The Residency-Intern Diary

By Omolara Grace Adeniran MD

Now that you matched or prematched, what's next? where do I live? What do I wear? What should I study and what are the things I wish I had known before starting? How do I balance my work with family? Do not look further. The Intern's Diary will guide you through every step of the way.

If you are an IMG, medical student, or AMG, recent or old graduate. Or perhaps you are already in the residency training, and it's hard to get through easily. This book is the best for you. It will change you completely to a better and strong intern.

Maybe you are not a medical professional, but you would like to give a gift to your loved ones in medical schools or about to start residency. This will be a great gift for them.

It will answer most of your questions that you might be shy to ask your colleagues, seniors, or attendings during rounds. It has some imaging, illustrations, and list of commonly used medications as well. The pocket size makes it handy during your clinical rotations, both inpatient and ambulatory.

It is designed for almost all specialties, including internal medicine, family medicine, psychiatry, and emergency medicine.

Wishing the very best in your next phase of career!

• Language: English
• Publisher: Fulton Books, Inc.
• Release date: Mar 13, 2023
• ISBN: 9781638602842

Book preview

Table of Contents

Title

Copyright

Preface

Acknowledgments

Introduction

Section 1: The Interview Season

The ERAS season

My prematch day!

Section 2: Preparation for July 1

Signing the contract

Getting the visa

How to improve your typing skills

Scrubs and coats

Getting accommodation

Advice from my predecessors

Message from a family medicine intern

Orientation week

Section 3: Internship Training

July 1

Week 1 (ambulatory)

Week 2 (coronary care unit [CCU])

Week 3 (night float)

Blood sample bottles and their common uses

Week 4 (endocrinology and rheumatology consult)

August: stroke unit and regular medical floor (RMF)

Stroke unit (neuroscience unit)

Regular medical floor

Basic workup for common signs/symptoms

The RRT (rapid response team) codes encountered

September

First week (infectious disease consult)

Second week of September (ambulatory)

The third and fourth week of September (medical intensive care unit—night rotation)

October

Week 1 and 2: vacation

Week 3: ambulatory

Floor rotation (October/November)

Fourth ambulatory week (November 18–22)

November (night float and admission team)

December

My third and last week of night float as PGY 1

Ambulatory week (Christmas week)

Regular medical floor

February

Medical intensive care unit (MICU) day rotation

February 14 (a memorable day)

Vacation

March

Ambulatory week

Subcardiac and telemetry units

Section 4: COVID-19 Season

COVID-19 crisis

Second week of the COVID-19 crisis

Third week of the COVID-19 crisis

Fourth week of the COVID-19 crisis

Week 5 of COVID-19 (critical care medicine team)

Week 6 of COVID-19 (CCM night team)

Week 7 of the COVID-19 crisis (admitting team)

May/June rotation

Section 5: Lessons from Other Specialties

Family medicine

Psychiatry

Section 6: Common Medications and Their Doses

Common Medications and Their Doses

About the Author

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The Residency-Intern Diary

Omolara Grace Adeniran, MD

Copyright © 2023 Omolara Grace Adeniran, MD

All rights reserved

First Edition

Fulton Books

Meadville, PA

Published by Fulton Books 2023

ISBN 978-1-63860-283-5 (paperback)

ISBN 978-1-63860-284-2 (digital)

Printed in the United States of America

Get Equipped for the Residency Training!

To the Almighty God, who has inspired me to put my thought into writing to benefit others and make the residency a smoother journey to embark on

Preface

The purpose of this book is to guide every medical intern step by step from the matchday/prematch to the end of your PGY 1. Residency is an arduous journey, and the internship year is more robust. Initially, I started to write this diary for fun, but then a day came, and I was reading through it; I found that what I wrote was inspiring to me, and then I wondered what it would look like for new interns. I decided to publish for others to learn from my past, from the matchday/prematch offer to completing the first year of the residency program. This book is unique in that it is a day-to-day guide. It includes the ups and downs you will encounter, how to overcome the hurdles, building your resiliency, and bringing out the best in you.

It is advisable to read this book at least once before your training starts to equip you and guide you easily during the program. If you are already in the program, it's never too late to pick this up. It will also guide you through each rotation.

Through my experience and those of my colleagues who have also contributed to this book, you will learn the following: getting your visa and types; getting scrubs; how to improve your typing speed; different tests to prepare for during the program; research and conferences to attend; how to be very efficient as an intern on the floor, ICU, or ambulatory; and advice from other interns in different specialties such as pediatric, family medicine, psychiatry, emergency medicine, and internal medicine.

Acknowledgments

First to God Almighty, who inspired me and made it possible despite my busy schedule.

To my program director, Dr. Conrad Fischer, who has been a great inspiration. When I informed him about the book, he said, Terrific idea, Grace. I am sure it will help.

Also, to Dr. Lauren Shaiova, Dr. Abrol, and Dr. Udevbulu, who helped with editing; and my outstanding chief resident, Nermeen Botros.

