How to succeed in internship
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Transcript of How to succeed in internship
Khanjan ShahFall 2013
HOW TO SUCCEED IN INTERNSHIP
What They Neglected to Teach You in Medical School
Attractive BrilliantStudiousHilariousConfidentMeticulous
ORGANIZED
MOST IMPORTANT INTERN TRAITS
PhysicianScholar
EducatorResearcher
CommunicatorSecretary
Phone OperatorScribe
Event PlannerSpouse
ParentChild
Applicant
THE MANY HATS YOU WILL WEAR THIS YEAR
Have a system!
Be prepared to change your system
Ask your colleagues what’s working for them
Be introspective
THE SECRET
Wake up on time!Enjoy your routinesPotential 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
THE EARLY BIRD
The most critical 1-2 hours of your dayPay attention during night float handoff
if you’re last in line, go see a patient!Do not backtrack – your feet will thank youPrint off a new handoff – updated vitals/labs!Minimize unnecessary copyingCheck the updated med listHave a designated work spaceExamine your patients well the first timeBe friendly with the nursing staff
PRE-ROUNDS
EXAMPLES (H&P)
EXAMPLES (H&P)
EXAMPLES (DAILY)
EXAMPLES (DAILY)
EXAMPLES (DAILY)
Pay attention to all the patients (not just yours)Write down everything you need to do
Box, double boxBe flexible with the pagerFind the nurse as soon as possible with plans Involve the social worker for the floorHave consents readily availablePlace orders/review labs on WOWKeep a list of topics to read about later
ROUNDS
Run the list with your seniorWork 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!
IMMEDIATE POST-ROUNDS
Go to them!
We are an academic hospital – be academic!
Efforts are under way to minimize pages
NOON CONFERENCE
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
AFTERNOON
Finish up work on established patients (including sign-out)
Eat/drink when you can
If no admission unti l 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 unti l tomorrow
ON CALL
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!
WEEKENDS
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
CLINIC
Finish your work early
Do not be afraid to sign-out work – we are part of a team!
Go home!!
THE “HAPPY” DAY
Your days off!
Spend your days with the people you love doing the things you love.
Do not always feel compelled to study
THE REAL “HAPPY” DAYS
Leave work at workDo not excessively check the EMR at home – your
colleagues are good doctors, too!Vent when you need to, but learn to forgiveDo not start “note battles” with other servicesCommunication is key – dare to be the listener Introspection – did I play a role in staying until
midnight?Read something edifying daily
SANITY
WHY I AM EFFICIENT
I look forward to working with you all!
THANK YOU AND GOOD LUCK