Thursday, June 02, 2005


As the medical school year comes to an end hundreds of graduates prepare for the grueling year they’ve been anticipating their whole life. Graduations are celebrated across the country and the seniors, thinking about their fleeting time, come to realize that the now they must apply all they’ve learned in their new world, the medicine floor. I thought I would take the time to give the incoming class of interns a few suggestions I think will certainly come in handy.

The most important thing to remember is that like any other workplace the hospital is it’s own society, with it’s own rules. Each is different in that it has it’s strentgths and its faults. You still do not know most of these about your particular future place of work, no matter how many times you interviewd there. More importantly in the hospital, like the real world, it’s not what you know but who you know. If you want to be an effective intern, know everyone.

Let us begin, remember, the keys are in the details:

1. Most of medicine is common sense. You’ve heard this so many times and yet you don’t understand it yet. You will, later this year.

2. Don’t make your resident look bad. You will pay for that.

3. When you don’t know, find someone who will. This is really not about you. Anyways, we think you don’t know anything, regardless of what you really know. So take advantage of that.

4. You’ll hate the nursing, no matter how good it is. Understand, you will catch a lot more bees with honey. BTW, nurses can make your life hell so your choice will be smart and well-rested versus right and exhausted.

5. Having your own patients is so much better than seeing four new patients each session. This way, you will learn nothing. If you have a continuation clinic, know the months that you will be there. Schedule your patients to come back on those months. If your patient must be seen during a time when your not there, make a deal with another resident and send him your patient, so that he will send your patient back to you.Your patients will love you so much more for it.

6. Most of the time your diagnosis will be a symptom, that means, what you actually learned in medical school only applies less than thirty percent of the time. I’m not kidding!

7. If a patient has more than three complaints in one office visit the diagnosis is depression. There is no other diagnosis, don’t waste your time and our money.

8. You will need to bribe everyone. Since you can’t use money (You won’t have any) chocolate is the next best thing. You can move mountains with chocolate. (this is my personal favorite advice, consider yourself lucky to know this before you start, you can get any tech motivated with enough chocolate)

9. When you call a consult say “Hi, this is Joe Schmoe, intern in medicine” don’t say “Hi this is Dr. Shmoe” it just sounds more confrontational and is the key to a bad phone call.

10. Some operational alerts:
a. When a patient says he only drinks alcohol socially, your follow up question should be “How social are you?” You’ll be surprised.
b. When you ask if a patient smokes and he says yes your follow up question is not “How much?” but rather “What?”

Good luck guys. Remember, for any difficult question you always have two residents, yours and the MHM.