Congratulations, Interns of 2012!

The job offers have starting trickling in for next year's interns.

I can't believe it was only one year ago that this was me. So much has changed since then. My career aspirations are still the same, but a lot of other things have shifted slightly sideways.

So, to next year's interns, I can share with you some things that happened to me, and you may also experience in the first half year of your working life as a doctor:

You will find your feet as a junior doctor. Granted, like me, you may spend the first couple of weeks absolutely scared out of your skull. But you'll get used to it and after a few months, you will manage to have some nights where you don't dream of clinical scenarios and ward rounds all night long . . .

You will face challenges, both personal and professional, that you will overcome with varying degrees of success.

People will find their way into your lives, if you let them, and these people will change the way you see the world.

Some people will loosen themselves from your lives and move on and you may miss them for what they used to be to you, but that is okay because we all change.

You will grow up, some of you will become more cynical, but some of you will become more zen and learn how to enjoy the small things in life, and many of you will do both.

You may go from being terrified at choosing to write and dispense that first script for a drug (probably an antibiotic) to writing them in 30 seconds flat and knowing the number in a box off the top of your head.

You will hopefully come to see that being a doctor is a job, not some mystical calling sent out to you from the universe. I think this is good. If you see it as a job rather than an entitlement or a state of being, you are more likely to realise that you need to work hard at it to be good, and more likely to leave it at work when you can. You may also realise that other doctors are people just doing their jobs, too.

You will encounter death, grief and loss. If you can meet this with compassion, dignity and humility, it will be better for everybody involved.

The first death you need to certify will probably be in a room full of grief-stricken family. Know what you are doing and have a plan before you walk in, and although this is your first time, hide your uncertainty and terror. Be kind.

Document, document, document. This will be reinforced whenever you look back at your notes after something has happened, and you find that you clearly documented what you needed to. Document!

Good luck! And don't forget to take care of yourselves, both physically and mentally.

Things I Have Learned During Internship #4

A few brief extras, suitably random:

a) Find a system that works for you. You may carry around a clip-board with printed notes, a card system in your pocket, some big plastic box with everything you will need should there be a mini-apocalypse at the work station that wipes out all of your request forms, an iPad or just a scrap of paper that you keep in your pocket with the salient information on it for the day.

Feel free to change this at any point. Just don't lose all of your patient information and then have everything explode and fly everywhere in the middle of a busy ward round because you won't recover until later in the day and this will throw off your groove completely and not even a big cup of coffee bought for you by a sympathetic medical student will help.

Also, what works for one rotation will not work for the next in the same way.

b) Having a weekend off any responsible adult activities and subsisting on Indian takeaway, toasted sandwiches and Twisties will leave you feeling crappy. Add wine to this list and your mouth will taste terrible by the end of the two days.

c) On-line shopping: Good for a temporary mood boost, both at the time and when that package you have forgotten ordering arrives a few weeks later. (Yes, being in Australia and ordering from the USA teaches you patience.) Unfortunately, it is easier to spend more than your overtime and you may not get paid it correctly anyway, so be a bit penny-wise while having some fun.

On-line shopping where you buy exercise DVDs that you actually use must be a positive, seeing as you don't have time to even see the sun any more, right?

d) Applying for your next job roughly 6 months before you will be starting it is a strange experience. I'm just starting to really feel comfortable as an intern, but not only do I have to start considering where I might go next, I need to actively plan and apply for it.

e) Paying somebody to clean your house is a luxury, but it is a brilliant one, and may save your life by preventing the next super-bug from its genesis in your uncleaned shower. That is my excuse, and I'm sticking with it.

f) You will have loads of tips for other interns, but you may lose the attention span and motivation to write them down on a blog post, and go with random stuff instead. All of the iPhone apps and personal diaries in the world cannot help you, your only saviour is the passage of time and the hope that one day you will be finished internship.

