Intern Year: Cliff Notes and Survival Guide

I’m not sure I’m entirely qualified to write this post, seeing as I just graduated from intern to PGY-2 at that magical hour of 12:00 am on July 1st last week. However, I like to think I somewhat maintained my sanity and a slightly sunny disposition, albeit probably more jaded, and made it from July 1, 2013 to June 30th, 2014  sane, happy, and healthy, for the most part.

The short of it is this: intern year is hard work. This is what you signed up for. Get used to it. All you have  in your back pocket is a positive attitude and enthusiasm. Hold on to that as best you can.

Here are some truths about intern year:

1. IT IS NORMAL TO FEEL OVERWHELMED. I think I have PTSD from last July. Not that anyone was mean or awful to me or anything particularly bad happened. The transition to intern year was just a really hard adjustment for me and I learned that I don’t deal with change very well (I mean, I would get really sentimental when my parents would get rid of cars for a new one…I’m not sure why I didn’t know this about myself). I think the hardest part for me was feeling inept and helpless. Even with 8 years of higher education, I still couldn’t tell you on July 1 of last year how much motrin to give someone. You aren’t supposed to know what you are doing, but you are supposed to be trying your hardest to learn. That’s what counts. I  went home every day last July thinking I was going to be fired for incompetence. The learning curve is steep. Hold on!

2. IT IS NORMAL FOR THIS FEELING TO LAST THROUGH A LOT OF THE YEAR. Just when you think you have something down, the labor floor or something will rip you a new one.

3. IT IS NORMAL TO FEEL LIKE YOU’RE GETTING MIXED MESSAGES: One attending will tell you to do this and the other will ask you why on earth you’re doing it like that. Some days, you’ll feel as if no matter what you do, you aren’t doing anything right, even if you delivered a baby upside down and blindfolded. “But, why did you put the blindfold on that way? Who taught you that? I mean, I guess you can do it that way, but don’t.”

Its normal to feel like you're owned by this little box.

Its normal to feel like you’re owned by this little box.

4. YOU MIGHT HAVE MOMENTS WHERE YOU FEEL LIKE “YOU’LL NEVER BE ABLE TO DO IT.” I think there was a moment last August when I thought I was never going to be able to do a C-section well.  And then you realize you’re being dramatic and its a four year residency for a reason. [Side note: this still sometimes happens, I’m fairly impatient with myself, at best.] And then you do approximately 150 C-sections by the end of your intern year.

5. YOU MIGHT HAVE DAYS WHERE YOU FEEL LIKE YOU DID NOTHING RIGHT: There are days where you’ll be pretty sure you’ve done everything wrong down to the placement of your pinkie finger when grasping an instrument. And see #3 and #4.

6. YOU MIGHT FEEL LIKE YOU’RE A BURDEN OR DEAD WEIGHT: Maybe this was just me, but I often felt like I was dragging everyone down because they had to teach me and guide me so much. I realized (and was reassured) that this was sort of the norm for the beginning of intern year but its still hard to feel like you’re slowing down efficiency.

Here are some tips for intern year:

1. IT IS IMPORTANT TO EAT AND DRINK WATER. You cannot subsist on air alone. You need food to think. Bring snacks. Take advantage of saltines in the hospital in emergencies. And diet the water machines on all the floors.

Resident hydration at its finest.

Resident hydration at its finest.

2. BE NICE TO EVERYONE. It will only help you. And, I feel like people should do this anyways. You know, that golden rule thing…

3. IN YOUR TIME OFF, DO WHATEVER MAKES YOU HAPPY. For me, this was exercise. I’ve spent more money on exercise this year than food (well, maybe) but it was worth every penny spent. It was something I looked forward to and my reward at the end of the day (or night). [Disregard this is if I’m evicted soon. Thanks to deep sea predator spin instructor and power tool pilates instructor.]


GROUP exercise - kill two birds with one stone.

GROUP exercise – kill two birds with one stone.

4. DON’T UNDERESTIMATE SLEEP BUT ALSO DON’T MISS OUT ON YOUR LIFE. This one surprised me. I am big on my 7-8 hours of sleep. But, sometimes you’ll get six (or less). Sometimes you’ll forgo a little sleep to do something with your friends that you’ve been looking forward to. Always do what is going to keep you happy – sleep, exercise, friends, eating, trashy TV. Do whatever that thing is.


Here are some things that might help you:

1. LIKING THE PEOPLE YOUR WORK WITH. To me, this is the most important thing. If you like the people you’re working with and can laugh about the shit hitting the fan at 3 am the next morning, you’ll be ok.

My NYU family, who I see more than my real family.

My NYU family, who I see more than my real family.

2. THE FOUR COLOR PEN AND CHECKBOXES. Ok, actually these two are the most important things.

3. REMEMBERING THAT UNLESS YOU ARE NEGLIGENT OR DISHONEST, IT IS NEVER THE INTERN’S FAULT.  This is the secret of intern year you won’t realize until about half way through the year. Unless you don’t report information or are dishonest, nothing will ever be your fault.

Here are some things that might happen to you:

1. INTERN CHIC APPEARANCE:I No make up? Hair a little squirrel dog? Breakouts from stress? Wearing scrubs with winter boots and a sweatshirt? Intern chic. Make it your thing. And you can always blame you appearance on “the 80 hour work week.”

2. A “WHATEVER” ATTITUDE OUTSIDE THE HOSPITAL: You will suddenly care far less about things you used to care about. How many weeks is it until that marathon? Maybe 10. What do you want to drink? I don’t know, surprise me.

In the end, this is what I hung on to (one of my favorite quotes of all time) and still do:

Ability is what you are capable of doing.

Motivation determines what you do.

Attitude determines how well you do it.

– Lou Holtz

I sure hope that’s true.


Until next time…

5 thoughts on “Intern Year: Cliff Notes and Survival Guide

  1. These are so great to read! I’m a M4 (thinking PM&R) and love reading your updates, recommendations, and twitter accounts of how my life is going to change in a year… scary and exciting!

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