Tuesday, January 23, 2018

Tales from intern year

I am now several months into intern year. The first few weeks... months... of intern year almost seemed like a daze. Wake up. Work. Eat, sometimes. Sleep, maybe. Rinse and repeat. It was only a few short months ago, which almost seems like a lifetime ago, that I was looking back at the trek through med school and wondering what loomed ahead in intern year.

Several weeks after that, I was sitting in an orientation for newly minted residents, listening through a whirlwind of talks about figuring out the EMR system, deciphering HR benefits, wellness talk by the program director, who predicted our intern year trajectory would go thusly: "first 2 months being scared s#@*less, next 2 months starting to feel little more comfortable, and the next 2 months, which puts us squarely in the middle of the long dark nights of winter, being depressed, the gloom of which will start to lift off with more daylight hours".

The beginning of intern year felt so jarring, to one day suddenly have people refer to me as "Dr. Lastname" instead of "Firstname" or "yo medstudent". Not exactly an unexpected outcome, I got plenty advance notice that was coming after 4 years of medical school. But I was so used to being either ignored by nurses or being treated as a nuisance, that when they suddenly started asking or paging me about whether to give insulin to this patient or Ativan to that patient, yeah, my thoughts at the time are illustrated above.

I remember agonizing endlessly over the smallest of decisions in the beginning. "Doctor, this patient is asking for Tylenol". "Let me call you back in 10 minutes after I do a thorough chart review to make sure I don't harm this patient with Tylenol with some contraindication that I haven't thought of as yet". I distinctly recall the jubilant moment of the first day of intern year when my co-intern and I high-fived each other after our biggest accomplishment for the day, figuring out where the restrooms were!

As months rolled on, just by the virtue of doing the same thing over and over, I started to feel more comfortable. Though I have soooo much more to learn and improve upon, reduction of that initial cognitive burden (figuring out the EMR, where the restrooms are etc.) has helped with efficiency. Some things have started to become second nature, with enough jolts to snap me out if I become to reliant on heuristic thinking.

There was something to what our program director said in the beginning of the year. We mostly followed his predicted trajectory, cluelessness --> tenuous comfort --> gloom. Which now brings me to the deep dark cold months of winter, which coincides beautifully with the peak of influenza season, everyone getting sick, chaos of finding coverage, and on a personal front, uncertainties of kindergarten/pre-K lotteries. Perhaps his predicted trajectory will continue, and when things settle down, and there are more daylight hours, gloom will lift?


  1. LOL! This transition of anxiety and independence unfortunately was six years delayed to the beginning of my first job when my name went on the pathology report. I remember agonizing over benign nothing findings forever. Cauterized anything would make me scared of what was hiding in the burned tissue that I was missing. Showing my partners everything. Once, when I discovered t cell lymphoma in an incidental heart valve, my mentor told me that I'm making him feel guilty for not looking at things too close. If a clinician called me with a question I didn't know the answer to, I would pretend I had a frozen and would call them back to give me time to look it up (now I just say I don't know let's google it!) You miss the forest for the trees, and occasionally find something. Then you get a handle on the forest and the occasional misstep will snap you back to focus and attention. I hope your gloom lifts! Great post.

  2. I remember this feeling from intern year in January oh so well. It does indeed get better in the spring, and also gets better with every year of training. Hang in there, you’ve got this!

  3. It gets better mostly when the new people come and there is someone below you on the totem pole. Hang in there. Residency is thankfully only a few short years in the grand scheme of things.

  4. I'm looking into attending med school but I'm not sure how it works being a mom. Yes there's the time constraints, but how do you pay for food and housing for your family while in med school? I don't have a working spouse to provide for me or the kids and I've heard there's no time to have a job.

  5. I remember my first day on inpatient service as an intern tentatively asking my senior if I could order my patient some miralax 😂 cheers to being halfway done with intern year!

  6. I am halfway through intern year too (OBGYN) and I am enjoying the sense of mastery starting to creep into things. I know my scope will expand in July and I'll feel like a newbie all over again, but for now I'm just appreciating knowing my place and feeling like I'm learning appropriately. I suspect the second half of the year will continue to be a relief at every stage of the process!


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