What are five things you wish someone told you as a July 1 intern?

1. It’s ok to feel lost. You’re in a completely new environment with new people and likely a new EMR, performing tasks you’ve never done before. Never hesitate to ask for help. If you get pushback for asking for help, it’s not on you. Always over communicate before you feel comfortable in your role. 2. You will make mistakes. This is the nature of residency training; you are in an environment where you can feel safely. Own your mistakes, learn from them, and move on. 3. Residency is a marathon, not a sprint. Take care of yourself; eat well, sleep, and prioritize exercise as you are able. It will make you day-to-day much more pleasant. 4. Make friends and build relationships with everyone you can. The better your reputation within the hospital, the more trust you will earn. 5. Enjoy the process! It’s easy to get bogged down by the long hours and extremely stressful environments. Keep in mind that this is your dream and all you’ve been working for. Enjoy the process and make the most of your training.

1. Create your own system for getting tasks done and holding yourself accountable. I used a double check-box system -- first box to ensure I had placed order / consult / made the plan; second box to make sure it got done and that I had seen the results or closed the loop. 2. Write your notes early!!!! Be efficient and knock out documentation as you go otherwise it will drown you at the end of the day. 3. Ask, ask, ask. NO one expects you to know much at this phase, so take advantage of this time to ask the "stupid questions". Better to ask and it be silly than to not ask and wish you would have. 4. Set alarms and timers. Lab follow-ups, post-op checks, team updates. Keep yourself honest with alarms set on your phone! 5. Keep notes on how the process works! If you're rotating on different services, hospitals, etc., keep a running note on important lessons learned, phone numbers, attending preferences and more. It will help. 6 (bonus but most important than anything else) -- NEVER LIE. This is a no brainer, but your reputation sticks with you forever. Lying is never the answer and ultimately hurts patient care (and your reputation / moral integrity).

1. Trust, but verify. Value the guidance of your seniors and consultants, but always confirm critical information with your own eyes. 2. Err on the side of overcommunication. When in doubt, ask the question. Clear communication is one of the simplest ways to prevent mistakes and provide better patient care. 3. Use your time in the hospital efficiently. Once you become proficient in your service responsibilities, you may find yourself in the hospital waiting for signout with hours left on your shift. Ask the junior resident if you can join them for consults, find an OR to scrub, or get a head start on studying for your in-training exam. This will pay dividends in free time at home once your shift ends. 4. Always be respectful, and remember names. Treat everyone with kindness and make an effort to learn their names, from nurses to the OR cleaning staff to attending surgeons, every person contributes to patient care and deserves your respect. 5. Enjoy the journey and be proud of your work. Residency will challenge you, but remember how far you have come and that you are doing meaningful work. Take pride in your growth and the privilege of caring for your patients.

1. Reliability is your biggest asset - as a new intern people expect you to make mistakes. If you make a mistake - tell the senior resident on your team right way and include how you plan to manage/correct this instance, and how you plan to avoid it in the future. This demonstrates thoughtfulness and maturity. Do NOT try to cover it up or place blame elsewhere. Hand in hand with this is not lying. If you are asked for information you don't have say something like, "I think the WBC was normal this morning," say that you don't know but you'll find out. 2. Every order has three parts - placing the order, making sure it gets done, and following up on the results. The task is not done until everything has been completed. In practice, this looks like making sure the CT scan gets done in a timely fashion and calling radiology for a read or following up on the consult's recommendations. 3. Trust no one, verify everything - do not report second hand information (especially from well meaning medical students), check the chart yourself, this goes for vitals, results, drain output, etc. 4. If you get a call from a nurse expressing concern about the patient - SEE THE PATIENT. You need to develop the clinical instinct of "sick vs not sick" and you cannot do this without seeing thousands of patients. 5. Fifteen minutes early is on time, on time is late, late is unacceptable.