10 tips for thriving in your intern year

Congratulations on completing medical school and becoming a doctor!

Your intern year can be challenging, but our tips can help smooth the path from university to hospital. Individual needs vary and some of these tips may seem obvious, but we hope that having a ‘reminder list’ will be helpful.

1. Make the most of every rotation

Start with a positive attitude to all your rotations and secondments. They may not be your first preference, but you may be surprised.

Rural posts can provide opportunities for one-on-one learning and skill development.

Surgery may not be for you, but a surgical rotation could be one of your only chances to be in theatre.

Routine tasks such as organising pathology and imaging and discharge planning, will take you around the hospital, and provide valuable insights into other areas of medicine that you may not have considered.

2. Know your professional and legal obligations

Read the Medical Board of Australia’s Code of Conduct and understand what is expected of you.

If you are practising interstate, be aware regulations such as those about privacy and health records, can differ from state to state.

3. Treat others how you want to be treated

Your intern year can be tiring, but always try to remain polite and respectful. Avoid negativity and don’t get involved in workplace rumours or gossip.

Provide your patients with the level of care you would expect for your own family member.

Avoid confrontations with your colleagues and find ways to voice concerns by addressing them with a peer, senior colleague or your DPET (director of prevocational education and training).

4. Be organised

Find out early on what is expected of you from each of the teams you work in.

At the start of each day find out where your patient’s care is up to and have their investigation results handy.

You will work more efficiently if you are organised. Check and update your patient list on the record system and anticipate your daily tasks; radiology orders, consults, family meetings etc.

Keep a prioritised ‘to do’ list, but always be mindful of patient privacy – losing a phone or piece of paper can lead to a privacy breach. Understand your hospital’s policy on securing information.

Once you have finished looking at results on the computer, close the screen and sign out.

You should never leave the hospital with confidential patient information.

5. Take care with all forms of communication

Good verbal and written communication are essential for patient care and managing your workload.

Rounds and handover

Familiarise yourself with the hospital and your team’s approach to documenting patient assessments.

Use a structured system for your rounds and handover summaries.

When sharing patient information with colleagues, cover what’s medically important and important to the patient. Be mindful about patients and their families listening to your ward rounds and handovers.

Medical records

Accurate and contemporaneous documentation is key to maintaining continuity of patient care. Your notes should be clear and concise, and provide a clear understanding of the clinical decisions made by you and others. Avoid using jargon and acronyms that might be misunderstood. If you do need to provide handwritten notes, try to make sure your colleagues will be able to read your handwriting.

Your notes may be viewed by the patient or a family member, so never write anything in the records in a way that you would not want them to read.

If you’re unsure how to complete forms accurately, for example a death certificate, seek advice from a senior colleague.

Use of technology

Always adhere to the hospital’s policy when using electronic communication, including email, SMS and messaging apps.

• You can share patient information electronically within the treating team for the patient’s care, without having to obtain specific consent from the patient.
• Get your patient’s consent before contacting them by email or SMS.
• Consider if any messages are part of the clinical record and if so, make sure you save them to the record.
• Delete any clinical notes or images from your personal device(s) or account(s) once they have been transcribed into the medical records.
• Review your device and account settings regularly to avoid any accidental breaches of privacy and confidentiality.

If you have to leave a voicemail for a patient or colleague, request they call you back and tell them if it’s urgent but don’t include any identifying clinical information.

6. Savvy social media use

Always adhere to the Medical Board’s Code of Conduct, Ahpra’s guidelines and your hospital’s social media policies. Do not:

• discuss patients online without their consent
• post patient information, including images, without specific patient consent, even if it appears to be de-identified
• post information without first considering the impact on your role as a doctor, patient access to care, and the profession’s reputation.

AMA’s ‘Clinical images and the use of personal mobile devices’ guide and our factsheet provides more information on the use of social media.

7. Practise within your limits

You’re not expected to work independently, so make sure you practise within your limits. Never be afraid to ask questions.

Verify and document each patient plan with your senior doctor. Know why you are requesting each investigation and be able to justify your request. 

8. Treating friends and family

Review section 4.15 of the Medical Board of Australia’s Code of Conduct on providing medical care to anyone you are close to.

When it comes to treating friends, family members or colleagues, remember:

• Avoid doing so except in an emergency.
• Do not prescribe Schedule 8 and other drugs of dependence.
• Do not perform any elective surgery.

If you do need to treat someone close to you, document your treatment carefully and handover to another practitioner as soon as possible.

Be aware that you may have to justify your decision to the Medical Board, a court or tribunal.

9. Look after your own health

The transition to internship can be challenging, particularly if you are away from your home support networks. It’s important to:

• look after your own wellbeing and avoid burnout
• eat regularly and well, and exercise
• make time to maintain relationships with friends and family
• book your holidays
• have your own GP.

View our health and wellbeing resources, including tips on ‘Navigating your first year’. You can also call our confidential Personal Support Program on 1300 360 364.

10. Protect yourself

During your career there is a chance something may happen with the management of a patient. Whether an incident is your fault or not, your defence may not be fully covered by the hospital’s insurance, so make sure you have your own cover. Avant’s Intern Indemnity Insurance Policy* provides cover for:

• issues that arise as a result of your employment as a medical professional
• approved and recognised training program disputes
• defending an inquiry, investigation or complaint brought against you by a hospital.

More information

If you need expert advice, contact our Medico-legal Advisory Service on 1800 128 268, available 24/7 in emergencies.

Thank you to Dr Victoria Phan, former Avant Doctor in Training Medical Adviser and Dr Jane Ingham, former Avant Senior Medical Adviser, for their contribution to this article.