Khanjan Shah Fall 2013 HOW TO SUCCEED IN INTERNSHIP What They Neglected to Teach You in Medical School

 Attractive  Brilliant  Studious  Hilarious  Confident  Meticulous  ORGANIZED MOST IMPORTANT INTERN TRAITS

 Physician  Scholar  Educator  Researcher  Communicator  Secretary  Phone Operator  Scribe  Event Planner  Spouse  Parent  Child  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 routines  Potential 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 day  Pay attention during night float handoff  if you’re last in line, go see a patient!  Do not backtrack – your feet will thank you  Print off a new handoff – updated vitals/labs!  Minimize unnecessary copying  Check the updated med list  Have a designated work space  Examine your patients well the first time  Be friendly with the nursing staff PRE-ROUNDS

EXAMPLES (H&P)

EXAMPLES (DAILY)

 Pay attention to all the patients (not just yours)  Write down everything you need to do  Box, double box  Be flexible with the pager  Find the nurse as soon as possible with plans  Involve the social worker for the floor  Have consents readily available  Place orders/review labs on WOW  Keep a list of topics to read about later ROUNDS

 Run the list with your senior  Work 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 until 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 until 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 work  Do not excessively check the EMR at home – your colleagues are good doctors, too!  Vent when you need to, but learn to forgive  Do not start “note battles” with other services  Communication 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