Congratulations! You've graduated or about to graduate and are now facing the biggest turnaround in your medical education since the transition from second to third year.
Biggest word of advice for those starting their intern year: there is little you can do to prepare for intern year apart from the 4 years of medical school you have already completed. Enjoy your time off, spend time with the ones you love, and get your other life things in order. Repair your car, schedule automatic payments for your bills, and start reviewing the different loan repayment options. The 1 month or so that you have off after graduation is the only truly free period you'll have until you are done with your residency and fellowship training.
On the day you start intern year, you'll be faced with a lot of problems that you saw as a medical student but never directly affected your time. These things include but are not limited to coordination of discharge (such as planning and communicating with the case manager and social worker), managing day to day medical issues (such as correcting electrolytes and ordering appropriate labs for the next day), consulting specialty services, updating the team list, and learning a new EMR. These are all things that will come when they come.
What you can do before the start of intern year is to ensure that you have everything in order so that when you do start intern year, you will know where to look for answers and already have what you need in order to survive.. Here are the essential tips and tools to get ready for your intern year of medical residency.
General advice for incoming interns and residents
Never lie
It should go without saying that you shouldn't say that you've examined things when you haven't or make up answers to questions you never asked. It's really never too much of a problem if you forgot to do something or ask something—you can always go back and do what your forgot. You're just starting your true medical training and it comes with the territory. Lying, however, can change medical management and patients can suffer true harm from decision making based on faulty information. Suck it up, admit your forgetfulness, say you'll go back to do it, and move on.
Make checklists
Every morning you will have an updated list of the patients under your purview. Before, during, and after rounds, constantly write down and review the tasks that you have to do for each patient. Check off the tasks you've already completed. In the beginning, when your memory may not be as in tune with patient details, write down your physical exam findings or pertinent facts in a different color on the side. Essentially, write down everything and periodically check throughout the day that you are accomplishing the tasks that you have been assigned to complete.
Ask for help
Your senior is an invaluable resource to asking questions. You're going to have a lot of questions and a lot of it won't be found on UpToDate. Your senior is there to guide you.
Remember how to present
Given that you're coming from fourth year, it's likely been awhile since you rounded/pre-rounded. Take a quick refresher on presenting and pre-rounding here.
Call your consults early
Understand that most specialty services sign out between 5 and 7 PM. If you know you're going to have to call a consult, do it early during the day or immediately after you discuss a patient during rounds.
Eat when you can
You will very unlikely have dedicated meal breaks. Keep a bar or two on hand.
Don't forget to exercise
Walking during rounds doesn't count; make sure you curb your stress and your weight by taking some time a few times a week to go to gym or run outside.
Best books for intern year of residency
Quick, immediate texts for answers to patient problems and medical scenarios
Maxwells Quick Medical Reference
A tiny, spiral bound pamphlet that fits well in the breast pocket of a white coat that has normal lab values, an eye chart, quick algorithms, templates for notes, and a built in ruler that you can refer to when you need it. The best sub-$10 resource you can own.
Pocket Medicine
A small 3-ringed book that easily fits in your white coat pocket that succinctly goes over medical pathology and management. A must have for any medical resident. Even for surgical residents, Pocket Medicine will likely serve you better than its surgical counterpart, Pocket Surgery
Longer texts that help jog your memory and gives you a good framework to looking at clinical problems:
When looking for answers to day to day clinical questions, such as the immediate management of hyperkalemia or what to order for a patient with reduced urinary output, it can be cumbersome to go through a whole UpToDate article or look through your own notes. There a few texts out there that simplify the common questions and scenarios that you will be facing as an intern doing floor work and taking call, the best of which are the Washington Manual Internship Survival Guide as well as On Call Principles and Protocols by Ruedy.
Washington Manual Internship Survival Guide
Essentially second and third year of medical school condensed into an outline-based format, comprehensive text.
On Call Principles and Protocols
A paragraph based text that goes over common call questions and scenarios with the proper questions to ask the nurse and patient, physical exam findings, and the appropriate management for each problem in an easy to read format.
Other essential things to have for intern year
Reliable Pens and Highlighters
Do yourself a favor and buy a large pack of reliable pens. The Pilot G2s are reliable with a clean gel ink that quickly dries and doesn't fade out; it comes in a variety of colors and, when bought in dozens, are quite affordable. As an intern scribbling tiny notes onto your precious list, you will want either the .50 nib or, for the especially precise, the .38 nib. These retractable highlighters will come in handy as well to quickly accent the things to do on your patient list. Keep a stash of pens and highlighters in the glove compartment of your car.
Penlight
After going through a number of different penlights and often being frustrated with standard dim yellow penlights, we recommend the ThruNite Ti3 LED flashlight. Small, light, and incredibly bright — able to shine 120 lumens on the maximum setting — the ThruNite at <$15 is a cheap purchase that will pay in dividends when you are trying to quickly check pupils (on its low setting, of course), doing a skin examination, or illuminating a bedside procedure. Keep it attached to your keychain or your hospital badge.
Headlight
If you're a surgical resident, consider buying a headlight for bedside and emergency room procedures. The GRDE LED Headlamp is remarkably reliable and can shine up to 2000 lumens for only ~$20. You'll never have to strain your eyes or spend 15 minutes looking for a bedside light again before suturing that lac. Light is easily adjustable and focusable and comes with a charger. A bargain and an essential for any proceduralist.
Coffee Machine
To save yourself the trouble of going through the motions of brewing coffee in the morning, purchase a Keurig machine, which runs ~$100. There are a large number of different K-cups you can purchase, including the Original Donut Shop Regular, a popular type which comes out to about 50 cents a cup if you buy 72 of them. Break up the sometime monotonous rounds with a different type of coffee everyday by purchasing this sampler pack. If you're looking for a standard drip coffee maker, the Black & Decker DCM600B can make 5 cups, is an Amazon best-seller, and is reasonably priced at ~$15.
Hospital Shoes
You're going to be rounding and standing a lot. Check out our guide here for the best hospital shoes.
Best of luck during intern year. Until then, enjoy your time off and accomplishments!