I really meant to write something more useful, but alas my brain is in a field somewhere frolicking in the sun and is refusing to stop playing and come back inside the house, so I'll stop now before this degenerates into a drivel of random words.

Take care.

Things I Have Learned During Internship #3

Three things this time:

1) It seems that you get good and comfortable in a rotation, and then is time to move on and I don't want to move on from this one because I really like it. Also, the next rotation scares me.

2) I am tired. A lot. Sometimes it seems like it is out of proportion to the hours I'm working, which aren't bad, but I know this tiredness isn't excessive. This happened last time I started to work full-time after uni. It passes. Slowly.

3) Being looked down on as "just an intern" by patients is now amusing rather than affronting. I know I'm just the intern and I'm happy to have somebody else look after you if you don't think I'm good enough. It makes my "to-do" list a few items shorter. ;)

And one extra thing that I already knew:

I don't get a lot of time for blog posting, and there are so many things that I can't and won't ever write about, so the writing here is more sporadic.

Things I Have Learned During Internship #2

I actually enjoy teaching (or trying to teach) medical students.

It probably helps that it has been a very short amount of time since I was a student, so I remember what it is like. As a student, any time you get doing interactive learning of practical skills feels immensely valuable and helps keep you interested.

Also, there are no "gunners" in the group of students who are on my ward, although they are all generally enthusiastic, so it is fun to tell them what I know and try to get them to start learning practical skills.

Nobody has followed me into the bathroom yet, so all is well with the world. I guess that since I'm not the one marking them, they don't feel the need to impress me with their keenness at every opportunity.

This results in a level of interaction where they are with me for only short periods of time, and are doing other things most of the time, allowing for brief and enthusiastic interactions where I don't get tired of them, and they don't completely exhaust my limited pool of knowledge. Fun times.

New blog to follow

A previous commenter mentioned her blog, and I liked it so much that I had to link to it here:

Wellness Rounds.

I'm a huge advocate for looking after your personal health, both physical, mental and every other aspect of your life, so this is just the kind of thing I am passionate about, and it would do you some good to have a read, too.

I know that it is drummed into us all of the time - doctors and medical students don't take enough care of our own health. This is bad for us, and if we end up unhealthy as a result of lifestyle choices, our patients are less likely to believe our advice when we counsel them to change their ways.

Plus, we end up miserable and ill, and nobody really wants to end up an unhappy and sick, particularly if your entire day is spent looking after people suffering the exact same issues, right?

We don't need to be health fanatics, but a little moderation, exercise, stress relief and balance (where we can fit it in) can go a long way.

Ironically, two months into internship I'm feeling better both physically and mentally than I have in a long time, and I was genuinely happy by the end of medical school. I got into some healthy habits to cope with the extreme stress I felt when starting out, and as a result, they have helped me feel much happier now that I have gotten used to life as a junior doctor.

What have I learned works for me? Meditation (relaxation, mainly), moderate exercise with my significant other (making it social), and eating well.

My favourite tip so far? I read from various sources that it was a good idea to have some kind of ritual when you finish work at the end of the day that would help you disconnect from your "work time" and help you enter in to "home time".

For me, that is going for a nice walk or run with my husband. I get to have a good chat and get some incidental exercise. I know it isn't much, but it has gotten to the point where it doesn't feel like exercise any more. I know I'll go through rotations where this isn't possible every day, but it has been lovely being able to establish this habit.

For other people, the ritual can be five minutes of relaxation and deep breathing in the car before getting out when you arrive home. Others need to spend a certain amount of time alone in their own space when they get home from work, so they can switch off and re-energise before entering into their family space.

The point is that we need to be able to detach from work in order to live a full and well-rounded life. Medicine can be all-consuming, but this does not produce healthy or happy doctors, and being a well doctor is a vital thing that you can do for your patients, yourself and for your family.

Take care.

Things I Have Learned During Internship #1

You can survive a whole busy evening shift on nothing but adrenaline, two biscuits from the ward kitchen and a bottle of water.

But you don't want to do this, and it is awful.