I like to think my shenanigans on the blog are useful to other people, that it’s not just Jamaican-accented self-gratifying chatter amidst all the other self-gratifying chatter that clogs up the internet. So in the same vein as my posts on medical school and UWI, I’m transitioning into something a little more adult. Still PG-13. Well, depends. Some internship stories are pretty out there.
Internship will probably be the worst year of your medical career. Scratch that. It will be the worst year of your medical career, unless further down the line you end up with a horrible boss who treats you like an incompetent intern. That would probably be worse.
But it’s also supposed to be the most liberal year of your career. The level of responsibility is much higher than medical school (for obvious reasons) but much lower than it will be once you get fully registered as a doctor. Internship is the test the waters year. Dip your toes in all the specialties and a few sub-specialties. See what you like and what you don’t. Free time is limited because you’re first call and therefore can never leave the hospital, but just like med school – doctors work hard and party harder. And sleep even less.
Between the working and the partying (notice how no one cares about the sleeping) it’s important to learn as much as you can. There are aspects of patient management that only become apparent once you start working. Add to your skill set and exposure – minor amputations, sutures, chest tubes, thoracocentesis, paracentesis and neonatal resuscitation (among others) are all the forte of the medical intern. If you show interest, people are almost always willing to teach (because some people are dicks, and there’s nothing you can do about that) and there’s a lot to learn.
While you’re busy learning, take everything with a grain of salt. Always, always be cognizant of the complacency of third world medicine, and the fact that sometimes the things we routinely do are not the internationally acceptable things. Double check your management with evidence-based guidelines (and be up to date), Youtube your procedures to see how it’s being done in more resource-rich centres. Keep your standards high, even if you don’t live up to them.
One inescapable downside to intern year is that people will be mean. People will be mean and cranky and at some points downright bitchy. They will take their frustrations out on you; you will end up being blamed for the incompetence (and sometimes sheer slacking off) of other people. Patients will yell and cuss. Staff will grumble and talk about you behind your back. Work environments (as I have discovered) are rarely if ever rose gardens. And even if it smells pretty, there are usually thorns.
So, keep the faith. Remember why you started doing medicine in the first place. If that doesn’t work, remember that you won’t be at the bottom of the food chain forever. If that doesn’t work, remember that at least you have a job that pays more than most in this country. And even though sometimes I feel the urge to be just as mean back to them, I have found time and time again that it pays to be nice (even if you have to fake it til you make it). Also that having friends in every department is pretty much the only way to get things done for your patients in an overwhelmed, understaffed system (as I have mentioned before).
In my last seven months, I’ve developed some words to live by to help me keep my sanity.
Don’t be a hero, is what I learnt from Paediatrics.
Surgery taught me that responsibility is informing your seniors.
And on Internal Medicine, I am learning that you catch more flies with honey than with vinegar.
Somewhere in these ramblings, I hope you find a truth you can apply to your own internship. Or maybe it’s enough to know you’re not in the struggle alone.