University of Wisconsin–Madison

The Surgical Intern: An Inside Look

Written by Sarah Tevis, MD, who completed her general surgery residency with us. 

During my third-year of medical school I had just begun a surgery rotation when my senior resident handed me a patient chart and said, “You will be my intern today, let’s round.” I frantically wrote down all of the progress notes and orders as she went from room to room seeing patients.

“AFVSS. ARBF. OOBx3.”

I had no idea what most of it meant and the morning was a complete whirlwind. But, I had a great time.

At that moment, I never imagined I would pursue General Surgery as my specialty. Before I knew it, my alarm went off at 4 a.m. on June 24. It was the first day of my intern year and I dove into residency training head first.

My first rotation was Vascular Surgery. I was both excited and little nervous. Throughout the day I made sure that I asked any available resident or faculty member that I could find for advice. My teachers all said the same thing: Load the boat, write everything down, the nurses are your friends, start your day with discharge paperwork, and never promise your significant other you will be home at a specific time.
It was all great advice. And even though we received an intern handbook on our first day filled with guidelines, conference schedules and instructions on how to admit a patient, it still wasn’t an instruction manual on how to be an intern.

I was relieved that I was not on the call schedule for the first few days of my rotation. I tried to absorb everything the Vascular fellow threw my way:

“A cold limb is an emergency.”
“Never ignore a headache after carotid surgery.”
“If you think about working someone up for MI, do it!”

Again, lots of great advice but I began to realize that the unknown would creep in between everything I had studied, learned and observed over the years. Nothing could prepare me for how to handle having a patient in the CT scanner with an intracranial bleed and mental status changes. Or the patient with respiratory distress postop. Or how to calmly tell the patient with chest pain that he is having a heart attack. And I was definitely not prepared for all three of those things to happen in rapid sequence during my second night on call! I remembered the advice I had received (load the boat), I called the Vascular fellow backing me up, and got through the night with all three patients stabilized.

After many more sick patients, call nights, and words of wisdom from my teachers later, I am now almost six months into my intern year.

Reflecting on these months, my fellow interns and I came up with a top 10 list:

10.  A programmable coffee maker is a must

9.  If you think of something to do, either do it immediately or write it down.

8.  A good attitude and/or sense of humor goes a long way.

7.  The nurses really are your friends!

6.  Use vague language when describing when you will be leaving the hospital.

5.  The right way to do anything is the way your attending wants it to be done.

4.  Talk to your fellow interns; they know exactly how you feel.

3.  The most common advice received and possibly the truest – load the boat.

2.  Spending time in the OR makes it all worthwhile.

1.  There’s a lot more to learn. Luckily it’s a five-year program!

Learn more about the general surgery residency program.