Reflections on Intern Year as a Family Medicine Resident

Hello and welcome to another Medical Mondays!Ā From randomly coming to NJĀ between rotations before interview season really went under way to Match Day (aka one of the happiest days of my life), it was a whirlwind of a journey leading up to starting my residency here at RWJ (orientation feels like such a long, long time ago!).

Getting here for my actual interviewĀ two(?!) years ago was an adventure all on its ownĀ (for future reference, try to never schedule 4 interviews across 3 days in 3 different states!), but it was obviously worth it, given that I ended up matching to this program, andĀ some rather awesome things the faculty told me during my interviewĀ still stick with me to this day!

Reflections On Intern Year As A Family Medicine Resident

Reflections On Intern Year

I’ve officially finished all my rotations for intern year, and there are lots in store for this upcoming year that I’m super excited about, so I figured I’d share with you some reflections on intern year before second year really gets rolling!

They say intern year is the toughest of them all–I was in in a new place with an entirely new EMR. I knew 2 people in this state (one that has since moved away). I’d never worked in a hospital with over 500 people before (RWJ has almost 1000 beds), and since most of my experiences were in small community hospitals, I’d had very limited experience with programs where there was actually more than one residency program there.

One of the reasons why you want to make your rank list based on your gut/how well you felt you’d fit into the program is because they become your family, due in part to the inordinate amounts of time you spend with each other–there’s little time to spend elsewhere (although I managed to gouge out time ;P ).

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“You’re the fastest intern east of the mighty Mississippi. Your ability to finish it quickly means nothing to me.” /Ā “I’m so glad I’m working with you for my last two weeks of service ever–you would’ve ruined everyone else for me.”

Favorite Medical-Related Extra-Curriculars:

Favorite Rotation: Not an actual rotation, but I liked seeing patientsĀ in the office (outpatient clinic) the most. I’m looking forward to next year’s rotations more than anything! Night service was actually pretty fun (but only because I wasn’t alone), and radiology gave me some really glorious hours!

Most Memorable Moments:

  • I’m still super proud of my diagnosis of a BJJ injury for one of my patients–my hunch was a lateral collateral ligament sprain, which is pretty rare to see isolated (it’d almost always come with some other injury elsewhere) but I was right! :P
  • I ended up being dragged into a lot of patient cases involving courts and investigations–from trying to avoid taking sides in custody battles to speaking with the state detective about potential abuse.
  • We had a super sweet patient who found out she had cancer and had really severe anxiety so on a day where we were a little less busy, I went up there to talk with her and go through different deep breathing exercises with her. She had an amazing support system and always had at least one family member or friend there with her. <3

Most Interesting Cases:

  • A patient who came in with a stroke (middle cerebral artery) that we put on anticoagulation as per protocol…but who then ended up with a gastrointestinal bleed, so we had to stop the anticoagulation. It was a mess in terms of trying to balance it out since the risk of a repeat stroke was definitely more devastating than a repeat GI bleed (which could be much more “easily” managed than the potential repercussions of a stroke).
  • A patient who was on service at the same time as the case above who technically “died” for a few seconds, then ended up in Torsades and an unstable arrhythmia who was seen by cardiology and recommended to the cardiac care unit but was rejected by both the CCU and the ICU…so we started an amiodarone drip on her on the floor and I got held hostage on the floor because they weren’t allowed to run that medication without someone on the floor to monitor. Twas not a fun time (my senior was at clinic while all this was happening).
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“All of us had great things to say about you, but Kyle especially. You’re the most efficient intern we’ve had.” / “You have great insight on the things you need to improve on.”

My mottos for the year:

  • Fake it til you make it. (Imposter syndrome is very real. I’m still working on my confidence/learning not to doubt myself.)
  • For the harder times: This too shall pass. No matter how bad it got, I knew I could get past it.

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Least Favorite Rotation: Hands down, inpatient pediatrics. (I’m so glad that’s over. >_> )

Worst Mistake: Starting an albumin infusion in the wrong patient. Granted, I caught this super quickly and had it stopped + went over to apologize and let the patient know what happened. She was (thankfully) completely fine with it and said it actually made her feel better.

Most Annoying Case:Ā We had a patient who stayed for basically the entirety of my first month on service. He was rude, abrasive, insulting, dishonest, and completely uncooperative with any of the treatment modalities we offered…but we took it for the team, and after he almost assaulted our night resident, he was [finally] discharged from our practice.

