Year One down!


As you can tell from the lack of posting, my intern year was extremely busy!

Twelve months have flown by and I have learned, seen, and experienced a great deal. My intern year started out with my first inpatient month in August, after a month of orientation into the program and hospital system. Prior to starting this rotation, I had some crazy notion that it would be similar to my inpatient month while I was a medical student. Boy was I totally wrong! As a medical student in comparison to intern year, my responsibilities were completely different and the hours were much shorter. As a medical student, I would simply look over the patients’ charts, talk to the nurses about the previous night events, and present my assessment and plan to the attending. In comparison, as a intern, my responsibilities were significantly increased, as I did the same task as a medical student plus more. As an intern, I placed orders, made decisions prior to the attending’s arrival, spoke with patients’ family members, explained the treatment plan and gave prognosis, in addition to obtaining consent prior to performing procedures.

By the third day of inpatient month, I felt as if it were the 30th day of the month. The days felt long and tiring. I remember one evening after working a 14 hour shift, I sat in my car as the rain tapped on the front window, thinking “What did I just sign up for?”. I was told by my mentors and other physicians that this day would come. BUT on my third day of inpatient rotation! I was naive and thought my experience would be different. It is true that everyone’s experiences is their own however some share similarities. I decided that my outlook needed to change. By week two, I realized the work was challenging and demanding but I embraced it. I embraced the complex patients. I embraced answering several difficult questions from the patients and their family. I embraced the beeping sounds of the pager and the several daily progress notes that needed to be done by 1pm. I embraced that since my program also works at a private hospital that everyday was call day. My goal was to get the patients better. That was the ultimate goal. That was the mission. By the end of the rotation, I felt as if I had won a race. I was tired and fatigue but exhilarated with the thrill of victory at completing the rotation and a new found understanding of patient care.

With each following month came a different rotation. From Women’s Health, which meant performing several PAP smears, checking cervices, and reading microscopic slides of vaginal smears for possible identification of vaginitis to Sports Medicine which included performing numerous SCATs (Sports Concussion Assessment Tool), learning to read various X-rays and other imaging, and perfecting the musculoskeletal exam. By November, I was back in the hospital for Pediatric Wards. It was my second inpatient month but now only managing illness of the pediatric population. It was a busy month and it was a great learning month. I learned to take care of patients who could not verbally vocalize their symptoms. As you can imagine that can be very difficult. I then had to learn the non verbal cues. The smiles instead of the grimacing faces.The playful sounds instead of their hours of crying. It was a rewarding and fulfilling month.

As a family medicine trainee, clinic is the setting I see myself most in. I encounter different ailments in various ages of a diverse population. From preventative care screenings, procedures such as corticosteroids injections, 2 month new born check up, to bearing the news of a breast cancer diagnosis. Each day presented a different and interesting case. The month clinic rotation confirmed my passion for clinical preventative medicine. I have absorbed an ample amount of information and my medical knowledge has grown immensely.

These 12 months I realized some important strengths about myself. One of my strength is being positive during hardships. This is not to say I did not get down on myself or had a negative attitude about a rotation. That negative attitude changed because I managed to see what I can get most out of the rotation to help me with my future practice. I realized that being negative will bring unnecessary stress in an already stressed situation.

Some things I have learned in the past 12 months:

  1. Ask questions. There is no such thing as a silly questions! I use to write down my questions and then look it up myself at a later time. I felt maybe asking questions showed weakness. In actuality, it shows progression and interest. The point of residency is not only showing what you do know and practicing it, it is also showing what you don’t know so those gaps can be filled. This is your opportunity to ask those questions because in 3 short year you will be expected to know all the answers. So don’t be afraid to ask questions!

  2. Be confident. If you know the answer, speak up! You have obtained an abundance of knowledge through medical training and now it time to express it, thus making it functional knowledge and pertinent to immediate patient care.

  3. Read. Alway find time to study. You won’t have the time you did in medical school. One advice I was given, was finding a condition from one of the patient I had that day and study it inside out.

  4. Make time for yourself. My residency program emphasizes resident wellness. Reason being is you have to take care of yourself in order for you to take care of someone else. It can be nail day, spa day, movie day, or a day of rest and relaxation.

  5. Celebrate yourself. Reward yourself. At the end of my difficult months, I would head to the mall to buy a gift for myself. Self critique pushes you to work harder but self celebration is also needed to reward the the hard work that is done.

All the best,

Dr. A

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© 2017 Dr. Ashley Alphonse

Philippians 4:13