9 things to know to start a successful residency or internship

You know the feeling. Classes are practically over, all of your exams are done and graduation is just around the corner. As tough and demanding as these years of school were, you’ve made it through. Take a sigh of relief and pat yourself on the back—it’s the end of an era. 

Now take a deep breath, because it’s the beginning of a new one: depending on your program, residency or an internship.

The deep breath isn’t because your years of school aren’t going to help you through—they’ll be crucial. The difficulty, and probably the thing that a lot of people fear with residency, is that you’re about to take the step from the textbook into the hospital. It’s the difference between the theoretical and the practical, and that difference can be scary to a lot of people. 

Luckily, there’s no need to be completely blindsided by what awaits you on the other side of those hospital doors. Knowing what to expect can help soften that cultural shock, and that’s where we come in; here are 9 things that you’ll want to know to have a great experience in your internship or residency. 

Hold on to your motivation

Once you’ve been admitted into your program, taken off your medical student lab coat and tried on your doctor coat, you’re going to feel on top of the world. Find a way to hold onto that! Everyone will, of course, have their own way of doing this. You might write a letter to your future self; if you’re more of a creative writer or even a poet, you might jot this feeling down like a story or write an epic poem. If you’re a songwriter, you might write a song about it!

How you keep this feeling alive doesn’t matter so much, it just matters that you do.

It’s no secret that some very long and stressful days lie ahead. You’re bound to see and experience things you had never necessarily wanted to come across, and you’re going to have to endure impossibly long shifts. This, by no surprise, can be plenty tough to get through! In fact, for a lot of people, this can lead to questioning why they’re in this position in the first place, and can even lead to question the entire career choice. This is when that letter, video, poem, story, song, or whatever comes into play.

Just remember: sometimes, a simple reminder of why you’re doing all of this can be more than enough to help you keep pushing on. 

Embrace your new role

Yes, even at the beginning. You might be used to studying and watching out for yourself with only your grades to consider, but now other people depend on you. This can be scary at first, but going in nervous about your new real-life role can, in turn, make your patients feel uncomfortable with you regardless of how crisp your new, custom lab coat looks.

Even more so, going in nervous can make you more prone to mistakes, which is certainly not something you want to risk. 

Even though there’s still much to learn, it’s better to take pride and confidence in your time at medical school. You have a great base, you’re going to learn what you have left to learn, and if you take a deep breath and go in with confidence, both you and your patients will be better off because of it. 

Adapt your learning

Medical or nursing school turned you into an absolute studying machine. You spent countless hours, night after night, poring over your textbooks and class notes and learning every possible bit of information that might pop up later. You know exactly how to mark up your course literature, and you know all the best methods for flipping through dense text. 

Unfortunately, those skills don’t necessarily translate as the only skill you need residency. Furthermore, you’re going to have even less time to study and read during an internship or residency. The good news? You can change up the way you study and take advantage of the situation. There is a silver lining—the key here is to figure out how to learn on the go. 

Working incredibly long shifts really does a number on your ability to retain information. Beyond that, there’s no syllabus to help you prioritize content, and reading random textbook chapters and articles might be interesting, but only with questionable relevance.

One habit to pick up that both caters to the relevance issue and works wonders for retention is reading up on your own patient diagnoses. This, of course, is directly relevant to what you need to know, and also helps you stay on top of all of your healthcare responsibilities. Moreover, retention of that information is much easier since you’ll be referring back to it regularly. 

A lot of the theoretical foundations you need to know are the ones you already have from school, and a lot of the practical knowledge you need you will learn on the job. Unless specifically recommended and relevant, going home and reading chapters out of a textbook for the sake of reading probably isn’t the best use of your time. If you feel there’s something you need to brush up on, asking someone with more time and experience at the hospital can help you to pinpoint exactly what you should be reading and studying. 

Know your patients

Your patients obviously aren’t just names and diagnoses on charts, and getting to know them both medically and personally can be very important for a good number of reasons.

For one, taking some time to get to know a patient and take an interest in them—even if only for a few minutes at a time—does a lot to get them to trust you and feel more comfortable both with you and with the whole procedure in general. In this specific context, the patients don’t just have to trust that you’ll do a fine job as a service provider, either. In many cases they might have to trust you with their lives. The least you can do is help them out a bit in feeling more at ease with you and with the situation. 

Knowing your patients is also critical for strictly medical reasons. You’re their doctor, and this means everyone is going to look to you for the most up-to-date information about them and their care plan. How well their care goes is, in large part, up to how well you know their information and how well you manage all the details.

