Surviving a Medicine Intern Year as a Non-Medicine Resident
Written by Ankur Parikh, MD
The prospect of being an intern is daunting for all graduating medical students, but it can seem especially challenging for those who intend to eventually join another specialty altogether. Many rising interns will have done few, if any, internal medicine rotations as fourth-year medical students. Instead, most focus on their desired specialty early in the year and towards the end enjoy the last few months of medical school. As I reflect on my nearly complete preliminary internal medicine year, there are a few things I wish I knew before starting. Here they are, in no particular order:
1. Don’t worry about not remembering “the basics” of internal medicine.
For better or worse, nothing can really prepare you for intern year, whether you completed three acting internships in medicine as a fourth-year, or zero. Moreover, this process occurs every single year. Every senior resident was in your shoes not long ago, and every attending has guided countless interns through the same process. Nobody expects you to know how to do it all on day one. Remember that in the typical medicine team structure, most major medical decisions are made by your senior and attending. However, there are a few things they will expect. Show up on time, be efficient, be a team player, and be teachable. As an intern, a positive attitude >> aptitude.
2. Find a system as quickly as possible and stick with it.
Pre-rounding, presentations, sign outs are things that took me quite a while to feel comfortable with. It’s completely normal to feel overwhelmed by these things, but try and approach it systematically. Build your routine bit by bit. On your first couple rotations, ask your seniors what their system is. Everyone has one, and it just takes finding one that fits your style. By the same token, try not to constantly change your system as you progress through the year. You’ll be far better off, especially as a prelim, sticking to one that works reasonably well for you. You don’t have to be the best resident in the building, but as mentioned above, do what you need to do to take care of your patients each day. If you do this, 3-4 months into the year, your routine will become natural, and it will make even the earliest AM sign-outs much less stressful.
3. Get to know your categorical medicine colleagues.
Some of my closest friends are PGY-1 categorical residents. Categorical, preliminary, or transitional; you’re all in the same boat. There is a sense of camaraderie in going through it all together. Especially if the days are long, walking in excited to see your friends can make all the difference. If you’re sticking around the same institution, it’s even more important.
4. Look for relevant take-aways.
Every time you sign out at the end of the day, try to think of one thing you saw or learned that’s relevant. It may be a clinical pearl, but more often than not, I found it was actually the non-clinical knowledge. Your medicine colleagues are some of the best in the building at dealing with difficult situations, and you can learn so much from them. Delivering life-altering diagnoses to patients on a heme-onc service or reasoning with an upset patient are experiences that are universal.
5. Remember what you are working towards.
On the longest days on the wards, or when you’re calling down to the emergency department for your seventh admission of the night, these tips will seem irrelevant. In those moments, remember what you’re working towards. You’re so close to doing what you want to do for the rest of your life.
Good luck to everyone starting their intern year, and please reach out if you have questions!
