It’s almost too good to be true and although I’m still in training pursuing a fellowship, the end of residency is a major milestone. We had a graduation ceremony about a month ago. A lot of spouses, fiances, significant others and children were around. Just a sprinkling of parents and siblings though. The graduation ceremony was on a Wednesday evening, so a lot of us had to rush from the hospital to the hotel were the ceremony was being held. Somehow we made it!
It was actually quite nice. The program directors introduced each graduate with a little synopsis of their ideals and goals as stated on our personal statements when we were applying for residency. They read comments about us from fellow residents, medical students, and attendings. Everybody sounded so altruistic, smart, and pleasant. It was just so amazing to be there. I’m going to miss them all!
I was a day-float for my last month as a medical resident. Specifically I covered various teams when that team resident had the day off or was in clinic. That meant lots of signing out of patients. Not fun! There could have been a better way for me to end, such as on a cush elective but at least as a day-float I didn’t have to take call overnight or otherwise.
Even my one week overlap with the incoming interns wasn’t too bad. I was painfully reminded by how awful intern year is. Yes, even with the new 80 hour work week restriction. The poor things. You could see the angst and fear in their faces and actions. They were overwhelmed! A beeper would go off (and they go off frequently), and the poor owner would jump out of their skin and you could almost visualize their hearts pounding, knees buckling, and hands trembling as they made their way to the phones to answer the page. They would literally drop whatever they were doing at the moment, even if they were in the middle of presenting a patient, to answer the page. You could see their eyes growing bigger as they listened to whatever the person on the other end had to say, and then they would end the phone call stammering something that almost invariably included “let me talk to my senior resident and/or attending and get back to you”.
The intern would then slowly make their way back to the team, this time as if with a heavy heart, or maybe relief that it wasn’t someone reporting a grave mistake on their part or a sudden death of a patient due to their oversight (which is everyone’s fear). They would ask something like “Ms. So and So has a potassium of 3.4, can I give her 80 meQ IV?”
Now it is your turn as the senior resident for your eyes to enlarge a bit (and probably have a very weird expression on the face) as you realize Ms. So and So only has a puny peripheral IV line and has been eating just fine. So you reply, “Errrrrrr, how about you give her the replacement potassium in tablet form and errrrr, how about we give her 40 meQ and see how she does with that first”, as you in turn have a sigh of relief that you’ve saved the patient from burning intravenous potassium pushed through a peripheral IV. You thank your lucky stars that at least you have an intern who is wise enough to know what they don’t know and ask questions before they put in orders!
Nope, intern year is not easy and I never want to repeat it. What with the new city, new hospital, new responsibility, after all, you are THE DOCTOR, the pressure of wanting to do well, it’s amazing that we survive. And I think as residents, we bury the experiences of that year far from our reach and carry only the knowledge that we survived. We say among ourselves “can you believe this new intern did that” or “can you believe that intern didn’t tell me such and such was going on with the patient”, or “OMG my intern doesn’t know how to write a simple SOAP note!…what medical school did they go to?…are they a prelim?…how did they match here?” But the truth is we’ve each been that intern. Not just in Internal Medicine, not just at Brown, but in all residency programs in all teaching hospitals, #1 in the US World & News Reports or not, Ivy League or not, American graduates or not we’ve all been there. I wonder now what my senior residents had to say about me behind my back in my first few months.
So in my last week as a resident during which I interacted with several interns in their first week of residency, I exercised patience, understanding, and supreme vigilance. But, I am human so I couldn’t help but join the gossip mongers in the daily “can you believe….”
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