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For the new surgery interns, Congratulations! Here is my advice to you all that I wish someone had told me, when I embarked on the same path back in 2013.
#surgeryinternship
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#surgeryinternship
#match2020
#july1st
#MedTwitter
#surgeryresidency
1/
Remember you are NOT alone. A typical team can include several members (junior, senior or chief resident) PAs & NPs. Don't be afraid to ask for help, specially early on.
Remember you are NOT alone. A typical team can include several members (junior, senior or chief resident) PAs & NPs. Don't be afraid to ask for help, specially early on.
2/
If you unsure about something (orders, discharge, paperwork etc), ASK a question. Do NOT assume anything.
If you unsure about something (orders, discharge, paperwork etc), ASK a question. Do NOT assume anything.
3/
As an intern, you have the luxury of simply running anything UP THE CHAIN.
Meaning, you should ask, tell, question anything pertinent to a senior member of the team.
You shot NOT be making any decisions, that's the job of the attending/chief resident.
As an intern, you have the luxury of simply running anything UP THE CHAIN.
Meaning, you should ask, tell, question anything pertinent to a senior member of the team.
You shot NOT be making any decisions, that's the job of the attending/chief resident.
4/
Try to be an efficient intern. Write down EVERYTHING on rounds that revolves around your patients, so that you don't have to ask again.
Make a box for every task and don't forget to tick the box once the task is done.
Try to be an efficient intern. Write down EVERYTHING on rounds that revolves around your patients, so that you don't have to ask again.
Make a box for every task and don't forget to tick the box once the task is done.
5/
Get to discharges EARLY on in the day. Some patients may need lengthy discharge summaries, social work assistance, or coordinating with receiving facilities.
You want to ensure the patients that the team wants to be discharged is GONE before you leave.
Get to discharges EARLY on in the day. Some patients may need lengthy discharge summaries, social work assistance, or coordinating with receiving facilities.
You want to ensure the patients that the team wants to be discharged is GONE before you leave.
Repeleting labs should be your FORTĂ. Start memorizing some common repletion doses of the BMP and replete them once you see they are abnormal (your senior will ask you eventually, so might as well get that out of the way)
Also good to know what is the normal range of BMP/CBC/LFTs
Also good to know what is the normal range of BMP/CBC/LFTs
7/
If you have to call consults do them early in the day, since your plan may depend on the plan of other teams.
If you have to call consults do them early in the day, since your plan may depend on the plan of other teams.
8/
You want to practice being an effective communicator.
There are many teams, specialities, people, patients and their family members that you will be talking to.
Be clear and concise with your information.
You want to practice being an effective communicator.
There are many teams, specialities, people, patients and their family members that you will be talking to.
Be clear and concise with your information.
9/
Keep updating the LIST! The list is the most crucial part of the team. It's what keeps the team inorder. The list can vary depending on the hospital, but typically has the location, MRN, PSH/PMH, Allergies, Meds, Plans and any important notes that keeps the team informed.
Keep updating the LIST! The list is the most crucial part of the team. It's what keeps the team inorder. The list can vary depending on the hospital, but typically has the location, MRN, PSH/PMH, Allergies, Meds, Plans and any important notes that keeps the team informed.
10/
If you have the consult pager for whatever reason and you get a consult. Take down the pertinent information including:
Patient MRN, location
Why the consult is being sought
Hospital course.
The rest can be found in the chart.
Always thank the person on the phone.
If you have the consult pager for whatever reason and you get a consult. Take down the pertinent information including:
Patient MRN, location
Why the consult is being sought
Hospital course.
The rest can be found in the chart.
Always thank the person on the phone.
11/
If there is an OSH transfer, go to radiology to upload any scans they may have to your EMR.
Read the discharge summary (OSH transfers usually have a billion pages to go through), to figure out what was done, what happened and why transfer occurred.
If there is an OSH transfer, go to radiology to upload any scans they may have to your EMR.
Read the discharge summary (OSH transfers usually have a billion pages to go through), to figure out what was done, what happened and why transfer occurred.
12/
If there is a change in the patient's clinical status, immediately update the seniors! Don NOT sit on the information until later on.
Remember you have the Luxury to pass the info up the chain.
No one should fault you for patient not doing well.
If there is a change in the patient's clinical status, immediately update the seniors! Don NOT sit on the information until later on.
Remember you have the Luxury to pass the info up the chain.
No one should fault you for patient not doing well.
13/
If you need to update the senior but can't make contact with them, update ANY member that has more experience than you.
Typically you can call, text, page and don't forget TO GO TO THE OR to update if needed.
Dont sit around and say I couldn't get in touch with you.
If you need to update the senior but can't make contact with them, update ANY member that has more experience than you.
Typically you can call, text, page and don't forget TO GO TO THE OR to update if needed.
Dont sit around and say I couldn't get in touch with you.
14/
During rounds, try to be pro-active.
Carry dressings, tape, steth etc to make rounds easier.
Anticipate what the next patient will need such as yellow gowns for C-diff etc.
During rounds, try to be pro-active.
Carry dressings, tape, steth etc to make rounds easier.
Anticipate what the next patient will need such as yellow gowns for C-diff etc.
15/
Although your days will be long, try to set up some sort of a reading schedule.
Depending on your learning style, you can hit the major books (Cameron, Greenfield etc) or read the high yield books.
But try to read consistently specially the conditions your patients have.
Although your days will be long, try to set up some sort of a reading schedule.
