Tips for the intern class of 2020

JUST how many tricks can an old dog teach? Welcome to the third instalment of my tips for new interns. Let’s give 2020’s interns some tips for success:

Get a mentor or two

We’re now swimming in an ocean of doctors in Australia. We number over 100 000 and more medical schools seem to be opening every year. Despite the crowd, sometimes work can be a lonely place and you need to “dial a friend”. Make sure you have at least one or two such friends to provide you with clinical and career advice, and emotional support.

You’re no longer a student … or are you?

Remember to take off your mortarboard on your first day. Undoubtedly imbued with the latest and greatest pearls of wisdom from your medical faculty, it is easy to get ahead of yourself.

Humility is one of the best tools in a doctor’s armamentarium and we’re all lifelong students.

Security

Sadly, a hospital is not as safe a workplace as one may think.

Many of the large hospitals have labyrinthine layouts, meaning you may have to walk (and sometimes run) long distances between tasks. When this happens after business hours it can present safety issues.

The general problem of understaffing throughout the public hospitals can result in you not having someone else with you when consulting violent or unstable patients.

Don’t be afraid to ask for security if the situation is not safe.

Lost in translation

In Australia, about 28.5% of the population was born overseas. So don’t assume that your patient understands all you say.

Avoid jargon. Take your time explaining things. If in doubt, call a translator.

Behind each successful patient is a good GP

In my mind, one of the great shames of the modern teaching hospitals is the absence of GPs.

While the system excludes GPs from the large hospitals, for a patient to do well outside of hospital, a good patient–GP relationship is needed.

The patient’s GP is your friend. And the GP probably knows more than you may realise. Don’t be afraid to give the GP a call. It’s worth the effort.

Discharge letters

There have been three excellent articles on discharge letters in InSight+ recently (here, here, and here). Read them carefully as this is one task you’ll be doing over and over. Further to those articles, be mindful of these basic yet important points:

• Who is the addressee? If it’s not loaded into the system, your discharge letter will just sit in the patient file and go nowhere.
• Who else may need the letter? Forward it to relevant specialists and allied health.
• Avoid addressing discharge letters to organisations – it is best to nominate an individual, so at least someone is responsible for reading it.
• Don’t write “GP to chase such-and-such result”. Remember what I said in the past article: you order a result, it’s your responsibility.
• Don’t assume GPs are sitting with empty waiting rooms, just waiting for your discharge letters. Some GPs have waiting times of several weeks and GPs are also entitled to take holidays and study leave. Therefore, discharge letters that say “see GP in 2 days” can be highly inappropriate. If you feel your patient needs to see a GP that fast, ring the GP practice and make sure that it can happen.

Who else needs to know?

So much of a doctor’s work time is spent “chasing things”, particularly results of pathology and imaging.

This problem shall never be eliminated but it can be significantly minimised when we include the other participating doctors on the request form.

Given the interns are usually given the job of ordering tests as well as chasing things, it may just improve your chances of getting time for lunch or coffee!

Wishing all the interns of 2020 a wonderful and fulfilling career in Medicine!

Dr Aniello Iannuzzi, FACRRM, FRACGP, FARGP, FAICD, is a GP practising in Coonabarabran, NSW, and a clinical associate professor at the University of Sydney and University of New England.

The statements or opinions expressed in this article reflect the views of the author and do not represent the official policy of the AMA, the MJA or InSight+ unless that is so stated.