The Ten Commandments of Internships
6. Treat everyone with respect. Treat the medical student with respect; you were once a medical student who was confused and intimidated. Treat your upper year with respect; you will soon be an upper year trying to teach the interns, and you may have a really smart intern who knows, or thinks he or she knows more than you do. You don’t want to be that pain in the neck intern. Treat your attending with respect; if you don’t believe this one try breaking this rule – it’s a great way to learn. Treat those who collect the garbage or deliver the patient meals with respect – if you are honest you already realize that they do as much or more than you do for infection control, and unless your ancestors were the treating physicians on the Mayflower, it is likely one of your close relatives had a similar job, so treat them as you would want someone to treat your family. Finally, treat your patient with respect; you will be a patient soon enough, too.
7. Don’t forget to call your mother – or father, or sister, or brother, or aunt, or any of the family members whose sacrifice, love, and encouragement enabled you to be where you are today. If you are married, enjoy time with your partner; if you have children, spend time with them – they did not request a doctor for a parent. You will be busy, and there will be long periods where you won’t have time. Make time.
8. Be on time – better yet, be early. Don’t make the team wait for you. Get to rounds on time. Don’t spend hours toiling to make a chart note into a masterpiece – include what is needed and get it done. Spend time connecting with your patient or learning from your colleagues. Don’t make the attending alter her work flow to accommodate your inadequacies. If you can’t get things done in time, start showing up early. Nothing indicates a desire for success like being to work early and getting everything done. The day is long; use it wisely.
9. Not all diarrhea is C. diff – and not all shortness of breath is pneumonia, and difficulty with thinking isn’t always dementia. Beware of cognitive biases, particularly confirmation bias. We all fall in love with our own ideas; don’t hold onto diagnoses when they don’t fit.
10. Enjoy each day – take care of yourself, find time to exercise, to play music, to read a poem, to talk to a friend. Eat when you can, sleep when you can, and pack your pockets with snacks. Stay well rounded. At the end of each day, think about what you have learned, who you have helped, who you have been kind to, and what made you smile.
All members of this working group are from the Family Medicine Residency Program at Abington Hospital–Jefferson Health: Dr. Skolnik is an associate director, Dr. Sweeny and Dr. Durtschi are new interns, Dr. Ulbrecht and Dr. Bonnes were second- and are now third-year residents, and Dr. Baranck who was a third-year resident at the time of this writing is now an attending in Cape Cod, Mass.
