Internal Medicine Intern Guide

My intern gave me a present today: her old copy of a guide for Internal Medicine interns. The chief resident was passing out new editions today, so my intern didn't need the old printing that she had herself inherited from someone in a previous class. From the way she gave it to me, I got the impression that this would prove to be a very valuable gift; I didn't realize just how valuable until I heard one of the fourth-year students ask if there were enough copies for the sub-interns to get one, too. There weren't.


Flipping through the booklet this afternoon, it looks like there's a lot of general advice for new interns (e.g. how to stay sane, how to work efficiently, how to act professionally) as well as "the experienced approach" to a spectrum of disorders and diseases commonly encountered on the Medicine service. Most of this advice can be equally well applied to third-year medical students. Just like interns, we are also experiencing one of the most dramatic transitions in our careers.

Here are some words of wisdom that I think are especially useful for third-year medical students:

Always at the forefront of our minds has to be the patient. They are the reason we all have jobs, and caring for them in a compassionate, professional, and intelligent manner is our ultimate endpoint. ...

Your patients will come to you scared and looking for answers. Your mission... is to learn to help with these two things. The diagnosing and treating can be tricky and time-consuming without always being fruitful. Sometimes you will find the cause and realize that there is nothing to be done to cure it or halt its course. This is why it is the second most important thing you can do for your sick patient. The first is helping to alleviate the fear that comes with being ill. When done right, this goal can be accomplished almost every single time, in almost every single patient.

Make an effort to see your patients for who they really are: people, just like you, with families, goals, dreams, and desires, who see all those things being thrown into disarray and peril by a gnawing pain in the gut or a sudden flash of pain across the chest. Every "interesting" or "cool" case for you is a potential threat to their existence. Be mindful of this. While we have come here to learn and expand our knowledge, it is only because of the patients and what they are going through that this is possible.

So be respectful of patients and their families. Understand that anger and irritation on their part is not directed at you, and do your best to not take it personally. When you take the time to understand that a patient's anger might actually just be one of the stages of loss or dying, this becomes much easier to accept. Learning to step outside yourself and think in terms of the patient first will help to bring all of these things into perspective.

...Your time in the hospital over the next few years is going to be an incredible life-changing time for you. Understanding that it is the same for your patients will make it all that much richer, and you will become a better doctor for it.