Junior Doctors

A guide to medical internship

This time of year can be one that is high in emotion for anyone. Today I want to reach out to final year medical students who are about to start their internship. The elation of finally graduating from med school is often mixed with the anxiety of starting work as a ‘real’ doctor.

Just remember that all the other doctors around you have gone through internship, too. There will also be a lot of other interns who are just as scared as you are, or more. You don’t have to put pressure on yourself – you are part of a team and you can (and should) ask for help. No one expects you to be perfect. As someone who has been an intern, as well as a registrar who has supervised interns, I want to share with you a few things that I hope will relieve any pressure you may be feeling.

The three L’s

Don’t be late. Don’t be lazy. Don’t lie. They’re the three L’s I was told when I started my internship. Registrars are in charge of the daily running of your team, and carry a lot of responsibility, like the decision making. A good registrar should also be your confidante and mentor. Having a good working relationship with your registrar will make such a massive difference to your every day.

Get there a bit earlier to print off the patient list for the ward round so that the team can start on time. If there’s something you don’t understand or can’t do, be honest. It’s the registrar’s responsibility to make sure he or she gives you clear instructions about what tasks need to be done, so if you didn’t quite get it, it’s okay. Just ask.

If you work hard, your registrar will notice. He or she might not say anything to you but a registrar definitely knows the difference between a hard-working intern and a lazy one. No one will judge you on your knowledge or skills, but your attitude to work will be noticed.

People who can help you

The senior doctors on the team are responsible for looking after you day by day, so make sure that you ask them for help if you need it. Don’t feel silly about asking questions that you think might be really simple. Chances are, they asked the very same questions when they were in your position. If you have a bad experience at work, make sure you debrief about it. This can be with anyone, but often best to do it with a senior doctor you trust because they are experienced and can help you deal with it.

There are lots of people who work on the hospital wards. Be nice to the nurses – there are many nurses who have been there for a long time and can really give you some good tips and help you navigate the “system”. Good communication with the nurse in charge of the ward is so important. At the end of every ward round, make sure you catch up with the nurse in charge to communicate what the plan is for each patient.

The ward pharmacist is also someone who can help you (a lot!). Pharmacists scrutinise the medication charts and can inform you exactly how to prescribe certain drugs. Again, don’t feel silly about asking about dosages of medications that you feel you ought to know. It’s better to ask than to make a mistake.

We all have our strengths and weaknesses. Interns should help each other. I guarantee that there will be at least one intern who absolutely loves cannulas and procedures (because I was one of them). If you’re having trouble taking blood or cannulating a patient, ask a fellow intern or resident. Most people are happy to help you. Don’t feel bad if there’s something you can’t do. We can’t all be good at everything.

Lastly, introduce yourself to the JMO Manager. He or she may not be able to help you with your clinical tasks but they are an important resource. They allocate the rotations and often do the rostering as well. If you’re struggling with a term, talk to your registrar or term supervisor first, but if that doesn’t work, the JMO Manager is the next person you can talk to.

Patients and their families

Always put the patient first. It’s easy to get caught up in tasks and feel stressed out about the pager beeping so many times, but remember why you are there. Patients are in hospital because they are either sick or injured. They are in a vulnerable position, and in an unfamiliar place (kind of like how you’ll probably feel at the start). Be kind. Patients are people too, and I promise that whilst you might not think that you’re important, you can make a really big difference to their experience.

Patients won’t remember the fact that you forgot to order an x-ray, but they will definitely remember that day you took a few extra minutes to have a good chat with them. Families are also worried about their loved ones in hospital – if you can spare a moment or two, offer a family member a cup of tea.

Look after yourself

There are going to be good days and bad days – this is inevitable. Make sure that you debrief about your experiences. When I was an intern I kept a diary. Make friends with the other interns, and tell each other how your day or week has been. If you don’t look after yourself, how can you look after your patients? Make sure you get adequate sleep, eat well, exercise, don’t forget to drink water and go to the toilet, and don’t skip any meals. Sounds really simple but doctors do forget to drink and go to the toilet, which can affect both physical and mental health.

Some days will be hectic but you can’t run on empty petrol. I used to carry around some “emergency” food with me like trail mix to munch on just in case I don’t have enough time to go to the cafeteria. On Sundays it might be a good idea to meal prep for the week. An easy meal to bring for lunch is a container of salad leaves and a can of tuna. Add can to container. Done.

Work-life balance

The beginning of internship can be a very steep learning curve and you might not have the reserve to pick up any hobbies, and that’s okay. After a few weeks into the new rotation, you will become more familiar with your job and there will be time. Having activities to do outside of work is important – it gives you a mental break away from medical stuff and it may be an opportunity to make some new (non-medical) friends.

During my internship, I ran and did yoga. At the start of internship I could barely run 3km, but by July I did my first half marathon. And then another one a month after that. Having a sporty hobby has a few benefits – it keeps you physically fit, and the endorphins help keep you happy. If you have an exercise buddy, there’s your social fix too.

Lastly, enjoy your internship. You worked hard to get through medical school and now is your chance to shine. You have entered a wonderful profession that can make a difference to others.

Take care,

Miko xx

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