Tips for medical students entering intern year

by Elizabeth Breuer, MD

As intern year winds down and all of the giddy 4th year medical students are shelling out 200 dollars to rent that a robe for one day of pomp and circumstance, all of us interns are impatiently waiting for the fresh meat to arrive.

Having just experienced every single emotion under the psychological rainbow this year, I am going to give a few pointers (or not really pointers but just some anecdotal evidence that it’s ok to feel the way you’re feeling). I am stupid enough to admit to all of the silly things that I did. This is not to prove that I’m an idiot, but to allay the fears of anybody who finds themselves in my shoes starting July 1.



1. You might have been a good medical student but you now know essentially nothing. You also have much more power and ability to screw things up than you ever had. This, however, is ok because you are being very closely watched by every single nurse, medical assistant, older resident, attending, even the lady who empties the trash, and you will not really do anything so stupid that you could actually hurt somebody (hopefully). You will do really dumb things though, for example, a wet prep is called a WET prep for a reason…you need to put a few drops of water on it. Somebody, not to name names, did a DRY prep. The whole point of residency is to do dumb things. The dumber the thing you did, the more likely, if you’re smart, is to not repeat the dumb thing.

2. Accept the fact that you will dumb things and you might hear about it. It might be a change from being a protected doe-eyed medical student to be paged by an older resident or attending to ask you to explain why you did such a thing. Don’t argue. Just say, I’m sorry, cry in the corner for one second and get over it. The whole point of residency is to do dumb things. You are not a bad person or incompetent because you made a mistake.

3. Having a pager sucks. The only profession ever that still uses an outdated contraption invented in the 1970s for drug dealers, residents and all doctors for the rest of eternity are given pagers which need to be worn and answered at all times. This cannot be turned off and have the potential to bring bad news at any time. However, I must add that having a pager is also something that becomes normal very quickly and grows more annoying than scary as time goes on. You might start to feel naked without the two pounds of buzzing plastic with two lines missing from the screen.

4. It’s ok to be absolutely terrified. I was so nervous when I did my first speculum exam as a resident that it took me five minutes to realize that the speculum was actually broken and that I wasn’t just a complete idiot that didn’t know how to use it. Being nervous reminds us that we are taking care of people who are sick and we shouldn’t be nonchalant about it. When I did my first delivery, I think I almost vomited. Being scared is totally normal.

5. If you are completely over your head, ask for help. Seriously, even if it might seem dumb to somebody older than you. Because, back to point 1, you are stupid and everybody knows that. Don’t pretend to be smart because that is dumb.

6. Things that seem scary will become second nature. The most awesome thing about being an intern is that while I almost vomited during my first delivery, I now am comfortable in the delivery room and can handle many different situations. Lots of bleeding, ok! Bad laceration, ok! (to a point, then same thing, ask for help). I’ve done enough deliveries now that I have fun with them. You will develop your own style and you will learn. Everybody does it. Something that helped me get through all the nerves is reminding myself that almost everybody that graduates from medical school survives residency and graduates to be a competent physician. So, if they can do it, why can’t I? You can do it too.

7. It’s ok to complain. Residency is full of sacrifice. You will miss holidays with families, weddings, birthdays, weekends off, dates with boyfriends. You will be grumpy. You will be exhausted. My advice though is to complain to your co-workers. Complaining at home and to your family doesn’t really work as well because they are also suffering your hours and your holiday-missing and they really don’t understand how much your job sucks. I have completely failed to follow this advice. Fortunately I have an understanding family and a wonderful, exceptionally tolerant husband. (And on a completely personal tangent, avoid getting married as an intern. The wedding was great but planning ruined my life.)

8. Step back and realize how totally amazing your job is. You get to help people at their most vulnerable moments. I get to use needles and knives, scissors and suture as everyday tools. I bring life into the world. Wade through all of the crap, the hurt feelings, and just appreciate how great it is to be a physician. Even though the field of medicine is changing probably to the disadvantage of all of us, there is a reason people are willing to sacrifice so much to do what we do. Medicine is rewarding, stimulating, complex and most of all, really fun. Residency is a great community and an awesome bonding experience. Enjoy it.

9. Most importantly, work hard, keep your head down, take care of your patients and take responsibility for your actions.This is by far what will get you through and all that people really expect of you. Just keep going and you’ll be fine!

Summary of the points she brings up:

1. You might have been a good medical student but you now know essentially nothing.
2. Accept the fact that you will (do) dumb things and you might hear about it.
3. Having a pager sucks.
4. It’s ok to be absolutely terrified
5. If you are completely over your head, ask for help.
6. Things that seem scary will become second nature.
7. It’s ok to complain.
8. Step back and realize how totally amazing your job is.
9. Most importantly, work hard, keep your head down, take care of your patients and take responsibility for your actions.

The last point is the most important. The worse species on earth are HOs who will shirk their duties, abandon their colleagues and patients, be dishonest in their clerking and work.

Source: here.