I just realized it’s July… #illumedati


Hey everyone it’s Medicine Mondays again. And… I just realized it’s July… Everyone knows what that means, right?

It's July

Stock Photo from: Pexels

What does it mean?

It means it’s time for the new interns to start! However, it’s already July 2nd so that means the first day is already over.. and the first day is the hardest. For some it may be harder than others, for example if you started on the ICU or night float or trauma or something like that. However, there should be safeguards built in with someone more senior than you to help you out.

If you haven’t already, check out my prior posts:

Preparing to start residency:


Hmm, now that your first day is done… now what?

Well, you’ll get through your first week, and then the first month will have passed without you even knowing it. All of the sudden you’ll be a fixture in the hospital, only having been there a month or two. You’ll know where stuff is and how the day-to-day stuff is done. It’s amazing how fast humans can adapt to new environments.

However, there are a few things during these first few months of internship that are important.

Mental Health and Well-Being

Take stock of your own happiness and well-being. Depression is common amongst medical students and residents, and this can be set up during times for great stress, for example, intern year. Make sure you’re getting adequate rest and doing your best to eat well. However, if you feel like something is off or don’t feel “like yourself”, there may be something more there. Don’t be afraid to ask for help, see your primary care physician and maybe have an assessment from a psychiatrist. You may or may not need medication. However, as I’ve said before, the medical field is very much a “suffer in silence” culture that I really hope changes. Physician Suicide is a real problem and Good Doctors are Bad Patients.

Also, you guys need to watch out for your fellow interns. Don’t let them suffer in silence. When I was an intern, we were a pretty tight-knit group. When certain people were having a particularly tough time, we always extended offers to help. I think there will always be a few interns who are overwhelmed and will want/need your support. I felt my group of interns in particular was pretty progressive at the time, back in 2008, about starting the conversation of seeing a psychiatrist.


Changing Residencies

Sometimes we make a mistake. Sometimes you match into something and you thought it was what you wanted to do, but a month or few months into intern year and you just don’t want to do it anymore. It is true that intern year is different than being a resident or an attending in your field.  For this reason, in general, I think it’s reasonable to go into your 2nd year before deciding to change residencies. As a 2nd year resident, you will be doing less scut work and more of the nitty-gritty work of your specialty.

However, for some people, they will know within the first few months that they made the wrong choice of specialty and need to change. I’ve met neurosurgeons who switched out in radiology, internal medicine guys who switched into anesthesia, and radiologists who have switched into psychiatry. If you have this feeling that you made a mistake and definitely need to change, talk with your program director as soon as possible. This will help the program director to plan to have you leave, write you recommendation letters to transfer somewhere else, and give them time to find someone.

You should also be prepared to be flexible and help out in anyway you can. By leaving, you are putting your program into a tight spot which may require you to change some rotations around, and either do some of your call earlier or do more call. This will allow you flexibility to go on interviews and continue on to a different specialty.

Don’t burn your bridges.

The absolutely worst thing for you to do is to unilaterally find another spot without your program’s knowledge and then just tell them that you won’t be returning the following year in June, or something like that. Your colleagues that will be continuing on will have to absorb your absence with more call and your program will be scrambling to find a replacement. Medicine is a small world, and you will forever list your time at Program X as an intern year before you switched.

If/when you need a professional reference, if they call your intern year program, you want them to say “Dr. Smith was a great intern. It was too bad that he decided to transfer into specialty X, but he had to do what was right for him. I recommend him without reservation.

However, if you left your program high and dry, that call would go like this “Dr. Smith told us he was coming back for his 2nd year, during June of his intern year. He had already lined up a spot in a different specialty somewhere else — without telling us. This left a hole in the call schedule and the rotation schedule. We weren’t able to find anyone to take his place and his class had a really hard time. I can’t recommend him at all.”

To be honest, when it comes to professional references, I’m the most interested in references from jobs you’ve left, especially if they were short stints.


Don’t forget to “turn off” Dr. Jones

Long before you were Dr. Jones, you were someone else with other interests. You will get more than enough “doctor time” while in the hospital. Don’t forget to carve out time to do things that make you… you. For more on that, read this:

Mr. Smith and Dr. Jones

For a more recent example of my own, let me tell you a little story. When I was a kid, I wanted to be a baseball player, like for the LA Dodgers. I grew up playing catch with friends, played Little League, but didn’t have talent or skill necessary to play in high school, and obviously not higher than that. However, I still remember those days as a kid watching my Dodgers, although they were pretty bad for most of my childhood, aside from 1988 (Thanks Orel), when I was 7 years old. I still watched the games once in awhile during end of high school, but not with nearly as much fervor as when I was kid — I guess I got old and jaded.

During college, medical school, etc, I would watch the Cal football games, but I never really watched the Dodgers games. My fraternity did play in the Intramural softball league, so that was fun, but my love of baseball never really returned. During internship, residency, and fellowship I didn’t really have a desire to watch baseball either. Most of my life was consumed with medicine, surviving night float, and passing the boards. When I did have free time, I mostly just zoned out and watched whatever was on TV. Of course, it probably didn’t help that there wasn’t really any Dodgers games readily available in Maryland, New York, or Rhode Island.

So what happened?

Interestingly, it wasn’t until I moved to Hawaii that I found my love for the game again. This is partly because my cable provider, Spectrum, actually gets Sports Net LA, and so I get to watch just about all the Dodgers games. My son and daughter have also taken an interest in the game as well. My son more with batting and my daughter more with throwing. For right now, they hate watching the games, but I’m hoping as they get older and understand the game better, I’ll be able to make Dodgers fans out of them. Just need to buy them some hats and gloves maybe.

Before I was ever “Dr. Nguyen” — I was just a little kid who liked the Dodgers, but that little kid got lost somewhere along the way.

It took a few years and a move to an unlikely place, but I found that little kid again. He hopes the Dodgers win another World Series someday.


TL;DR

You survived your first day as an intern! Soon you first week, and your first month…

Take stock of your mental health and well-being… as well as your colleagues. Get help if you need it. Advise others to as well.

Changing residencies is hard — but if you’re going to do it, do it the right way. Don’t burn your bridges.

Before you were ever Dr. Smith, you were just a little kid with other interests — Don’t forget about who you were before you were a doctor.

 

Medicine Mondays Sensei

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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