Advice - expectations

[laistesgift]

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[Law2Doc]

hi..i'm 3 months into my internship and think i'm turning into that over-anxious intern. Just needed to share and welcome any advice please..

On a pretty intense ward service at the moment only a few wks in: fast-paced, high patient turn-over. We switch attendings very often so must keep up with change in work styles etc.

I trawl these forums often for advice on how to shine on ward service, how to be efficient etc. However i seem to be dropping the ball on many an occasion. Nothing major, just things that don't throw me in a very favourable light in front of my chief residents or attendings e.g. getting their instructions confused, needing to clarify often, not having the info when asked. Somehow, in spite of all that, i've been getting the work done just not looking very slick going about doing it. Trying to get better, but read on:

Because we change bosses so often, i often miss the opportunity to impress - and therefore i'm afraid they'll get the wrong impression of me i.e. that i'm incompetent. I worry for when performance review-time comes around.

I'm trying to fix all that i can - but dont want to run out of time. I'm already prioritising tasks, already trying to be the expert on all my patients. Any advice on how to impress on ward service?

First, odd that you started internship in January. Must be a story here.
Second, it sounds like you have to learn to "listen better" and be more detail oriented. Try not to multitask when an attending is speaking, and try to actually hear what they are saying, rather than be distracted and have to ask them to repeat. Also use some "check the box" system to make sure all tasks get done.
Third, everyone in internship has to learn to work with multiple attendings. It's a skill, and a learnable one. No great insight here other than try to find out through the grapevine what each attending expects before you actually work with them.
Fourth, read a lot. It's better to be that socially awkward anxious person who knows a lot than that awkward anxious person who has no redeeming qualities. Being a fountain of information on every condition, and who knows every detail of the patients medical record is usually a good defense against being regarded as incompetent.

 

[Gastrapathy]

Fourth, read a lot. It's better to be that socially awkward anxious person who knows a lot than that awkward anxious person who has no redeeming qualities. Being a fountain of information on every condition, and who knows every detail of the patients medical record is usually a good defense against being regarded as incompetent.

I think the rest of this is good advice. But, you really can't expect to "read a lot" as an intern. Try to do quick focused reading on each patient's primary problem and any problem that will appeal to the attending (if I'm on service and the patient was admitted for PNA but has Crohn's, guess which I'm going to ask about).