Docstoc

Intern Wisdom

Document Sample
Intern Wisdom Powered By Docstoc
					Original version: June 30, 2008. Edited on July 29, 2009.

Dedicated to the intern year; it shall never be the same.

This is a short, non-official guide to the intern year rotations. Things we wished we knew
before, learned as we went along, and want to share (what we don’t want to share won’t
be here.)

Rotations:

Ob/Gyn – takes place at the Weiler Hospital (next to Albert Einstein Med. School).

-How to get there:
from Manhattan train #6, get off at the Westchester Square stop, then the bus to take is
the Bx21 or the Bx31 (both go right past the hospital.) or take express bus, BxM10;
from Monte housing/hospital by free shuttle (2 shuttles, one on Gun Hill, another on
210th), get schedule on Albert Einstein med.school website
http://www.aecom.yu.edu/studentlife/page.aspx?ID=4132
(Belfer and Weiler stops are almost the same); by car (free parking at the Weiler with
special permit, inquire at Weiler security and have the form signed at the FM
department).
By gypsy cab: $12. Getting there from Monte by public bus is a pain.

-Set up: 2 months with alternating 2 sets of 2 wks nights and days.
-Goal: deliver 30 babies (ACGME requirement). Will mostly follow MMG-2 group
patients (it’ll make sense when you are there) but also may follow other group pt’s that
are about to deliver.
-Useful tips:
    1. Be patient. Ob/Gyns are very tired. Sometimes very, very tired. They may snap at
        you. Many times. Just be patient and focus on your goal (to deliver, go home,
        finish intern year, get to another reincarnation, etc). Seek out residents, attendings,
        PAs, midwives, and nurses that are good teachers, open-minded, respectful of
        patients, evidence-oriented, caring and/or like-minded.
    2. Introduce yourself to all staff. Get to know the nurses and show respect for their
        important role on L &D. Some are wonderful. Others are not so.
    3. Bring your food, especially, at night. Weiler cafeteria is worse than Monte. At
        night you may go hungry and there is nothing around. (Someone ate someone
        else’s abandoned cold and old French fries one night out of desperation.)
        Sometimes you may get on the ball and order with Ob/Gyn residents. Doesn’t
        always happen.

Resources:
Becky’s Little Book, made by Rebecca Middleton, class of 2008 (thanks, Becky, for
making it!). Dr.Williams’ site: http://www.rewillia.com-a.googlepages.com/ is a great reference for
prenatal care guidelines. Also SOAP for Ob/Gyn or any board review book (like “Boards
and Wards”).
   4. Never deliver without a resident or attending in the room. As soon as you see a
      hint of head crowning, ask the nurse to call the resident. If she says that there is
      still time, go and call the resident yourself. Some of us had babies fall into our
      hands. Then Ob residents came in and screamed. You don’t want that.
   5. If you have trouble at Weiller (traumatic experience, conflict with providers, rude
      behavior, etc.), seek out your fellow residents for support.
   6. If you have downtime, spend it with patients – laboring and post-partum. This
      may be the only prolonged human contact they will get through their hospital
      experience (an opportunity to teach pt’s re. labor process, relaxation techniques
      (besides epidural), contraception, breastfeeding, etc).
   7. The prize will go to the person who will figure out a place to take a nap at in the
      night….


NW7,aka “The Floor” – do your best to be positive. It’s a great place to learn if you see
and make it that way. Remember that the reason number one for your presence is to help
patients get better.


FHC – This is a very special place. 

-How to get there: from Manhattan, train#4 or D, Fordham stop or express bus
BxM4A/4B. From Monte housing/hospital: free shuttle stops in front of 210 St hospital
entrance w/sign “Fordham”. It leaves 5 min past each hour; stops at Fordham center. OR
walk – it takes 30-35 minutes. OR take bus 34. OR take D train (Kingsbrige Rd or
Fordham stops). Don’t take bus 28! OR take gypsy cab for $7-8.

-Don’t look back and wonder how organized your clinic would have been if you’d had
been assigned to Williamsbridge – you are stuck at FHC for the next 3 year so might as
well begin to love it.
-Patients at this clinic are truly special. No irony involved in this statement.

-Sometimes you will get a flow of patients that doesn’t seem to stop. If you feel
overwhelmed, ask your colleagues to help you see a patient. If you had a no show, ask a
colleague if they need help seeing patients, especially the upper years (you will know by
the 2nd year how helpful it can be).
-Read up on the cases as they come up.
-If you have any concerns, discuss it with the preceptor.
-Prenatals: for us, the policy was that the interns could not follow prenatals at all until the
Ob rotation and even after only those who are due after July 1st. In other words, no
deliveries until you will become a 2nd year. Check in with Dr.Williams if that policy is
still in place.
-RNs and CNAs and front desk and everyone else at FHC have been there for many
years. They have their ways…sometimes these ways are frustrating… Be persistent and
polite when needed to get things done or just do it yourself…All these folks are terrific
and will help you, eventually.
-Books: Current Family Medicine – nice book but the format is not very concise…Still
looking for a “Pocket Medicine” version of outpatient medicine…
-Call NYC Department of Health (800-698-0411) and request amazing patient brochures
to be sent to you in unlimited quantities for free! In English and Spanish! Check them out
at http://www.nyc.gov/html/doh/html/pub/pub.shtml?y=alert
-Again, it’s a great place to learn if you make it this way


PEDS- 1 month on CHAM 8 (infants, floor 8), 1 month on CHAM 9 (2 weeks general
peds, 2 – heme/onc; floor 9).

