JULY 1ST INTERNS

I recently saw a meme on www.gomerblog.com poking fun at July 1^st interns. It had a picture of Johnny Depp from the movie Pirates of the Caribbean where he is making a bolt for it to escape from his adversaries, with the caption “NEW MEDICAL INTERNS START JULY 1^ST, RUN FOR YOUR LIFE”.

Interns are first year medical residents and July 1^st is the first day of the rest of their lives after graduating from medical school. There is some kernel of truth to the proverbial “deer caught in the headlight” feeling. Not only is an intern responsible for taking care of sick patients but also tasked with memorizing the layout of a new medical building—he or she will have to be present at any specific site within the building in the blink of an eye when a ‘code’ is announced—having operational knowledge of new electronic medical record (EMR) systems, resetting their circadian rhythms (ready for weeks of ‘nights’), and keeping abreast of the latest medical literature about a topic for bedside rounds with the Attending Physicians among others. It is a steep learning curve but to assume they are rudderless on July 1^st is somewhat naïve.

Prior to getting to July 1^st, interns spend anywhere between 6-8 years honing their skills. This includes on average, 3-4 years of undergraduate studies with completion of “premed” courses and 4 grueling years of medical school. During their training in medical school, medical students in their 3^rd and 4^th years spend the lion’s share of their time taking care of patients and working on their clinical decision-making abilities. As a fourth-year sub-intern, medical students are essentially in a dress rehearsal before stepping into their shoes as first year residents.  Thus if we are to believe what the famous Scottish-born inventor and scientist Alexander Graham Bell said, “Before anything else, preparation is the key to success,” interns are bound to succeed and hence no need to run for our lives.

In fact, one could very well make the case, that the level of medical care in the hospital during this time of the year is probably as good as any other time. Part of it has to do with the attitude of the intern. Being aware of their limitations, interns tend to be extra alert and cautious with their decision making, going over lab values, vital signs, imaging results, and pertinent physical exam findings repeatedly to avoid egregious errors. Having gone through this phase twice, once as an internal medicine intern and then as a first year gastroenterology fellow, I can attest to it. Additionally, the level of collaboration, co-operation and oversight at this time of the year is unprecedented. During my initial couple of months, I always had one if not two senior residents guiding and supervising me (not to mention the Attending Physicians who serve as an added layer of scrutiny). This helped me build confidence quickly and ensured a foolproof system. At the end of the day, this translates into better patient care.

So next time, you or a loved one falls sick on July 1^st and need medical care, confidently walk towards your nearest ER/hospital and not away from it, taking comfort in the knowledge that these “interns” who have spent the better part of their lives preparing for this day are waiting to provide you with the best medicine has to offer.