How to succeed in internship

1. How to succeed in internship Khanjan Shah Fall 2013 What They Neglected to Teach You in Medical School

2. Most important intern traits • Attractive • Brilliant • Studious • Hilarious • Confident • Meticulous • ORGANIZED

3. The Many hats you will wear this year • Physician • Scholar • Educator • Researcher • Communicator • Secretary • Phone Operator • Scribe • Event Planner • Spouse • Parent • Child • Applicant

4. The secret • Have a system! • Be prepared to change your system • Ask your colleagues what’s working for them • Be introspective

5. The Early bird • Wake up on time! • Enjoy your routines • Potential tips: • Put your clothes out before sleeping • Make breakfast while you pack your things • Pack a lunch the night before • Have a timer on your coffee maker • Keep your keys/phone in a designated place • Estimate commute time with different traffic patterns • Read patient updates while eating

6. Pre-rounds • The most critical 1-2 hours of your day • Pay attention during night float handoff • if you’re last in line, go see a patient! • Do not backtrack – your feet will thank you • Print off a new handoff – updated vitals/labs! • Minimize unnecessary copying • Check the updated med list • Have a designated work space • Examine your patients well the first time • Be friendly with the nursing staff

7. Examples (H&P)

8. Examples (H&P)

9. Examples (daily)

10. Examples (daily)

11. Examples (daily)

12. rounds • Pay attention to all the patients (not just yours) • Write down everything you need to do • Box, double box • Be flexible with the pager • Find the nurse as soon as possible with plans • Involve the social worker for the floor • Have consents readily available • Place orders/review labs on WOW • Keep a list of topics to read about later

13. Immediate post-rounds • Run the list with your senior • Work order: • C = call consults – with specific question! • O = orders • L = labs/imaging • D = discharges • P = paperwork (notes) • Tips for efficiency: • Call the operator ONCE • Keep all pager numbers for the month • Multitask – place orders while you’re on hold • Work together!

14. Noon conference • Go to them! • We are an academic hospital – be academic! • Efforts are under way to minimize pages

15. afternoon • Follow up on your little boxes • Write your notes and EDIT them – be concise! • Add addendums as important results/recommendations return • Start working on gold forms early – ask your seniors for help • Ideally, participate in resident/medical student teaching session • Edit sign-out as you go

16. On Call • Finish up work on established patients (including sign-out) • Eat/drink when you can • If no admission until later, catch up on discharge summaries! • See your patient immediately wherever they are • Work out efficient schedule with MS3 • Staff with a plan • Save note as you go • Some things can wait until tomorrow

17. Weekends • Plan for weekend discharged on weekdays • Find out senior staffing schedule and call early • Remember, you can sign-out to sister team • Meet your friends at Wolfgang!

18. Clinic • Consider looking up patients in advance (but remember high no-show rate) • Do not be afraid to place patients back in waiting room • Staff with a plan • Finish work while waiting (ordering labs, consults) • Write notes while talking to patients

19. The “Happy” Day • Finish your work early • Do not be afraid to sign-out work – we are part of a team! • Go home!!

20. The real “happy” days • Your days off! • Spend your days with the people you love doing the things you love. • Do not always feel compelled to study

21. Sanity • Leave work at work • Do not excessively check the EMR at home – your colleagues are good doctors, too! • Vent when you need to, but learn to forgive • Do not start “note battles” with other services • Communication is key – dare to be the listener • Introspection – did I play a role in staying until midnight? • Read something edifying daily

22. Why I am efficient

23. Thank you and good luck • I look forward to working with you all!