I’m finally a doctor, now what?!

   It’s officially 7 months post-graduation. The gifts and congratulations have stopped rolling in. Not that that was the focus of my attention. Man, I was just glad to be done with med school. Now I get to annoy my friends by wistfully saying things like, “When I was in campus…” or “when I was a student…”  As if that was a million years ago.

 That heady euphoria is long-gone and replaced by a different kind of euphoria. I’ve been working and doing actual doctor things for the past 6 weeks and it’s surreal at times. It’s also really exciting. There are aspects of internship that I was prepared for and others that I heavily underestimated. Some things I just did not see coming. It’s been a learning curve though and the good thing is that I work somewhere where everybody is willing to teach. So I’ll highlight some of the things I’ve learned and experienced so far:

1.       You become someone’s boss.

It is day 1 and you’re still trying to remember where the bathroom is but you are also technically supposed to be giving the nurses and clinical officer interns instructions. Someone goes like, “Daktari what would you advise?” And you’re just standing there frantically trying to remember what Medscape says you should do.

2.       Yes it is possible to work for 36 hours straight on just 2 hours of sleep

My first call was kind of scary. I knew that I’d have help but I was worried about whether or not I’d be able to figure-out what was wrong with the patients and what to do for them after all those years of med-school. I was worried that my clinical skills were rusty. I was also excited at the prospect of doing the real thing.

I was woken up at 2 am for a patient in the High dependency unit who was deteriorating. It’s the kind of phone call that floods your system with so much adrenaline that you find yourself instantly awake and moving. I didn’t hesitate to call my senior because I’d rather ask for help than potentially endanger a patient’s life with false bravado. I also wasn’t sure what I’d be walking into. My senior was really nice about it and we walked to the hospital together (we happened to be living in the same house at the time). We saw the patient and made a decision concerning management and stood there till it was done and the patient showed signs of improvement. I went back to bed at 3am and woke up at 5am to start a brand new day (a very long day) that ended at 5pm.

3.       Coffee is essential

Some call-nights are calm and I sleep like a baby all the way till morning. Others have me constantly walking up and down the hospital corridors until I find myself in the next morning and all I can do is run on coffee and good intentions. You get bonus points for owning a travel mug.

4.       Sleep when you can

After a call, before a call. During a call that seems to not have much going on. Especially if you’re not particularly assured of the next time you’ll get a good-nights rest.

5.       Use free time to do fun things.

I’m constantly learning and re-learning and sharpening skills. Work hours can get crazy. So if you have an opportunity to unwind, take it! You have no idea just how much you need it. Exercise, read a book. Catch-up with friends. You are a holistic human being, not just a machine that spouts out drug dosages. Besides, the quality of service you give your patients is directly proportional to your personal well-being. If you are in a sucky mood it’s generally likely to spill-over to your professional life too.

6.       Your people-skills matter

How you convey news and information could mean the difference between a patient consenting to appropriate treatment or them deciding that they are being mismanaged or them deciding to give up... Patients are scared and sometimes want instant solutions which we can’t provide, and it’s important to help them understand what it is that’s happening to them and what you can and can’t do to fix it. Some people need to be coaxed, others need tough love and it’s your job to figure-out who’s who.

Also, you will occasionally run into patients who think they know more than you and you don’t get to be rude or mean to them no matter what they say. Say it with me: P.E.O.P.L.E S.K.I.L.L.S.

7.       Be nice to the people you are working with

You don’t get to boss nurses around just because you can. You need them. They teach you things and they carry out the orders you write and they can generally make your life difficult. They actually know more than you do especially when you’re just starting out. So be nice. Humility doesn’t really cost you anything. I once had a nurse call me to the ward to do a procedure and found that she’d gone and laid out for me all the equipment I’d need. If that isn’t a blessing then I don’t know what is.

8.       Look-up what you don’t know or better yet, ask for help

Let’s be honest. Leaving med-school, you know the dosages of like 5 drugs because you weren’t prescribing them anyway and crammed information always fades at some point. The fact that you start work a number of months after graduation doesn’t really help that much.  So this is the point at which a decent internet connection comes in handy. Medscape and Uptodate are bae! Also, you’d rather ask the ‘dumb’ questions on day 1 than be forced to ask them in month 5!

9.       Remember to eat

You’ll thank me for this later. If you are especially busy you can forget to eat. And you only realize later when your energy levels are low and you’re cranky and miserable. I have personally learned that my body needs more sugar when I’m sleep-deprived. It keeps me functional. So eat even if you don’t necessarily feel like it because you might not know when your next meal will be. Especially on a call night. I’ve taken to carrying cereal bars in my back-pack just in case things get thick.

10.   Pray

For wisdom, for guidance, for strength. For calm call nights and just to say thank you. Just pray.

If you’re reading this and you’re an intern or a former intern, feel free to add your own lessons in the comment section below.

Ciao…