DOCTOR-TO-DOCTOR FIELD REPORT
Name: Emma Chan
Position: Intern at Logan Hospital, Logan QLD -Currently on Emergency Medicine
Application group: Domestic Group A (QLD) , NSW Category 2
Let’s dress to impress – applying for internship
How did I approach internship applications? After many sleepless nights, caffeine ODs and study cramming sessions, I was so relieved to have crossed the finish line to medical school. Yet only then did I realise I was about to start a new marathon as a practising doctor. Internship is probably one of the biggest transition points of your medical career. It was integral for me to start my medical career off on the right foot by setting a good work-life balance so as to avoid burnout and work fatigue. Hence I wanted to choose a good hospital that facilitated a supportive working environment as well as allowing myself to disconnect outside of work hours.
The following considerations helped me navigate internship applications, and hopefully these tips might help you too!
Step 1 – assess life priorities At least 38hrs per week (and most likely more) will be spent on the hospital grounds, so maintaining life hobbies and enjoyable activities outside of work are valuable aspects of disconnecting from work. Both my partner and I had spent a wonderful 2 years studying at the Toowoomba RCS with a loving and supportive student/ staff cohort, but we were both ready for a scenic change. We wanted to live amongst the hustle and bustle of Brisbane city, have relative proximity/ easy access to our hospital, live close to a gym (as exercise enthusiasts) and live walking distance to essential shops (ie supermarket, chemist) especially for those last minute meal decisions after work. We had also missed our Brisbane based family and friends immensely!
Another conflicting thought was the idea of trying to transition back to Melbourne. Similar to many other interstaters, I had left my hometown Melbourne to study medicine. Although I had a great support network in Brisbane, it has been emotionally taxing at times not being close to family and missing many events and milestones. However, the Victorian intern campaign operates very differently to Queensland; you create a priority list of hospitals in order of preference, and then undergo a separate application process for those hospitals involving CV/cover letter, GPA results, and sometimes an interview process. With my status as a permanent resident Australian trained graduate from an interstate school, it placed me in priority group 3 too (below permanent and temporary residents trained at Victorian clinical schools). With all this in mind plus all the effort to fly down for multiple interviews throughout exam block, it did not feel worthwhile to apply just for internship and decided moving back to Melbourne would come later down the track.
Step 2 – picture your future career Although internship is the first step in your medical career, it’s an important year to understand the hospital system and become familiar with fellow doctors, nurses, allied health, admin and hospital staff. In addition, knowing the opportunities available at your hospital that can help you develop interest, skills and knowledge in your field of interest can be beneficial. I’ve developed a keen interest for paediatrics/ emergency/ paediatric emergency, so finding a hospital that offered paediatrics and a busy emergency department (especially a split paeds and adult ED) was part of my priority list. I also wanted a hospital with a good medical education program, and opportunities to delve into some research.
Step 3 – prioritise your list of hospitals and chat to colleagues Putting lifestyle and career prospects into action, it was time to decide how to prioritise the list of hospitals in the internship campaign. I decided to prioritise Brisbane and coast-based hospitals for the reasons of wanting to live back amongst the city/ change the landscape up from my previous 2 year living rural. Although I am a bonded student, I had decided to complete my rural year instead in PGY2 or PGY3. Once you have a rough list of ideal hospitals, try to chat to doctors at that hospital! Amongst the hospital colleagues I had chatted to, there was a general consensus that I could attain more hands- on experience and learning opportunities at non tertiary hospital because there were essentially ‘less doctors’ to compete with. I was also learning towards non-tertiary hospitals with more generalist rotations on offer (ie general medicine and surgery rather than the specialties) as I wanted to see a whole range of general presentations as a junior doc. I narrowed my search down to medium sized hospitals too, as I felt there would be better opportunities to be noticed by my seniors and hence finding mentors and/or references for my CV.
I eventually narrowed my top 3 list of hospitals – Logan Hospital, The Prince Charles Hospital and Redcliffe Hospital. It then became important to acknowledge the amount of available intern positions and how many people had subscribed/ oversubscribed. I ended up choosing Logan Hospital as it was less oversubscribed and I was more familiar with the #Southside ;) Logan also has the second busiest ED in QLD with a very diverse demographic (disadvantaged SES, multi-cultural) which I believe presented a valuable learning experience and an opportunity to help a more disadvantaged population.
