Excellent Helpful Tips For New Intern Resident Doctors

July 1, new interns start their residency. Here are some Tips for New Doctors i.e. Interns. If you know someone who is about to start their residency, please share this. It might help them.

    • Use ‘Please’ and ‘Thank you’ as much as you can.
    • Show up on time to work or even early.
    • Say “I don’t know but I will find out”  if you don’t know. Do not guess. Do not be afraid. You don’t have to know everything. If you did not ask in history or did not do a particular physical exam, accept it. Check when you go back.
    • Learn others’ names especially, the nurses names. Be nice to nurses. No ego please. You will get your due respect with time but for now, listen to them. Be a team player.
    • If patient does not speak English, get interpreter phone, not their family member. You can not use family to be the interpreter.
    • If you order any test, you are supposed to follow the result. If you have to sign out, make sure the other intern follows.
    • Ask the patients about their goals for care i.e. level of care. Aggressive intervention choice does not depend on age. Intubation and resuscitation should be patients’ choices when clinically needed.
    • Listen to the nurses and seniors. Learn the practical work from them. In a couple of months, you will know most of the work.
    • Review the EKG and X-rays yourself. See CT scan and MRI films whenever you can. With time, you become good at it.
    • Keep yourself well hydrated. Otherwise, you may feel dizzy sometimes when you get very exhausted.
    • Listen more and learn more. You don’t have to show you have lot of medical knowledge. Everybody knows it. Focus on learning practical work.
    • Do not write prescriptions if they are not your patients. You can help your colleagues for their patients sometimes but if someone asks for a prescription in the hallway, don’t write.
    • Look up for more info if you do not know. Learn to refer to books, UpToDate or iPhone apps.
    • Be humble and nice to others. Your first impression is remembered by people for years.
    • Get ready to see some pics of cats and dogs of patients. They feel good showing them to you. Appreciate them.
    • If you do not agree with your senior’s treatment plan, do not argue. Deal with it professionally in a very dignified manner. Ask the reason behind a particular treatment plan if you don’t agree or understand.
    • If you don’t remember what questions to ask during H&P, ask about each organ from top to bottom.
    • Sleep well every night. Sleep early. It will make next day’s work easier. Do not drink too much coffee or caffeine.
    • When a nurse is concerned about a patient and wants you to see the patient, just go and see the patient.
    • Knock on the door when you enter patients’ rooms. Clean your hands with hand sanitizer before and after patient contact. Acknowledge [Say ‘Hi’ and introduce yourself first] all the family members present in the patients’ rooms. Try to sit at patients’ bedside while taking history.
    • “Patient comes first”. Give different treatment options and make sure patient understands them well before they choose which option they choose. This is very important. Patient drives his medical care in america.
    • Call the family members to update the patient’s condition on a daily basis especially if the patient is elderly and demented. Their families really appreciate this.
    • Never show anger on anyone. Keep frustrations and egos at home. If something goes wrong, apologize and make every effort not to repeat the same mistake. This will make you an excellent doctor.
    • Talk to the patients’ families and attendings whenever possible. It will help you make your work easy.
    • Don’t get needle sticks. Be extremely careful. Do not be in a hurry when you have needle in your hands.
    • You may be the topper of your medical school or you might have made 260s in the USMLE steps, it does not matter. Be polite and humble.
    • Don’t try to run home early, you will forget something or the other.
    • Before going home, think “1. Did I order Coumadin for whoever needs? 2. Did I see all my patients? 3. Did I sign out sick patients? 4. Is there any patient on IV fluids unnecessarily?-Write specific limits on IV fluids OR else you will forget to stop when not needed and patients goes into fluid overload”
    • Write down or remember the main extension phone number of all the floors of your hospital. They are useful to call back your pages. Similarly, collect all the  phone numbers of your colleagues. Save every number, either it is pager or cell phone of everybody in your hospital.
    • Don’t write very long progress notes especially when you are busy. Write enough to support your treatment plan covering all acute events. If it is not documented, it is assumed to have not been done.
    • Make sure the patient is hemodynamically stable when you send for imaging studies like CT scan, MRI, x-Rays, nuclear medicine studies etc. Also, patient should be stable when you transfer patient from ER to the floor.
    • Be extremely patient, Relax physically every minute you get. Some patients may ask you for Apple juice or something like that. Just tell the nurse or unit secretary and they will give it to the patient.
    • Live close to the hospital so you save time daily and thank me later too for this advice.
    • If you want to become chief resident later, be nice to the program director, current chief residents, visit department office periodically, and be nice and good at treating patients.
    • Call for help if you can’t handle the situation or activate RRT if the patient is rapidly deteriorating. ‘Calling for help’ does not mean you are failing. It just means patient needs more help. Call for help if more than one of your patient is sicker than you can handle. Read about one difficult patient condition a day after work.
    • Don’t keep complaining. Keep learning and do your best. Nobody likes those who always complain.