I would also like to give honor to whom it is due, my wonderful colleagues, who out of their busy schedules, took time to make this book a success:

Dr. Olubunmi Mary Fokorede, family medicine chief resident. She wrote the family medicine session of this book.

Dr. Sarfraz Ahmad Mohamed, psychiatry resident. He wrote the psychiatry session of this book.

Dr. Oluyemisi Amoda and Dr. Elmarie Alexander, my advisors, editors, and strong encouragers

Thank you all! Together, we did it!

And to my dearest family, who always believed in me and stood by me in making this book a reality.

Introduction

As I said, residency is challenging training, but it is doable! The training is usually for three years. The first year is called the internship year. In many programs, this is the toughest of all. This is because it has a lot of challenges—getting to acclimatize to the new environment, new people to work with, directing patients' care, and taking responsibility.

I decided to write this diary to reflect on my past—see how naïve I was and compare it to when I became an expert. Indeed, there are many things to learn as a medical doctor. This includes, but is not limited to, patient interactions; performing basic and standard procedures such as inserting a central venous catheter, arterial line placement, NG tube, midline placement, and many more; writing a standard H&P, progress notes, discharge summary, transfer notes, and procedure notes; presenting cases at the morning conference; and getting involved in research. A lot to do and to do well.

You can be a better intern if you are eager to learn, resilient, and work hard. More so, it is a learning ground to develop your soft skills. At the end of your first year, your confidence level should have significantly increased, your knowledge should have broadened, and your reasoning should have also improved.

As you read through my diary and learn from those who have been there before you, you can achieve more than we have done and be a better intern.

I wish you the best in your residency training!

Section 1

The Interview Season

The ERAS season

This is the season when you prepare your applications for the residency. Get at least three strong letters of recommendation, prepare your personal statement, and create your lists of programs that you fit into the eligibility criteria, and most importantly, your USMLE scores should be available.

In preparation for this season, I did a three-month externship program in DC, rotated in different private clinics, and got strong letters of recommendation. I wrote my personal statement for internal medicine, my field of interest, and got my applications set by September first to apply early.

The season usually starts in June and ends in May every year. But programs only begin accepting applications on September 15. And the second week of march is match week. This is the month you get to know if you match and where, unless you have prematch, then you would have known before March.

Coming from a low-income family and applying to 120 programs would cost at least $3500 plus the travel expenses to different programs where I would be interviewing and the cost of hotel reservations and feeding. My goal was to have at least seven to eight thousand dollars ready before the season. I finished the three-month externship in July. This meant I had only August and a few weeks in September to get the money. I could not gather the whole money, but with the help of friends and family, I was able to apply to as many programs as I could. I sent emails to the programs I applied to later in November to reiterate my interest. I did not get any interviews until the end of October; I was so worried about everything.

I finally got an interview in New York, and afterward, I decided to visit neighboring programs to show my interest. I have always loved Brookdale Hospital, but I knew it would be hard to get in as I did not completely meet their requirement in ERAS. Nonetheless, I still applied. I decided to visit also since it was close to where I just had an interview.

On getting there, the lady I met told me frankly, Your scores are not good enough. We select people with high scores. I know I have decent scores—230s and 240s—but to my amazement, the programs take only those in >240s. I was no longer confident to speak up, but still managed to say, I have other qualities beyond the scores if you could consider me for an interview. I thanked her for her attention and left. On getting home, I received another interview in another part of New York—Cayuga. I quickly picked a date before it got filled up. I went for the interview and loved the program, the environment, and the people.

Long after that, I received an invitation for an interview at Brookdale Hospital which I previously visited. I knew all I would have to do to impress them was to ace the interview. I read and studied the program like an exam and called people who knew anything about the program and what to expect. I booked a hotel near the hospital and got everything ready.

Brookdale Internal Medicine is a prematch program. This meant you will get to know the result of your interview before the match day.

My prematch day!

It was on the nineteenth of December. My family and I had driven to New York from West Virginia. We lodged in a hotel near the hospital—the Holiday Inn (affordable and comfortable). I could not sleep all night because my mind was occupied with the interview. I kept practicing the standard interview questions even in my dream. I got up early, dressed in my creamy top and black suit, and ate cereal for breakfast. Considering the traffic in New York, we left early for the interview. The interview was scheduled for 10:00 a.m. We got there at 9:00 a.m. My family went back to the hotel while I walked into the office. I was the first interviewee to get there. Everyone noticed my punctuality, and one of them asked, Why are you so early? With a smile, I responded to her.

I was directed to the small conference room, where we waited for others to come. At 10:00 a.m., the interview started in the same conference room. Residents walked in to say hello and tell us more about the program. Some attendings and faculty members also came. They asked questions, and we also asked questions. It was an excellent interactive session, and I did ask questions too, presenting my questions with a beautiful smile and confidence.

We had some snacks, and then each of us was called for a 1:1 interview with the resident and a faculty member. I started to get nervous and at the same time acted to look calm. Deep in my heart, I want to prematch, and I wanted to prematch in this program, and I was ready to prove that my scores were not the only