Step 4 – are joint applications worth it? If you’re in a couple situation, you may be pondering ‘is the joint application worth it?’. Essentially, the joint application considers two people as applications stuck together. It means that you are guaranteed to be in the same hospital; however you run the risk of missing out on higher prioritised hospitals if the hospital is oversubscribed – for example if one application misses out on that ballot (despite the other one being ‘accepted’), both your applications will be bumped down to be reballoted in the next undersubscribed hospital of your preference. My partner and I decided to go via separate allocations, accepting that if we got separate hospitals we would have a better chance of organising a swap OR would accept being at different hospitals as long as they were both within relative proximity to home
Positives Negatives Joint You are guaranteed to be put Greater risk of missing out on a higher application together preferenced hospital (since you both have to be chosen in the ballot) Separate Individually, you have a greater Greater chance of being split up; not applications chance of a higher preferenced guaranteed to be at the same hospital hospital, and you can organise swaps
Step 5 – tackle the application Oh yes, the dreaded intern application .. the cause of much despair! As a group A applicant, thankfully the application was just a process you had to complete because you were already guaranteed an internship position plus the spots were balloted rather than chosen on merit. My biggest tip for the application is to get all the supporting documentation ready EARLY – immunisation records, criminal history checks, identification documents that have been certified. I remember many of us having issues with having our identification documents correctly certified (ie there was a specific sentence that had to be written out word for word - despite the backlash from some Justice of the Peace signators) so check the fineprint. For references, I asked my Endocrine AT (med spec rotation) and my ED consultant (emergency rotation) as they knew me fairly well and had worked with me one-on-one. The CV is a great opportunity to reflect and document your achievements and extra-curricular activities! Although it’s not heavily weighted for the internship campaign, you can start building on it now so its all ready for the future RMO campaign.
Step 6 – internship form and chill Fill out that bad boy application and *chill*. Honestly, just chill. You will be tempted to stalk the position status report like an ex-partner, but for your own sanity limit this. Medical students are unpredictable, so trust your gut with your most ideal hospital, and just make sure that you rank any undersubscribed hospitals in your ideal order in case you get shafted. And if you don’t get your top choice, but just remember it is a) one year and the most junior year of your medical career, b) every intern has to complete 3 core terms so the experience is not too dissimilar amongst hospitals, and c) getting shafted may be a blessing and the perfect invitation to explore beyond your comfort zone.
Step 7 – let the internship offers roll in! In the end I ended up getting my first preference Logan Hospital along with my partner too .. we were stoked! It honestly just felt like a weight off my shoulders, mainly so I could start practically hunting for rental properties, furniture etc. It was exciting to hear of a few other close friends who would also be interning at Logan, but was also excited at the prospect of meeting lots of new interns and experiencing a new hospital
Let the caffeine addiction begin – ‘excuse me doctor, can you (insert many jobs here)’?
What did internship mean to me Internship was an invitation to become an active, contributing member of a massive hospital team and helping to turn lives around for better. 7 long years of accumulated knowledge and skills could be put to the test and the seeds of knowledge planted in medical school would start to exponentially grow with more patient exposure. It would give me opportunities to improve health literacy, to empower patients to care for their health, and to help those disadvantaged populations take control over their health. It also meant a newfound responsibility to be thorough with my patient care and learning to deal with the inevitable stresses of missing a diagnosis, patients deteriorating or getting stuck in difficult clinical scenarios.
Preparing for the job The most important part of preparing for internship was organising everything external to it – making sure our new accommodation was set up, purchasing my first car (!!), and sorting out heaps of life admin (eg superannuation, salary packaging). I put my focus towards being in a mentally positive state by enjoying life hobbies and seeing as many friends/ family as possible before getting bogged down with working life. I also treated myself to a new work wardrobe so I would walk into internship feeling fresh and dandy :)
I will admit I tried and successfully failed to read the ‘On Call book’ prior to internship #failedsummergoal. But as I’ve now learnt, 50% of the job is learning the process and 50% is clinical knowledge specific to the rotation you’re on. Plus orientation week mostly covers everything you need to know for internship!
Perhaps a small tip would be to purchase scrubs at least a month prior to your ED rotation as companies can take variable times to ship and deliver. Also find out what colour scrubs interns are allowed to wear – for example at Logan Hospital, there are different colours designated to consultants, regs, SHOs and JHOs/ interns. I was much less organised but thankfully my med reg saved me by gifting me her old scrubs!
Initial fears Being responsible for real lives and making costly mistakes. I’m a true sufferer from imposter syndrome and tend to question whether my knowledge and skills are adequate to be a doctor. As cliché as it may sound though, you really are supportive from all levels in the hospital and there is such a strong theme of collegial spirit amongst everyone! You have to accept that you won’t always know the answers, but you will have colleagues to fall back on for help.
Typical routine My current rotation is ED, so essentially my schedule is dictated by shift work. The following is an example of an evening shift (2pm – midnight)
8:00am – wake up 8:00 – 8:30am – brush teeth, skincare, dress in workout gear 8:30 – 9:00am – read emails, refine my ‘to do’ list 9:00 – 10:00am – home workout and shower 10:00 – 10:30am – smoothie or coffee time 10:30 – 12:30pm – studying 12:30 – 1:00pm – edit photos or watch youtube 1:00 – 1:20pm – get ready for work 1:20 – 1:45pm – drive to work ft podcast (currently listening to shameless!)
