In Jamaica, final year medical students have to apply for internship months before completing final exams. Internship starts only a few weeks after final exams are completed and results are given.
Many medical students have in their minds from the start of clinical years, where they can see themselves doing internship. The only issue is that the medical student experience and the intern experience are well… two vastly different experiences.
One of the best ways to make this decision is to rotate through as many hospitals as you can, of course, hospitals such as Annotto Bay don’t accept students (to my knowledge) but do accept interns. Along with going to the hospitals themselves, another must do is simply asking around.
Ask other Juniour doctors what their experience was like- this is not a question for consultants and SRs! In fact, I think the best persons to ask are current interns or persons who just completed internship… sometimes after a while I think we may misrepresent the actual hardships and struggles of internship with our nostalgia- just my personal opinion though… lol
Here are some things I think should be considered when making this decision and questions that should be asked.
Look at your overall life
Internship usually only lasts 12 months, but it becomes an important decision to make. Often times, persons who start internship in one hospital or region tend to stay in that hospital or region throughout their career. This shouldn’t be daunting because I think it’s often by choice.
When I say look at your overall life, I mean exactly that. Consider your expenses, your family life, whether you want to move back home or stay somewhere else. What is the cost of living and so on. Persons who may be more focused on earning and keeping cost of living low will benefit from going to more rural locations- but this comes with added workload and limited resources and facilities. Maybe you want to move back home and live with your parents, so apply to a hospital closer to them. These are all considerations.
Now, there is no way to go around it, the workload at some hospitals is more than at others, but that’s not the only consideration. Some hospitals or departments have expectations of attendance, whether it is 6 or 7 days of the week and unfortunately, some of those days are unpaid. (That is a tragedy and a discussion for another day- we press on). Knowing these realities, you have to ask yourself an honest question… how much work am I willing to do (and sometimes for free).
The reasons for the workload are varied, it can be attributed to patient load, hospital size, limited number of staff or a mixture of both. Increase workload does sometimes result in increased experience, practical skills and if you can find the time to read, book knowledge. However, you’re at an even higher risk of burnout, exhaustion and just overall feeling completely miserable. The saying “it’s just 12 months” has been the mantra that has kept several interns going!
The Overall Experience
What do you want to get from internship? This is something only you can answer. If you know what you want to specialise in its always best to go somewhere where you can get experience in that speciality but also make an impression with the consultants within that profession so you can get solid recommendations when the time comes.
Do you want a well rounded experience with teaching and practical experience, you might want to stick to hospitals that are teaching hospitals, but still have interns do a lot of practical work too. Usually this means avoiding places like UHWI who have so many residents that gaining practical skills will take a lot of effort and being deliberate on your part… maybe even a little pushy.
There are so many considerations with this one, some hospitals allow interns to rotate outside of the primary 4 rotations and that oftentimes is a valuable experience for those who want to explore subspecialties before becoming Senior House Officers.
No matter where you go, internship is going to be a difficult and challenging time. For many of us, it felt like a hazing process and there is really no way to sugarcoat this. You’re oftentimes thrown into the deep end and expected to swim. Even with all this, internship can be a time of learning, honing skills, creating friendships and forging a path towards becoming the physician you want to become.
If there are any other considerations you made I would love to know! I hope this helps!