Passing By

Intern year is the hardest year. It's the period of the most learning, growth, and acquisition of responsibility. It also involves the most "scut work." Interns make the cogwheels turn, to get the system to run. We call for outside hospital records, we put in every painstaking order, we call family members for updates, we write discharge instructions, we round with case management and social work. The year is difficult because there's so much to do - not only are we learning the practice of medicine, but we are learning the mechanics of it as well.

But it gets easier through the year. We figure out what's important and what's not. We become much more efficient, organize our to-do lists, anticipate nursing pages. We learn to start physical therapy early, order special mattresses so patients don't develop ulcers, and ask about a patient's primary care doctor so we can send them a heads-up. And suddenly wards isn't so bad. Last time I did this rotation, I was here consistently to 8pm on noncall days. Now I'm able to tuck things in an hour or two earlier.

If I were to be an intern forever, I could tighten up efficiency even more and probably even deliver better care. But thankfully I'm not an intern forever, I'm just passing by. I could be good at putting in orders and writing detailed progress notes and coordinating care, but the large medical decisions fall in the hands of the attendings, and that's what we want to become. So it ends up being the hardest year because by the time each intern class figures it out, they're out the door and the next group of interns start passing through. Oh well, I don't mean to stay.