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June 1, 2005

A Year Like No Other

Arch Surg. 2005;140(6):592. doi:10.1001/archsurg.140.6.592

There is really nothing quite like it. No other profession comes close in terms of duplicating the level of intensity, fear, or anxiety that comes with the first day of internship. Even though it occurs year in and year out, with the only difference being the faces, the training process, and the number of hours, it is still without a doubt the most exciting time of the year for me. What a process, indeed. The night before internship starts, interns will be waking up on the hour for fear of being late, having 2 or 3 alarms going off simultaneously. That clean white coat (this will be the cleanest it will ever be) and all the materials necessary will be laid out just like it was the first day of school. The skills developed in medical school in many situations bear no resemblance to the skills necessary to be a highly successful intern. Although they will have gotten their feet wet during their prior 4 years of medical school training, there is nothing like writing that first set of orders and signing their name to it, hoping the medications do not have adverse consequences and that they are “doing the right thing.” As soon as the surgical interns get through the first 30 days, we immediately move them on to a new service so that they are back to their high-anxiety levels again and their comfort levels are immediately extracted. The learning curve stays steep for 30 days, then drops back down and repeats itself on a monthly basis—new faces, new floors, new bathrooms to use, new skill sets, new data to read, new information to interpret, and new patients. Internship, in fact, may not be so much about learning the professional skill set needed to be a good surgeon or physician as it is about how to grow up as an individual. The success of a good intern depends more on one’s adaptability, flexibility, and resilience than on a lot of other variables that are much easier to measure. The maturation process of young physicians allows them to move through new services throughout the year and then move on immediately. It is painfully awkward, not just for the individual but for observers watching and monitoring this maturation process from the outside. It is an extraordinary time for young men and women. It seems appropriate that it is in the middle of summer that the academic year begins, when the heat gets cranked up, the intensity is increased, and the emotional intensity is palpable.