Let’s talk about How to be a Good Intern.

The first thing to understand as an intern… is that just about everyone else in the hospital has more experience/knowledge than you.

That makes you the most dangerous person in the hospital.

You need to be aware of your inherent limitations. At no time during your first year should you ever have no “back-up”. There should be always someone who you can call. Whether that is your senior resident, chief resident, or even an attending doesn’t matter. There are no dumb questions as an intern, only missed chances to learn something. Trust me when I say that very few, if any of the people overseeing you will get angry at you asking for help. They should know, as someone with more experience than you that even small mistakes can have huge effects.

A smart intern who thinks they know more than they do is more dangerous than an average intern who knows their limitations.

However, just by virtue being an intern places you in the unique position to learn a ton of information in a short amount of time based purely on necessity.

Your major goal during your 1st year is to help your senior residents and attendings do their work while absorbing as much information about how things are done. Real world medicine is probably more like an art than a science. Humans are complex creatures and no two humans are alike. You may think… well what about twins, aren’t they genetically the same? Well yes.

However, just as an anecdote I remember a case where a set of twins both had a CT scan, and they were essentially identical… except one of them happened to have a horsehoe kidney.

No two humans are alike, not even twins.

Just because your treatment for disease X worked on Mr. Jones, it does not mean it will work on Mr. Smith, or maybe it will work, but slightly differently. Treat every patient separately.

Try to learn one new thing everyday, no matter how simple. There are only so many days in a year, but if you have the determination to learn at least one thing everyday, this will serve you much better in the long term than reading all your textbooks back to back. If you see Mrs. Smith and she has CHF and your attending says something like, “Ok, let’s check her BNP, get a Chest X-Ray, reduce fluid intake, and heplock the IV.”

What did you take away from all that?

Well, there are a lot of things to learn, and things can definitely become complex based on renal function and/or electrolyte imbalance. But just take out a note card or type in your iPhone “BNP, what exactly is it, how sensitive/specific is it, what is its major usage?”

Then go home and read about it before you to go to sleep that night. If you can do that everyday, you will be a much better intern tomorrow than you were today – everyday. You will also be a much better senior resident to teach your interns than you would have been.

Just knowing how to do something isn’t as important as knowing WHY.

Be humble. Yes, you are a doctor. However, to everyone else in your hospital you are just a baby in a white coat. You need to be led around everywhere. Treat everyone with the respect they deserve. Trust me, I know it’s hard, especially when you’re on call and ridiculously tired and your pager is going off for the 10th time in 5 minutes and you were just trying to pee and wash your hands and the first thing you hear when you call back for the page is “WHAT TOOK YOU SO LONG?”

Take a breath.

Collect yourself, “I apologize, I had to take care of another urgent matter and called back as soon as I could.”

Take another breath.

“You have my full attention now, how can I help.”

Anger gets both you and the person on the other side of the phone nowhere.

Try to be the bigger person and de-escalate the situation. This person on the other side of the phone isn’t mad at you necessarily, they are mad at the situation. Understand that and you will feel less angry. Usually, if you act calmly and compose yourself well the person on the other side of the phone who is overreacting will come to their own self-realization that they are overreacting and apologize.

TL;DR

Don’t be overconfident. You are the most dangerous person in the hospital.

Help your senior residents and attendings.

Treat every patient separately. No two humans are alike.

Try to learn at least one thing every day and review it before you sleep.

Stay calm, especially if someone is yelling at you. De-escalate the situation.

-Sensei

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

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