In a critical situation, for example, the outcome of an emergency may very well depend on how quickly you can come up with a solution given your patient’s case and medical history. Knowing your patient well can be important for “small” reasons like a general feeling of comfort and ease, but it can also be life or death. 

Know your place

A lot of med students survived their program by working as a team, and if this was you, great! However, if you were more of a lone wolf (proud to get everything done by yourself), it’s time to learn how to be a team player. 

Of course, working in a hospital is all about teamwork, and information always needs to be communicated clearly and efficiently. This means communicating well to patients, nurses, administrative staff, and anyone that might need to know something.

Taking it a step further, to quote Kendrick, “be humble.” Yes, you’re a real doctor now, and no, you aren’t sporting a student lab coat anymore—but most of the nurses that have been at the hospital for some time can probably do whatever procedure you need to do quicker and better, so come in with confidence, but recognize others’ expertise, too.

In the end, you might have just survived some grueling years at school, but you’re just starting out here. Be respectful, be humble. Also, while confidence is your great elixir, pride is not your friend. If you’re asked to do something that you don’t know how to do, ask someone! Again, your grades are not what you’re putting at risk when your pride convinces you to not ask for necessary help. 

Patients always come first

Probably for the better, residency won’t be exclusively caring for patients. While helping people this way might have been your primary motivation for taking this path, it’s also very taxing and we all need a little break once in a while. While they aren’t exactly beach getaways, you’ll have meetings and other events to attend that aren’t even explicitly about healthcare, and some of them might even be a bit of fun! That said, as fun or as important as the meeting or event might be, it does not outrank your patients in terms of priorities. 

Take your time

Sure, working in a hospital is often fast-paced and (unfortunately) hectic, but that doesn’t mean you shouldn’t make sure you’re taking the time to make sure everything is done correctly. Especially at first while you’re still getting the hang of things, not giving yourself the time you need to do everything with precision can lead to making mistakes that, again, do not only affect your grades anymore. 

Of course, this doesn’t mean you can take hours on every task given. One way to give yourself more time without “taking” time away from other tasks is by getting to work early. Giving yourself a few hours before starting rounds to collect all patient vitals or all the information you need for the day can really help to make your rounds and your whole day run more smoothly. 

And remember, over time, you’ll get much faster and much more efficient at all of your daily tasks and you won’t need as much pre-allotted time to get everything done. Until then, make sure to give yourself plenty of leeway without getting in the way of others or of other things you need to get done. 

Friends and family

Believe it or not, your friends and family will probably play a pretty big role in your residency. If this sounds familiar at all from school, that makes sense, because it’s for the very same reasons. 

The truth is that residency is tough. You spend long, long hours surrounded by situations that aren’t the most comfortable. In fact, having to frequently deal with situations where people are injured, suffering very taxing conditions, and even losing their lives is bound to weigh heavily on your mental and emotional state. 

Having people with whom you can talk and express your feelings is vital, especially when you’re feeling overwhelmed with whatever might be going on at work. If the friends and family you talk to are outside of the white coat community, you might not be able to go into detail about the uglier parts of working in medicine—but you can certainly voice your feelings and have someone to listen to what you have to say. 

You can also talk to med school friends that might be going through the same things. As you spend more time in the residency or your internship, you’ll get closer with your coworkers, too, and will be able to talk to them specifically about what’s been up. The point of all of this being, of course, that having someone to talk to is a very important part of your internship or residency that will help you get through the tougher moments. 

Make time for yourself

This is all much easier said than done. Like school, the vast majority of your time is going to be consumed by work related projects, so taking a bit of time out of each day or even each week is no easy feat. That said, it is an important part of keeping your sanity. 

As mentioned already, you’re going to spend many, many hours and very long shifts focused on your patients, on medications, on procedures, etc. In order to alleviate some of that emotional and mental stress, take some time for yourself to do something that has nothing to do with work.

For a lot of people, this means exercising. This can be anything from setting apart chunks of time you have for the gym to going on quick 20 minute jogs before showering and heading to work. You can also set time aside to watch a movie (or two), read your favorite books, make music, or really anything that’ll help you relax and keep a balanced head. 

No internship or residency is a walk in the park, but that doesn’t mean you have to be blindsided by everything that awaits you. Knowing that these things are coming and preparing for them in whatever way works for you puts you a few steps ahead when you walk into the hospital and put on that white lab coat.