2:00pm – scrum and head to allocated ED department 2:15 – 4:00pm – see new patients 4:00pm – afternoon round (ie going through current list of patients in allocated department) Just prior to 5:00pm – get handed over patients from the morning team 5:00 – 11:00pm – continue to see new patients and take care of handed over patients Somewhere between above time period – take 30min break for ‘lunch/dinner’ 11:00pm – evening round, stop taking any new patients and just tidy up current patients under my care Just prior to midnight – hand over any patients to the evening team if they’re going to be in the department past my shift end
Midnight – drive home +/- maccas drive through 12:30 – 1:30am – return home, shower, relax and wind down for bed
Staying sane Take your breaks • You are entitled to a 30min lunch break as well as 2 x 10min minibreaks. Logan ED has been great in making sure we take breaks, however the nature of the specialty helps too as you can take a break in seeing patients, get someone to eyeball your patient while on break, or your patient can undergo investigations in that time • Gen med (my previous rotation) was much more difficult to get a proper break in. You were the only team responsible for your patient, some days the reg and consultant would be busy doing clinic/ consults/ meetings/ teaching, and unfortunately the pager and phone are unpredictable! Most lunch breaks would be spent in front of a computer still doing iEMR work, but if you get the opportunity to take a break out in the sunshine, you 100% take it (and pray the phone/ pager don’t go off!) Meal prep • Huge time and money saver! Create yourself some nutritious energy fuelled meals, save yourself from investing your hard earned money into uber eats and the hospital café, and avoid the stress of dinner prep after a late night shift. We usually dedicate Sunday to grocery shopping and meal prep, but we won’t say no to Friday takeout ;) Get your beauty sleep because #youreworthit • I used to be a total workaholic in med school … but these days I’m an absolute sloth. Full time work, especially in such a dynamic and academically challenging field, is genuinely physically and mentally exhausting. Because this work requires good brain power and attention to patient care, you need to give yourself adequate sleep so your mind, body and spirit are ready to take on each day. Exercise for the #extrafries • Get your body moving and release all those happy endorphins! Some rotations may involve rushing round the hospital with the COW/WOW, and others may be sitting continuously at a computer. Giving yourself dedicated and focused time to exercise is beneficial for giving your mind a break from work, alleviating work and social stressors, and just refreshing your mind, even if just for half an hour or so. Enjoy life outside of work • Workplace fatigue is real. You go to work all week, you’re likely to hang with friends from work, and it’s almost inevitable that you’ll chat about work. Having a break from work is important and finding friends and activities unrelated to work is valuable in helping you disconnect. Be kind and treat all hospital staff with respect • Doctors, nurses, allied health, admin, wardies, cleaning and kitchen staff – the synergistic effort of all hospital staff is what helps a hospital to flourish and attain optimal patient care. Be kind and respect each and every hospital staff member, because every member is valuable and plays a vital role in the hospital system. Plus you never know when you’ll need their help … I think I owe the hospital pharmacists big time for preventing many medication errors!
Most rewarding aspect Seeing patients do a full 180 degrees and completely change the way they think about their health. It’s empowering and rewarding to see your patients transform from admission to discharge and validates why I chose medicine as my career pathway. I also love the collegial team-work aspect of the hospital, especially when the team comes together for coffee round amidst a never-ending patient list. Oh and being paid also isn’t bad either!
Most challenging aspect Leaving the hospital physically but not mentally. There is no worse feeling than leaving the hospital grounds and having a lightbulb moment about things you forgot to ask, examine, order as an investigation, add to the management plan or even document! Sometimes I fear that my discharged patient will deteriorate and my iEMR notes will be legally audited for court evidence …
My first ward call shift was also really challenging, and frankly quite frightening. It was just myself along with another JHO were in charge of the hospital. It started off with a MET call and from then we were bombarded with left right and centre with pagers/ calls for PIVC insertions, bloods to be taken, BGLs to be reviewed, high scoring EWS’. Amongst all this, I got stumped on starting a heparin infusion I didn’t have much experience with (especially ordering on iEMR), a palliative cancer patient turned septic, and I had to perform a difficult IDC insertion in a prostate cancer patient. Thankfully, the other JHO and med reg were super supportive and happy for me to call whenever I needed – you should never feel alone in tricky situations!
What would I tell myself and my message to you: No matter what anyone says, how many so called ‘mistakes’ you’ve made or how many times you experience imposter syndrome … you will be an amazing and worthy doctor. It takes perseverance, sacrifice and a whole lotta dedication to become a doctor, so don’t ever doubt that you didn’t earn this career. Internship can be scary, daunting and overwhelming at times. It can also be exciting, rewarding and a step forward in your learning. Take the highs and lows as they come – learn to celebrate your successes and learn to grow from your downfalls. Do not burden yourself or suppress any angst/ sadness/ stress you have – reach out to friends and family, take mental health days to destress/ offload your worries, and don’t ever be afraid to seek professional help if needed. And remember to check in with your colleagues too
Good luck on your brand new exciting adventure – we can’t wait to welcome you to the hospital! PS feel free to reach out to me if you ever have any questions about internship, the hospital system, or just to have a general chat