Hi everyone,
This time of year, every year, new interns ask how to prepare. I always begin with two caveats. First, you’ll learn most of what you need to know when you start writing notes, signing orders, and examining patients. Second, enjoy your precious time between now and internship. Find a place to live, nourish relationships, and relax.
But if you do want to get a head start, consider the following:
- Practice Core Skills: Interns’ days are draining because you face so many new challenges. You can preserve mental energy by mastering core skills so they become second nature. For example, consider practicing EKGs, ABGs, and CXRs. Explore online POCUS modules. And begin learning your ACLS algorithms, so when you arrive for orientation, you can fly through the ACLS course.
- Plan for Presentations and Notes: As interns, you will need to communicate cogent histories, assessments, and plans. Prepare for success by adopting a consistent, streamlined approach to oral presentations and note writing. At Yale, we use 'The Yale Way,' which is, to be honest, the same approach used at most places.
- Consider your own learning needs: Each year, Dr. Savage prompts our incoming interns to assess their personal learning needs. We all have strengths and weaknesses. Some of us are comfortable choosing antibiotics, others less so. Some of us have already memorized Winter’s Formula, while others are now frantically looking it up. Honest self-assessments invite us to focus on areas where we need to grow.
- Plan a study strategy: You will learn much of what you need to know at the bedside, but you also need to study. Besides reading about your patients, set time aside to work through study guides like MKSAP, review topics on UpToDate, and keep up with the literature using resources like NEJM Clinician. I also recommend signing up for email alerts from core journals like the NEJM, Annals of Internal Medicine, JAMA, and JAMA Internal Medicine. For those of you who learn by listening, consider tuning into The Curbsiders and Diagnostic Atypia, which are produced by Traditional Internal Medicine alumni Mike Arcieri and Andrew Sanchez.
- Create a Wellness plan: To succeed as interns (and in life), you need to take care of yourselves. Don’t neglect the pillars of wellness: healthy eating, sleeping, exercising, and socializing. For those of you with physical and mental health needs, start planning how you will transition care (our GME office can assist with referrals). Also, find a nice place to live, ideally close to the hospital if that fits your needs, so you can walk or bike to work and be near friends and colleagues.
- Reflect on your values: As you wade through the tasks and minutiae of internship, you can easily wonder how or why you chose this profession. Plan for this challenge by defining your values. Why did you become a doctor? What do you hope to accomplish? What would a successful internship look like to you? What matters most? Create a personal mission statement to return to if and whenever you’ve lost your way.
- Turn outward: The transition from student to intern marks a shift of focus. Suddenly, patients, staff, and colleagues depend on you. Successful interns turn outward, prioritizing the needs of others. They return to patients’ bedsides in the afternoon to give updates, answer questions, listen to concerns, and offer encouragement. They check in frequently with the nurses. They help overloaded colleagues, and they bring in coffee and donuts for the team. These instincts will come naturally to most of you, but they’re especially important to remember when you’re tired. At Yale, putting others first is at the heart of our motto, “as good as any, nicer than most.”
You will all thrive as interns, and you are already well-prepared. The first few weeks will be especially hard, but having taught interns for over thirty years, I know you will succeed if you bring emotional intelligence, a good attitude, willingness to work hard, and a healthy dose of humility and commitment to growth. All of which is to say we can’t wait to see you on the first day of orientation, just 39 days from today…
Enjoy your Sunday, everyone. I’m headed out for a bike ride on the Farmington Canal. Tomorrow I start a seven-day stretch on MICU Green.
Mark
P.S. Thank you to Dr. Gupta for organizing our incredible Educational Half Days at the Yale University Art Gallery.
P.P.S. What I’m reading and listening to:
- AAIM Recommendations for Undergraduate Medical Education to Graduate Medical Education Transition Curricula in Internal Medicine By Lauren M. DiMarino et al.
- From Mission to Margin in Academic Medicine — The Impact of Corporate Medicine on Medical Training By Jatin M. Vyas
- Why the A.I. Job Apocalypse (Probably) Won’t Happen By Ezra Klein
- The Secret to Success Is ‘Monotasking’ By David Epstein
- Profound Autism Is Difficult Enough Without This Debunked Method By Amy S.F. Lutz
- What to know about rip currents after a Connecticut father died saving his son By Christine Dempsey
- Your Passwords Are Probably Screwed By Brett J. Goldstein
- The Last Moments of Flight 2216 By James Glanz, Mark Walker, John Yoon, Mika Gröndahl and Pablo Robles
- Wolfram Goessling: Lessons from the Other Side of Cancer on Health & Veritas With Howie Forman and Harlan Krumholz
- A Thousand Splendid Suns By Khaled Hosseini