Here’s a glimpse of an email from a RookieDoc graduate:

On my first rotation of my third week my attending told me she had never had an MS3 like me. She said that I was performing at the level of a PGY2. The last day of my third week of my third year I diagnosed a patient with a rare disease that all the attendings & residents missed. The patient is still alive he would have died within about 24 hours without intervention. I had the courage to state my opinion. Thanks Dr Tori!
- Trish – Miami, FL

Of course, I’m not saying this is what your results will be like when you join, but it does mean that it, at least deserves a sneak peek inside. So go ahead… Check it out:

One of the RookieDoc members shot me an email asking me about the pharmacology references I recommend to carry around in your white coat as an intern or a resident.

Here was a portion of our exchange:

Question:
I noticed you recommended Tarrascon Pocket Pharm – which edition is better, shirt pocket or lab coat pocket? I know the shirt pocket is a lot smaller, but will that be enough? It would be nice not to have to tote around a bigger book…if you could let me know what you think that would be great! Thanks again! I appreciate you getting back to me so quickly.

Answer:
You’re right, it’s better to carry around the smaller book.

Whatever you buy, save the receipt… and submit it for reimbursement if you have an education stipend.

I hope that helps

Dr. Tori
RookieDoctor.com

How does it feel in my first day of internship, at the end of the 1st week of my internship and at the end of the internship?

Here’s my response on YouTube:

Like it? Tweet this video.

Like it?  Tweet this video.

Anyway, in an effort to help some of the people out there stressing about interviewing for internship and residency, I jumped onto several forums and began answering some questions.

Most of the concerns and fears centered around actually getting interviews or how to answer the interview questions.

However, there were several threads where people were whining and complaining about their contacts at various residency programs “not coming through”, “leaving [people] high and dry”, “forgetting where they came from”, etc. Basically, several forum goers were complaining that they weren’t getting the favors they thought they were entitled to and were easy to give.

So, I posted the following response. I hope it helps you on your interviews for internship, residency, fellowship, and jobs…

Question: Hey guys do contacts help? One of my friends got an interview through some contacts, problem is i don’t have any!!lolzz

Answer: Contacts do help. I have done it for some and not for others, so you might want to understand why… what goes through someone’s head when you ask them?

Here’s the thing… Your contacts are being asked every year by tons of people to do this same favor. And while you might think it’s because they “don’t deliver”, or “they forgot where they came from”, or whatever… it’s actually not that.

If they recommend everyone who asks, it dilutes the power of their favor. And, if they don’t really know the person, they run the risk of being blamed for having lobbied for bringing that person in (if that person sucks).

So here’s the difference between which of your contacts will make a curbside reference for you and which ones won’t…

… ready?

… it’s not “contacts” at all… so, stop looking for contacts.

It’s RELATIONSHIPS. Just knowing someone’s name or having met them once or twice is irrelevant… However, if you stood out in some way (not just answering questions on rounds)… if you just focus on answering questions right, then you run the risk of not showing the real you… people don’t just care about your medical knowledge… they care about how you fit in as well. What other things will you contribute to the Program, besides medical knowledge?

Let me give you an example… one time in my training, I was taking a break leaning on a wall talking to the janitors and maintenance guys about football (American football – Go Eagles!). While I was leaning there, the Chief of Medicine walked by with a huge glob of white coats behind him. (Inside I was like O my God! My chances here are done.) He stopped in his tracks… stood right in front of me… and just looked at me. The other med students and interns looked at me like, “You’re toast”. While the Chief was looking at me, I shrugged and said, “What?… Football rounds.” and I smiled.

He cracked up laughing and kept walking. Later he struck up a conversation with me about football and later about some other stuff we had in common… cities we’ve lived in, universities attended, etc. When I interviewed at that program and other programs in that city, people said that he mentioned me.

Now, I never asked him to mention me, but he did. The reason… it’s easier to remember a relationship than it is to remember a contact.

So, when you’re on your clinical rotations of 3rd and 4th year, or when you’re on observerships, etc, don’t just concern yourself with answering medical questions. It’s the relationships that will be noticed… relationships with docs, nurses, administrators, secretaries, and patients.

And one last HUGE tip… Focus on what you can do for them, not what they can do for you. If you provide value wherever you go, people will notice in a good way. If the first question in your head is how can this guy help me, people will notice in a bad way.

I hope that helps.

If you have a question for me, Just Ask.

Well, when this mentor pulled me aside, she gave me a new perspective on things. So, it was better than an individual tip or a single pearl… She gave me a strategy. And I’m giving that same perspective, that same strategy, that same insight today. Here’s the link:

Here’s the link:

Revisiting the Intern’s Survival Guide

And here’s what I posted in the comments section back in June:

Great post.

For many, the appearance of arrogance actually comes from an intense fear of failure and fear of being exposed as someone who somehow slipped through the medical education cracks.

Unfortunately, some people try to cover or hide the fear, rather than saying, “You know what? I’m nervous. This is new to me. What has been your experience?”

“Smart interns forge alliances with the nursing staff” – great quote. If interns and nurses don’t see their missions as the same, they’re missing the boat. There’s a difference between a mission and a role. Both play different roles in the same mission.

And yes, there are too many new docs who start internship with an air of arrogance and, at times, downright rudeness. But, there is also a large pool of nurses that start off assuming there’s a turf battle. And both of these continue the cycle.

This probably sounds a little fluffy, but it would all be a lot smoother if we assumed the best in others.

For interns:
– Don’t assume you have to know everything.
– Don’t be afraid to ask for help
– Nurses know their job better than your attendings
– Social workers know their job better than your attendings
– The more you understand others’ jobs, the better off you’ll be
– Ask
– And when you ask, be polite about it.
– Communication is everything… more than words said, communication is an exchange.

