Every year in Sri Lanka at least two new batches of trembling medical students nervously enter the next phase of their medical training – internship! Like clockwork, a month or two before each batch gets their appointment letters, I receive messages asking for advice and tips on surviving the dreaded internship.
Its’ not that internship is a terrible experience, but it definitely is not an easy year on the mind, body and soul. You have to be tough not only physically, but also mentally in order to survive one of the most gruelling years in medical training. You work 24/7 with little to no time off whilst also dealing with being the bottom of the food chain – everyone tries to jump down your throat.
I have written a couple of articles a few years ago when I had just finished internship with some tips on how to conquer your internship year, and you can access them here: 24 hrs a day, 365 days a year: Internship Part 1, Survival skills 101: Internship Part 2, Lessons learnt from internshipand Paperwork – the plague of an intern.
But this year, I thought I would recruit some of my colleagues and social media buddies who have been through the process and ask them for additional advice that they would like new interns to know. Read on below for some tips and tricks from my colleagues –
“During ward rounds, make sure you look at the drug chart first and omit any unnecessary drugs. Summarize all the important findings on examination and the investigations so when you present to your senior/ consultant, it is short and precise.” – Dr. Malitha Muthugala
“Always and I mean always, make sure you document orders and ensure that the time, date and maybe your initials are mentioned. Don’t be shy to ask for help! A good doctor knows when he/she needs another opinion or a helping hand. Treat each patient as if they were your family, and you will realize that you won’t go wrong.” – Dr. Andrea Harley
“You may glide through your intern year with ease or u could have a tough time , but what matters at the end of the day is whether or not you did your very best for the patient and you can stand by your actions. Also it’s not always about pleasing your consultant, but a good relationship with the whole staff is what will get you through each passing day.” – Dr. Sandamali Muthugala
“Your attitude matters! If you got a good attitude, you can thrive well with everyone in this profession. Be humble, be genuine and communicate as much as you can with patients. Poor communication leads to catastrophe. Your words can mend so much in a broken soul.” – Dr. Tharindu Lankanatha
“Respect the ward staff, always!” – Dr. Lakshan Bokalamulla
“Internship is the best part of your medical career! You’re going to hate it but once you’re done with it, you’re going to miss it, trust me on that! Here are few tips which I learnt the hard way to make your life a bit easier and smoother.
– always enter the date and time when you write on the BHT (clear handwriting if possible, especially when you fill out investigation forms)
– always inform your seniors whatever you do and document it on the BHT (this will save you from a lot of troubles)
– don’t be afraid to try out new things “under supervision of your seniors”, once you master it then go ahead and do it by yourself.
– always refer to your theory/practical notes to brush up your knowledge whenever you see an interesting case
– have a notebook and write down new things you learn on a daily basis or whenever you can
– never try to show you know it all, always be humble but never lose your dignity because you’re a doctor already! Every time you have some free time, don’t forget to enjoy!
Don’t work hard – work smart! All the best 👍🏻”
– Dr. Janith Pathirana
- The first few days, you may feel overwhelmed with the workload and the need to learn so many new things in such a short span of time. But you need to realize, everyone is in the same boat, local and foreign, and everyone started the same way, and you will learn it all, so don’t worry about being a novice initially.
- Don’t take criticism from consultants or seniors personally. Sometimes, it may be justified, at other times not. But you should realize it doesn’t reflect on you as a person, so you should take it in stride.
- Eat when you can, sleep when you can. As an intern, you’ll never know when you can get free time. So best to do it when the opportunity comes, rather than waiting till all your work finishes (it never does).
- Your co-interns are the ones you’ll be constantly in contact with, almost 24/7, for 6 months. While problems can arise, it’s best to work together as much as possible, without conflicts and to have fun while at work. Because you need each other, like it or not, to cover off weekends or to cover a few hours or exchange a night, etc.
- Advice regarding specific specialities, I think whatever advice can be given, you’ll learn it best during your appointment. But, whenever an opportunity arises for a technical skill, do take it. Even if you fail at it, it’s still a learning process.
