6 tips for women physicians just starting internship

My introduction to internship was during my hooding ceremony at graduation when the revered Dr. David Wagner hooded me and told me that internship was a time to become “intimate with disease and the suffering caused.”

“You will live with it so that it becomes so much a part of you that you instinctively know what to do, what to expect, even without sleep, food or outside contact.”

Filled up with this over-idealized surgeon embarking to become one with illness and disease, I took Dr. Wagner very seriously.  Internship is a year of doing scary new things, discovery of your limits of endurance, and dilemmas of the kinds you never thought you might have.

And although many of the challenges encountered 30 years ago are still in play today, not all have to do with learning how to care for patients.  Some have to do with behaviors that are given short shrift in medical school when it comes to understanding the cultural mores that surround how women and men are expected to behave.  So I have compiled a list of important things to remember as you venture out into this new role where you are now a doctor and must assume awesome responsibilities for decisions that only you can make.

1. Trust but verify.  Never take the word of another doctor for the history and physical examination of a patient.  Every patient for which you are responsible, even “just overnight,” go visit, speak to them and find out what is going on.  Do your own examination as you will find out how quickly things can change and what you might miss in just a few minutes or hours.

2. Never lie.  No matter how serious your infraction of not checking a test or seeing the patient yourself, always tell the truth.  It’s better to say you didn’t do it than to falsify the record.

3. Develop a style of professionalism. Be prompt, polite, business like, dress appropriately, be friendly and likable. Yes, a tall order.  And all the men have to do is show up.  Women who are successful have a high likability factor.  Take cues from attendings and senior residents who command respect just because they walk into a room.  Be careful to clarify requests for projects or products that might seem a bit out of the ordinary, like making a video of a particularly ghoulish finding.  Treat the patient with respect, and always review it with a respected attending.

4. Find women you can emulate.  The great surgeon.  The independent leader.  The kind but firm professor.  The stickler for details.  Learn from everyone you can.  And from those you find off-putting or difficult, learn what you don’t want to become.  Remember everyone has something to teach you.

5. Be kind. To yourself, your co-workers, the nurses and everyone who helps support your efforts to get the job done.  That job sometimes may take a minute or two more for the effort you spent to say please and thank you.  These are precious minutes you don’t sleep or eat, but in the end they will give you much more.

6. Introduce yourself as “doctor.”  You have earned it. Correctly set the stage for appropriate communication, “Hello, I am Dr. Diane Burns, the intern on the medical service calling you for a consult at the request of my attending Dr. Bush.   You are not “Heather, on the green team.”  It tells nothing and doesn’t convey you place and authority (or lack thereof) in the conversation.

Now, not every situation you encounter will be covered by these 6 injunctions, but it is a good start.  And if you get these well integrated into your repertoire, you will be just about at the end of the year and will need to start on a whole new set of skills as you climb the mountain of care for the sick and needy.  Remember, it is a marathon, not a sprint, so take your time and take it in.

Linda Brodsky is a pediatric surgeon who blogs at Women MD Resources.

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