-Come between 6:15am and 6:45am for pre-rounding and sign out (done individually
from the night intern to day intern). Rounds on Cham 8 and general peds start at 7am;
Heme/onc start at 8am. Sign out btwn 4pm & 6pm, unless on-call. Call is Q4 but you will
split it with your partner, i.e. you’ll be on call roughly Q6.
You can find out your call days in advance on www.amion.com (enter “montepeds”).
Schedule your calls so that you are not post-call on your clinic days. Each one of you in
the pair will have 7 calls total over 2 peds rotations.

-Useful tips:
   1. Great resource, “Pediatric Intern Survival Guide”, created by monte peds
       residents is located on http://montepeds.googlepages.com/homepage
   2. You can go to NW7 for lunch if you get homesick…
   3. Be prepared to carry 30 patients while on call. Also be prepared to do more scut
       than you were used to. This is how things run in some places.
   4. Take advantage of peds teaching and try to make it to the morning conferences
       almost every morning and, especially, “professor rounds” on Fridays.

In the Monte neighborhood:
Food shops (from best to worst):
->Garden Gourmet on Broadway and 233rd (take bus 1 or 10 to Broadway), $4 delivery
to Monte I/II or take gypsy cab back for about $7-8
->Fish store on Bainbrigde->Fish store on Jerome
->Food Town on Bainbridge past D train/210th St. stop
->Fresh Fruit and Vegetable Shop couple of blocks down from Foodtown on Bainbridge
->Key Food on Jerome
->semi-fresh fruits and vegetables across the street on Jerome
->if you have a car: Stew Leonards on I-87, Trader Joe’s in Scarsdale, Costco next to
Stew Leonards, various Stop&Shops

 Get Fresh, mostly organic, fruits and vegetables from a farm in NY, in summer and
fall: Norwood CSA http://www.norwoodfoodcoop.org/
-> There is a little Koreatown by Bedford Park Blvd stop of D train (also can get Korean
food on Bainbridge)
->Very good wine can be located in the liquor store on Bainbridge across from Foodtown
-> Not categorized, various Farmer’s Markets throughout Bronx in the summer up to the
end of October; shops in Little Italy on Arthur ave (nice weekend adventure).

Post office: Jerome ave (closes at 4pm), Gun Hill Road (past train 2 stop)

Six ways to get to Manhattan by public transport: trains 4, D, 1, 2, express bus
BxM4A/4B, Metro North (Williamsbridge stop on Gun Hill Road)

Nice walks to: FHC, Botanical Gardens, Little Italy/Arthur Ave, Riverdale, down
Mosholu Parkway

Gym: Soma on Gunhill (opened just in 2008); Mosholu Community Center (on Gunhill
attached to the hospital); small gym in the Oval Park; various gyms around Broadway.

Doctors for you: you don’t have to go to Montefiore M.D. for your own care, EVEN if
you didn’t pay an additional penny for the health insurance.
M.D.’s that are part of the MIPA network are totally free for us; those who are part of
EPO network (much extended, makes it accessable in any borough in NYC) will cost you
$35 primary/$50 specialist co-payment per visit. Check out Empire website for the list of
MIPA providers http://www.empireblue.com/montefiore and
http://www.empireblue.com for the list of EPO providers.
Options for personal women’s health: Dr.Pandya (West Farms), Dr.Hadpawat (South
Bronx clinic). Dr.P is FP who recently graduated from Beth Israel program. Dr.H is Ob
who recently graduated from Monte program. Both are young, enthusiastic, and very nice
docs. (Just keep in mind that we do work with Dr.Hadpawat in GYN rotation and very
seldom with Dr.Pandya.)

Also, if you get ill one day (and it happens) and sick call gets activated and someone who
was on sick call that week hoping that they would not be called to come in on a Saturday
morning covers for you, dear friends, please have a courtesy of personally thanking them
for doing that. (Why did we write this here?  )

In Conclusion:

Intern year is trying… but it’s manageable. Prepare for a tough road, remember your
long-term goals, use free time to relax and take care of yourself… And ask for help and
support from those who’ve done this already – us! You are not alone.

Good luck!

Written by Marianna (Borkovskaya) Shimelfarb,
edited by collective and caring effort of Class 2010 and 2011

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:171
posted:3/30/2010
language:English
pages:4