to use the bathroom. And yes, you will get paged in the bathroom!
#6 – Read up on your patients. I know it’s hard to pick up an article or a book at the end of a 12+ hour day, but try to read a little every day. You can try reading articles, but I found that, at an intern level, it’s best to get a foundation by reading textbooks. Not Harrison’s or Nelsons textbooks, but Pediatrics – Just the Facts or Ferri’s Clinical Advisor for Medicine. Something quick and straight to the point. Once you have the foundation down, you can add to your knowledge with articles, guidelines, etc. The details come later. Get the basics down first!
#7 – Residency is work. You are finally getting paid to work, so don’t complain. If you have to vent, be careful to whom you vent because rumors spread fast and the last thing you want is to build animosity within your program. You will be working with each other for the next three to five years, so be nice to each other. Be respectful. Be a team player. Everyone had to be smart at some level to get where they are, so listen to each other. Don’t be condescending. Apologize if you’ve slighted someone. If you do have a conflict with another resident or nurse, speak with them privately. If that’s not possible, speak with your chief resident or director. They are there to help resolve conflicts. The last places to engage in an argument are in the patient’s chart, in front of patients, or in your evaluation of the program. If you have allegiance to your program, the last thing you want to do is jeopardize your program with a bad evaluation. Let your chief or director know you have a problem and give them a fair chance to rectify the situation before you put it in writing.
#8 – Smile. Yes, smile. Smiling goes a long way. Be kind to nurses, LPNs, social workers, respiratory therapists, pharmacists, secretaries, case managers, environmental services personnel — everyone you meet. Introduce yourself. Remember, you’re the new kid on the block. If you’re respectful, considerate and friendly to everyone, it will only benefit you. Those around you will be more inclined to help if they know who you are. There have been countless times when nurses have gone out of their way to place IVs or check labs when I was swamped. Respiratory therapists have called to update me on my asthmatic kids and pharmacists have corrected my orders. It is just nice to know that you are not alone.