- Also patients can be frustrating at times. Especially as they are uneducated and not very knowledgeable. But they are very grateful and you may get angry and scold them, but realize most of the time, it’s not their fault. We should treat them to the best we can, as if they are our own kith and kin, as that is what we would wish to our own.
- Remember there is no harm in taking a break. You aren’t a machine!
- If you get a district general or base hospital, don’t be disheartened. Practically, you will learn a lot more, than in a teaching hospital, where you might be mainly a clerk.”
– Dr. Keshab Mutupulle
“Practical Aspects:
- Plan to not have a place to stay at the hospital for a couple of weeks – I had to look for outside accommodation till they sorted our rooms for us and it took about a month.
- Be nice to the nurses – they can make you or break you. Be nice to everyone in general. It’s gonna be a extremely tiring so you’ll need all the help you can get.
- Try to fill out your intern diary at least once a month (you will be given one during internship). You can’t do it daily but if you keep it for too long it gets super annoying to fill up your daily hours at the last moment.
Mental Notes:
- You will be away from home for a long time. Prepare for that mentally. Lots of people struggled with this.
- You will get to come home once in a couple of months, so make sure you have people you can call and touch base once in awhile.”
– Dr. Amila Gunasena
“To the new intern,
Care, care, care! Can’t say this enough. Empathy HAS to be the foundation of medicine, and this is going to help everyone including you, and you’ll see how when you are having one of your worst days and a patient picks you up.
Work hard or work smart, whichever but UNDISTRACTED for one year and you’ll learn hellav lot!”
– Dr. Maryam Nizam
“Be nice to your nurses! They see new interns every 6 months and they know a lot!”
– Dr. Ruwani Alwis
“Try to be a nice human to everyone including the janitor. Eat whatever is available and sleep whenever possible!”
– Dr. Nuwanthi Nandasiri
“Even though internship will assess our level of knowledge and physical ability to work an learn in an absolute stressful environment, I believe everything depends on your attitude and mindset. During internship you need to be humble, willing to learn and work in this chosen SERVICE, have a strong mind to deal with the day to day trials and learn to enjoy the little personal accomplishments. If you achieve this, then you will be well respected and received by all healthcare workers and patients alike.”
– Dr. Romali Boteju
“Always give and take respect. Never expect others to respect you before you respect them.”
– Dr. Sri Sanjeevan
“Never be afraid to ask for help and remember to look after yourself!”
– Dr. Amanthi
“Don’t let the ward staff control you. Give due respect and maintain your standards as a doctor.”
– Dr. Praveenee Wickramaratne
“Don’t be ashamed that if you don’t know anything and don’t panic that you aren’t independent. You are not alone. The nurses are the best of teachers. They are super talented and experienced in judging patients . Get close with them and join them at tea time.
There may be some chronic SHOs who try to boss you around and put you down, but just ignore them. Everyone started as an Intern, it’s just that they forgot how they were during their internship .
Polish your basic history taking and differential diagnoses to impress your consultant. Always in ward rounds make a problem list and update it every day. Have a dynamic problem list including acute problems and chronic problems. Makes your life easy when presenting and you will never miss anything.
Don’t be afraid of practical procedures. Always volunteer and try because if you don’t try you will never learn – LPs, pleural taps, peritoneal taps, ABG s and even femoral lines (as long as your consultant is okay with that).”
– Dr. Ishfak Maisoor
But remember that at the end of the day, it is up to you to make the most out of your intern year. It is your year to learn, because learning after that one year isn’t always easy to come by and your responsibility is much greater. More is expected by you thereafter. So good luck junior doctors, welcome to the club! Use your time and skill wisely, don’t forget to learn from and with each other. It is definitely going to test you both mentally and physically, but hang in there – ask for help! Push through this one year and then you’ll be able to do anything at all!
P.s. Don’t forget to send me pictures of any interesting cases you may see.