Depending on your learning style, you can hit the major books (Cameron, Greenfield etc) or read the high yield books.
But try to read consistently specially the conditions your patients have.
16/
Start listening to "Behind the Knife" podcast. This is one of the BEST resource that is available for surgery residents!
They have an intern readiness course, highly recommended.
Follow them on Twitter aswell:
@BehindTheKnife
Start listening to "Behind the Knife" podcast. This is one of the BEST resource that is available for surgery residents!
They have an intern readiness course, highly recommended.
Follow them on Twitter aswell:
@BehindTheKnife
17/
For ABSITE, I recommend:
FISER
SCORE curriculum Qbank
Truelearn Qbank
@BehindTheKnife podcast
If you do all the above, you will easily get >90th percentile on ABSITE.
For ABSITE, I recommend:
FISER
SCORE curriculum Qbank
Truelearn Qbank
@BehindTheKnife podcast
If you do all the above, you will easily get >90th percentile on ABSITE.
18/
When starting a new rotation, touch base with the current intern and get a good sign out.
You want to be fully prepared to rock n roll when starting on a new service.
Makes you look good and makes life easier.
When starting a new rotation, touch base with the current intern and get a good sign out.
You want to be fully prepared to rock n roll when starting on a new service.
Makes you look good and makes life easier.
19/
Be nice to EVERYONE! Yes you are a doctor, but some people have been around forever and know more than you.
Be polite and always thank anyone that helps you.
Ancillary staff is your Ally.
Be nice to EVERYONE! Yes you are a doctor, but some people have been around forever and know more than you.
Be polite and always thank anyone that helps you.
Ancillary staff is your Ally.
20/
Putting this separately because I see how often this happens:
DO NOT PISS OFF THE NURSES! They will make your life hell of you do. Treat them with respect or else you will be getting paged every 5 minutes...trust me on this one ok?!
Putting this separately because I see how often this happens:
DO NOT PISS OFF THE NURSES! They will make your life hell of you do. Treat them with respect or else you will be getting paged every 5 minutes...trust me on this one ok?!
21/
If you don't know something, say " I DONT KNOW, BUT I WILL FIND OUT".
Don't lie and make up information because
1) That's dangerous
2) You will get that reputation and no one will trust you.
If you don't know something, say " I DONT KNOW, BUT I WILL FIND OUT".
Don't lie and make up information because
1) That's dangerous
2) You will get that reputation and no one will trust you.
22/
For prelim interns, remember this is your time to shine.
Don't waste this opportunity on playing politics.
You want to maximize this and be:
1) Trustworthy
2) Efficient
3) Hard worker
4) Not a complainer
5) Smart
Focus on being the best and not making other interns look bad
For prelim interns, remember this is your time to shine.
Don't waste this opportunity on playing politics.
You want to maximize this and be:
1) Trustworthy
2) Efficient
3) Hard worker
4) Not a complainer
5) Smart
Focus on being the best and not making other interns look bad
23/
Try answering the page ASAP.
If you delay, soon you will realize the pages will pile up and God forbid if it's a patient related emergency you need to address it ASAP.
Also in general, be an intern that is always available & not one that the senior has to spend hours finding
Try answering the page ASAP.
If you delay, soon you will realize the pages will pile up and God forbid if it's a patient related emergency you need to address it ASAP.
Also in general, be an intern that is always available & not one that the senior has to spend hours finding
24/
Since you are not aware of prescribing medications, it's always a good practice to ASK before putting in the orders for a medication.
Likewise, there are several apps available that you should have in your cellphone so you can read up on medications: SE, doses, Freq, route
Since you are not aware of prescribing medications, it's always a good practice to ASK before putting in the orders for a medication.
Likewise, there are several apps available that you should have in your cellphone so you can read up on medications: SE, doses, Freq, route
25/
Night float intern rotation can be a daunting task. But if you are organized you should be able to go through it without any major issues.
If any questions, don't be afraid to call a senior (yes even if they are sleeping)!
No one should fault you for seeking help!
Night float intern rotation can be a daunting task. But if you are organized you should be able to go through it without any major issues.
If any questions, don't be afraid to call a senior (yes even if they are sleeping)!
No one should fault you for seeking help!
26/
Internship year is tough and at times exhausting. Dont forget to take care of yourself Always have some time for yourself, make a schedule that works for you to enjoy your life outside the hospital including getting adequate sleep!
Keep at it with your hobby!!!
Internship year is tough and at times exhausting. Dont forget to take care of yourself Always have some time for yourself, make a schedule that works for you to enjoy your life outside the hospital including getting adequate sleep!
Keep at it with your hobby!!!
27/
Memorize this:
EAT WHEN YOU CAN
SLEEP WHEN YOU CAN
USE THE RESTROOM WHEN YOU CAN
DO NOT TOUCH THE PANCREAS (jk
)
Memorize this:
EAT WHEN YOU CAN
SLEEP WHEN YOU CAN
USE THE RESTROOM WHEN YOU CAN
DO NOT TOUCH THE PANCREAS (jk
)
28/
You have worked so hard to get to where you are, I am sure you will do great in the intern year.
Keep a smile on your face.
Bring that positive attitude daily.
Before you know it, internship will be over and you will be passing on this knowledge to the next interns.
Goodluck
You have worked so hard to get to where you are, I am sure you will do great in the intern year.
Keep a smile on your face.
Bring that positive attitude daily.
Before you know it, internship will be over and you will be passing on this knowledge to the next interns.
Goodluck
