Enjoying your intern year

By Clinical Professor Leanne Rowe AM

As your first year as an intern unfolds, consider seeking independent mentorship and career advice on your choice of specialty outside of your workplace.

However, try to keep your options open in your first year as it is usually too early to make firm decisions on your future career. Keep an open mind about your future specialty and try to obtain as much experience in all areas of medicine, surgery and psychiatry. Your wide experience will be very valuable to your future career and care of your patients, whatever specialty you choose.

Avoid taking on extra study or research outside your work hours in your first year. It is more important that you focus on your optimal performance in all your rotations. One of the great things about your intern year is having a break from exams.

Consult your trusted GP for any physical or mental health issue no matter how big or small. Strict privacy laws protect your confidentiality. Mandatory reporting only occurs if a doctor is at risk of substantial harm to patients, which is rarely the case. Most doctors with mental illness provide the highest standard of patient care, often at great expense to themselves. Doctors with optimal mental and physical health enjoy their medical careers.

To remain positive about your future, develop practical goals in all areas of your life not only medicine: spiritual life, relationships, mental health, physical health, social life. If you have a few bad days, you can put them in perspective if you have bigger goals outside medicine.

Influence the culture of medicine

  • Continue to listen carefully to your patients and your colleagues.
  • Continue to develop your communication skills.
  • Always be professional with patients, other doctors and staff, including other health practitioners – even when you feel overworked and tired, develop a reputation for being consistently kind, caring and professional.
  • As your first year goes by, you will develop more confidence to engage in constructive debate with your colleagues. Healthy debate results in a high standard of patient care. Try this exercise if you have disagreements with colleagues about clinical care or other matters:
  • List all the possibilities/diagnoses together, weigh up the pros and cons of each possibility/diagnosis objectively.
  • Agree on the best course of action after an objective assessment.
  • This may require mutual compromise.
  • Implement the agreed investigations/solutions, and agree to review them later.
  • If there is any misunderstanding about clinical care, try: ‘How can we work together to prevent this happening again?’
  • Be open to changing your opinion if more facts emerge.
  • Also practise responding to inevitable conflict or criticism constructively. Sometimes it helps to approach conflict by taking steps like this:
  • Listen without interrupting to establish the facts.
  • Ask for specific examples.
  • Understand the other person’s intentions.
  • Is the criticism valid or is this due to personal differences?
  • Ask what is really behind the conflict? Is it due to miscommunication or misinformation? Try:
    • ‘I can see why you would be upset over this’.
    • ‘I’ll bear this in mind in the future to prevent any misunderstanding.’
    • ‘Thanks for raising these issues so we can talk about it constructively.‘
    • ‘I can see we both want what is best in this situation.’
    • ‘I appreciate that you have high standards.’

Recognise and report bullying, which includes repeated, unreasonable behaviour that creates a risk to health and safety such as:

  • verbal abuse
  • criticism or intimidation
  • excluding, ignoring or isolating
  • giving people impossible tasks or timeframes
  • withholding information that is vital for effective work performance
  • spreading false rumours about an individual or group.

Also speak out if you or your colleagues experience any harassment or discrimination.

Care for your colleagues, including medical students. Personally welcome a new colleague, thank a departing colleague, call an unwell colleague to ask them if they are OK, congratulate another colleague on their achievement.

Reading this list may seem a little overwhelming because there is so much to do at work. These dot points are not prescriptive. They are a few practical suggestions to help you enjoy your first year. Trust yourself. Be kind to yourself. Keep connected. We are all still learning – please spread this article around and add your own ideas.

Clinical Professor Leanne Rowe AM is a GP and past Chair of the RACGP. Her book ‘Every Doctor: Healthier Doctors=Healthier Patients’ www.everydoctor.org, co-authored with Professor Michael Kidd AM, is about thriving in medicine as well as addressing the tough issues in medicine.

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