We also had a “dump” case where the Neurosurgery team was taking care of our patient for 1.5 weeks but neglected to ever mention this to us that he was even in the hospital until the day of his intended discharge, where they [barely] signed him out to me so they wouldn’t have to do any of the discharge paperwork or write his discharge summary.

nottodaybitmojiffThings I’ll Miss The Least: Writing discharge summaries and having to click 3248072394 times before putting an order in. Having to cancel an order and rewrite it entirely instead of being able to modify it was also a pain.
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  • What’s something you’ve learned this year?
  • What’s something you want to work on improving this year?

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16 comments

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    • VR on July 17, 2017 at 12:05 am
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    Always an interesting read!!! <3

    1. Thank you! <3!
      Farrah recently posted…Refresh Your Summer Skin with Ausome Hydrating Double MistMy Profile

    • A.K. on July 17, 2017 at 7:42 am
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    During the past year I’ve learned that the unexpected is always possible(be it positive or negative) and that some physicians just don’t have a clue while others are often quite gifted.One’s hunches, as well as shots in the dark can often spot on, even if just guessing at the time such tends to be accurate 50%. So how long does residency usually last?

    Finally starting my clinical volunteering tomorrow morning with the physio department of a convalescent care center (despite spending one hour commuting each way) Watch though, these first two or three shifts will probably be spent mainly pushing residents around and escorting them to therapy. Ah sleeping in will be sorely missed but so what, after being stuck in research talks, as well as classrooms for so long one’s batteries need recharging, especially after this past year.Despite being stuck in crisis mode last semester yielded a 9.3 GPA which isn’t bad at all considering what was going on.

    1. I feel like that applies to most professions/things in life–there’s good and bad in everything. The length of residency varies by specialty–I’m in family medicine, so mine is 3 years long.

      Glad you’re getting to start volunteering! I hope you have fun–I really miss it, but I hope to find more opportunities to start doing that again soon.
      Farrah recently posted…Tropical Fruit Chia PuddingMy Profile

  1. wow, I can’t believe your first intern year is over. It looks like you had some great experiences and learned a lot. LOVE your two mottos for the year. So accurate. :)

    -Lauren
    ShootingStarsMag recently posted…Somethingā€™s Brewing at Joeā€™s by S.J.D. PetersonMy Profile

    1. It went by so quickly! It’s kinda scary to think I have less than 2 years left (unless I do fellowship) before I go out into the real world forreal!

  2. You’re always a rockstar to me with ALL you do and accomplish! You’ve gained so much experience and skill this past year! You’re going to be an incredible doctor (even though you already are…you’ll just get greater and greater) xoxo
    Rebecca @ Strength and Sunshine recently posted…Microwave Gluten-Free + Vegan Mac & Cheese For One (Allergy-Free ‘Easy Mac’)My Profile

    1. Aww, thank you so much! <3 <3 I really hope I'm going to continue to get better and better! :D!!
      Farrah recently posted…Tropical Fruit Chia PuddingMy Profile

  3. Love these behind-the-scenes glimpses! I can imagine struggling with imposter syndrome but you know you have to be confident!
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    1. Agreed! I’m definitely still working on that right now!
      Farrah recently posted…Tropical Fruit Chia PuddingMy Profile

  4. Oh Fake it til you make it is my lifelong motto LOL
    I can only imagine the cases you’ve seen and interesting patients you get to meet!
    Great job on finishing all your rotations on your internship year, that is awesome!!!!!
    RunawayBridalPlanner recently posted…Can I Be a Guest Blogger on Your Blog? – I Need Your HelpMy Profile

    1. hahaha, I feel like that’s been one of my mottos since starting medical school! :P

      The cases I’ve come across (especially in the hospital) have definitely been really interesting! It’s crazy to think how quickly intern year went by! Less than 2 years left–I don’t feel ready!!
      Farrah recently posted…Tropical Fruit Chia PuddingMy Profile

  5. What a full on year – and what a mix of experiences you’ve had! Your most annoying case patient sounds like a TOTAL ass!
    Kristy from Southern In Law recently posted…Recipe: Hearty and Healthy Brown Rice and Vegetable Soup (Gluten Free)My Profile

    1. He definitely was–I’m so glad he’s not within our practice anymore! It was so difficult to work with him. :/
      Farrah recently posted…Tropical Fruit Chia PuddingMy Profile

  6. SO MANY CONGRATULATIONS Farrah. As a medical wifey, I know how hard intern year can be. You should be pretty pleased as punch with yourself! You are going to only get better and better!
    Susie @ Suzlyfe recently posted…Currently: A Week of Fitness + Work + Recovery (Coaches Corner)My Profile

    1. Thanks so much, Susie! :D!! I’m definitely happy to be done with intern year, although it wasn’t quite as terrible as I thought it would be? (I’ll take that as a good thing.) I hope I’ll continue to learn and improve! :]!
      Farrah recently posted…Tropical Fruit Chia PuddingMy Profile

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