Medical school feels like yesterday. Cliché- right? Now I am the medical intern with groups of 3-5 students who eagerly ask questions about topics I sometimes barely remember.
I remember how I felt, how I used to think interns were such a faraway ahead of me, not only in knowledge- but in experience. Turns out I was kinda right.
Internship allows you to put your book knowledge into practical use, in a way that medical school didn’t allow us to. A friend of mine, who is a year ahead of me, messaged me about one month into internship and asked me
“Do you still think the only difference between a 5th year student and an intern is one test?”.
…Which was something I obviously said to him snobbishly as a final year student while he was my intern.
The truth is, there’s more between a final year student and an intern than just a simple examination- this, however, isn’t necessarily a good thing. As the last 2.5 years of medical school are supposed to be an apprenticeship, which means we are being prepared to work as interns and ultimately, doctors.
So let me tell you how it was…
I started on July 1, 2019 as an Internal Medicine Intern, my most hated specialty. I had no talent in it and could never remember the drugs, what they were for or what their doses were!
I was lucky enough to be apart of a team that was supportive and facilitated learning and thinking. I fondly remember playfully arguing with my medical officer and senior resident about the management of a patient and why we should do x instead of y. An environment was created where I could challenge my peers and seniors without fear, because at the end of the day- we were all practicing medicine.
Not only did I get to be a part of the discussion, but oftentimes my plan and suggestions were taken, and when they weren’t we spoke about why. There was never a day that I didn’t learn. By the second month, I knew doses and regimes like the back of my hand, I could manage cases all on my own if I needed to (I never did).
Eventually, I began to love it. I felt like every day I was solving a puzzle, putting pieces together with histories, examination findings, and investigations… it all turned out like a Disney movie, and I loved it. I love internal medicine. A sentence I never thought I would say.
I won’t pretend it was all good, looking back, all the negative experiences never really came from the specialty itself, but from how underresourced our healthcare system is, often to the point of frustration… It’s the desire to practice first class medicine but being unable to do so.
But… You become resourceful, think of ingenious solutions to what seem like impossible situations.
Be on time. A few members of my team came to work a few hours earlier than needed often to get on top of the work or avoid human traffic and literal traffic. So it’s either being early or on time. The interns cover the ward and we really do run the ward rounds. Give yourself enough time to gather the outstanding results, take off important labs and possibly see patients before your rounds.
Know your patients. On ward round days, I realized seniors didn’t really care if you had seen everyone by 8 or 9 am (though it’s nice to do so) because they would be seen again by the senior during that time. What they did care about was whether or not you were able to answer pertinent questions quickly and confidently so decisions could be made. This is where having the most recent laboratory results on hand became necessary and knowing the series of events and the history of why the patient was there came in handy.
Ask questions. In medicine, you will always have someone to discuss a case or proposed plan. Your seniors oftentimes remember being interns and remember not knowing everything. You will usually find that one senior that you’re comfortable with asking anything, no matter how small or dumb you think it is. A friend of mine said her attitude towards internship is that she knows nothing, and the year is aimed at learning and gaining as much experience as she can.
Build rapport. Rapport can make life at work so much easier. It’s not about being friends with everyone, but it’s about being respectful and taking the time to learn names, from janitors, personal care assistants, nurses, lab technicians and doctors.
Always discuss your patient. At the end of the day, you’re an intern. Always talk up, always ensure that a senior is aware of a patient. Sometimes we might miss things simply because we’re not looking for it. It’s always nice to have a senior take a second look because it helps you, not only, cover your bases but it also gives you immediate feedback on your work.
Teach the students. You were a student once, you’d be amazed at the things you can teach them. intricacies about examinations, how to discuss topics, how to answer with classifications. Teach them, even if it means just watching them do an examination or listening to them present a topic.
Read. Reading now is so much more exciting than in medical school. I have found now, with the practice, topics I had to read 5x to remember stick because I saw it. Topics I read and didn’t understand make sense now that I’ve seen a patient and reviewed the material. I’ll be the first to admit that reading is difficult while working- but it’s not impossible.
Always document. Documentation protects you, protects the patient, protects the hospital. If it’s not documented it didn’t happen. It also makes managing the patient easier when you’re gone and someone else is seeing them. Always put date and time and the patient’s name and registration number at the top of the page as the bare minimum.
The first three months as a doctor came with a lot of mental and emotional growth. I’m looking forward to the next nine months and all the learning to be done! When I think of this year of internship, all I can think of is this phrase, from one of my favourite movies, “Si se puede!”.
Samantha C. Johnson
Thank you Dr. R. for taking this fantastic picture of me in my MONDAY shirt!