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