eager intern
Unregistered
Don't worry I have a life and have plenty of celebrations with friends and family planned but the time I'm actually working how should I best prepare for intern year?
I planned to rotate on service more to learn how to manage the floors and put orders in, but are there any other things ppl would recommend (reading Greenberg cover to cover, reviewing imaging, etc.)? What do you wish you had done?
Am also an eager future neurosurgery intern who just matched that would like to know if there are any key logistical preparations or tips for a smooth transition into residency?
Congrats to you both. Figure out how to set and keep a schedule, how you're going to feed yourself, lock down your housing and transportation, etc.
Regarding actual neurosurgery, it may be helpful to review the basics of reading a head CT, brain/spine MRI, and cerebral angios. Read up on the basics of subdural management, evaluation and management of an unstable spine, workup and indications for surgery for other common consults, and common neuro ICU pathways. Learn about antiplatelets/anticoagulants and indications/agents to reverse them.
This may make some eyes roll but if I could do it again I'd buy one of the ABNS review books (Citow, etc.) and browse through it. Don't worry about the boards-specific stuff like tumor histopathology but the clinically oriented topics are relevant to junior residency.
Talk to current neurosurgery residents about how to set up a workflow in terms of getting tasks and notes done. If you have clinical rotations left try to get in the habit of working through consults efficiently and thoroughly.
Work on endurance through physical activity, get into good shape if you’re not already.
Review Rhoton neuroanatomy and basic Neuroradiology.
Spend time with family, friends, have fun beforehand.
I have to disagree with studying Citow, that will go in one ear and straight out the other. Study anatomy, I’d recommend the Rhoton atlas, you don’t have to read it, just look at the images.
Junior faculty here.
Forget reading anything cover to cover. Reading Rhoton is fine, if you expect you'll be assisting/performing in major skull base cases as a PGY-1. For almost all of you, your time is better spent doing something else. If you're interested, by all means, it's a fantastic atlas, but I don't understand why this is commonly recommended. Ditto with Greenberg. It's designed to be used as a reference while on call. You won't understand much of what you read as a med student, let alone remember it. You have no context for any of it.
Most importantly, much of your intern year won't even be neurosurgery. What will cause you anxiety is not what type of condylar fracture you're looking at (your seniors will be making those decision and teaching you), but just HOW you are going to get everything done. Most of your first few months will be spent figuring out the ins and outs of doctoring. How to round, how to consult, what level of suspicion to have for patients going south. How to help your team take good care of patients. As others have said above, your focus needs to be on building efficiency. How you prioritize and handle the tasks handed down to you will define how good everyone thinks you are. Med students assume they are already good at this. They are almost always wrong.
Figure out a way to stay healthy. Establish good sleeping, eating, and exercise routines after your post-Match lifestyle throws it all to the wind. Find a place to live so that the "must-dos" like groceries, laundry, and cooking are achievable easily even when post-call. If you have a family, find schools, friends, carpool buddies, etc. early on because they will be your lifesavers when you're stuck in the OR until the early morning for a case and your kid needs to go to the pediatrician. Most of you younger folks will think this stuff is bullshit, but I promise your abilities as a resident will suffer if you don't address it.
If you REALLY want to read, find the old Boot Camp presentations online for interns. They're a great guide for things you need to know for your first nights on call, and a good starting point if you want to guide your reading of Greenberg or other sources.
And don't forget to enjoy yourself. You won't get the chance every again.
Thanks for that thoughtful writeup. Anyone know where we can find those presentations?
Yeah, just read rhoton. “Neurosurgery explained” also isn’t a bad book, despite how simplistic it is. Easy read too