For nurses:
– Interns are nervous, & everyone expresses it differently
– Be patient with the new folks
– Be especially patient with new interns from other cultures
– Don’t start off assuming a turf battle… sure defend that last piece of pizza
– The more you understand about others’ jobs, the better off you’ll be
– Ask
– And when you ask, be polite about it.
– Communication is everything… more than words said, communication is an exchange.

Also, be on the look out for an awesome freebie coming from RookieDoctor.com… very soon. The quantities will be limited because I can only ship out so many (before I go broke .

Residency tips and pearls should be a little more accessible than having to ask all of the time. Especially because there are some questions people are reluctant to ask… like about stress. Here are some coping tips for internship and residency…

No baby yet, so I had time to address some questions… One question was posed (on a forum) about extreme levels of stress and anxiety in internship and residency. Here was my response. Some of these tips and pearls come from the free report you can signup for at the right (just put your name & email in there & follow the directions… easy-peasy). Some of the other tips & strategies come from RookieDoc members-only videos. And some of the others were specific to the questioner. Anyway, check out my response and let me know if it helps you.

Also, if you have a question for me, Just Ask.

What you have expressed is ultra-common. It is, by far, the biggest thing I deal with every year from May to about October. I give talks to and provide services for new interns… I’m not going to plug my stuff here, but I am going to give you some background and a little proof that it is common.

When I started internship, I came in pretty average or slightly below average. I felt like any minute I was going to be declared a fraud & that somehow this whole medical school thing was actually a mistake. I was also immensely fearful of hurting someone.

Because of those two things – harming someone & being declared a fraud – I was always the first one in… always the last one to leave… At night I was dreaming about my patients. During the day I had palpitations, fatigue, reflux, etc. And throughout the day I was dreading any situation in which I could be called on or humiliated. Now, I wasn’t paralyzed with fear and I did my best not to show it, but I was definitely burning out.

So much so, in fact, that there was an intervention. Two attendings pulled me aside and took me under their wings.

One & a half years later I was Resident of the Year, then Chief Resident, and now I hold a prestigious position at my institution. Now the unfortunate thing is that not everyone gets attendings to guide them through it all (despite the whole idea behind our training). The fact is, you’re right, many people do talk about specific interns behind their backs. Some even pigeon-hole them into categories and give them labels that stick with them throughout their training – passed from attending to attending.

So I started giving talks to new interns and started some web sites and services. In the process, I have interviewed or surveyed well over 1100 interns anonymously and as a coach/counselor.

And guess what? Most of them list those same two top fears that I said I had. (My surveys always ask for the 3 top fears… and these 2 are the most common) Fear of harming someone is always number one… and fear of being the weakest link or worst of your peers or exposed as a fraud – almost always number two.

So what you are feeling is more common than you think. Actually, it’s probably normal.

Now, is it as intense as you describe? Not usually.

Now, on to some things to help cope…

1 – You are not alone. You know when you’re sitting around with the whole team – the students, the interns, the residents, maybe fellows, and the attending? And you know when the attending starts throwing questions out to the group? At that moment, everyone is secretly hoping they’re not called on. Everyone is eager to blurt out an answer when they know it… because they want to be absolved from answering the ones they don’t know. (Incidentally, because of this fear, I always start with the students, then the interns, then the residents when I’m asking questions to my team)

2 – The 10-Year Litmus Test. Ask yourself, “10 years from now, will any of this matter?” And the answer is no. It will not.

3 – Strengthen Your Strengths. This might sound like an odd suggestion & maybe even unrelated, but it is not. Most people are worried sick about their weaknesses. But think about this… How are you going to stand out? How are you going to provide the most value to your program? How are you going to forge the career you want, that’s in line with your passions and goals? Do you think you will do these things by working on your weaknesses? No.

If you want to stand out… If you want the people around you to say good things when you’re not there… If you want to like the company you keep… and if you want to make an impact in your patients lives or even on the world at large…

Then you should strengthen your strengths. Provide value to your program and your patients and your fellow interns with the areas you are strong in. (Related to medicine or not)

4 – Compare Yourself To Yourself. Too many of us worry where we stand relative to someone else. Like you said, “i will compare myself to my class mates and convince myself that they are all so much better than i am”. You are comparing what you know of yourself to what you do not know of others. You have no idea what they are thinking… what their fears are… or even what attendings think of them… or the vibe that patients get from them… or whatever. The best comparison to make is “This is where I am now – am I better than a few months ago? And how much better do I want to become?”

5 – You Are Not At The End Of The Road. Just because you are a doctor doesn’t mean that you are done. You are not at the “end of your training journey”… you’re right in the middle of it. You’re in the middle of the process. Trust the process a little bit.

Thousands of interns have come before you and thousands will come after you. All have their strengths and their weaknesses. This process helps make those weaknesses into competencies (maybe even strengths depending on you and your program). But the ultra-successful ones will be the ones who leverage their strengths.

So trust the process and add value along the way.

6 – It’s All About Communication. It’s not about knowing the right answers or even ordering the right tests the first time around. Those things come with time.

The best doctors are the best communicators. (By the way, so are the best wives, husbands, parents, etc) More on this another time.

7 – Avoid Complainers – Steer clear of complainers. Complaining is infectious. And whining will get you nowhere.

8 – Avoid the backbiters.

9 – Laugh a little bit. Check out sites like GiggleMed.com’s Medical Humor Blog, Placebo Journal and Q-Fever. But find humor only in appropriate things related to work – not in individuals or demeaning things.

Anyway, I hope this helps.

The images of CDs, books, and DVDs in this video correspond to downloadable products.