Categories, Featured, Journeys in Education, Mental Health and Wellness
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At last…
As the year ends
we rejoice and we say
that our intern year is over
in June.

Yet here…
The memories,
the friends we made this year
are on to bigger and better
things now.

The shared letters
that we all had at the start.
No longer needed anymore.
So fast.

They are all here,
a new set of faces
looking to start off their year strong.
Good luck!

The previous four cinquains help to shed light on the transitional intern year (TY) and how the diversity of rotations can simultaneously separate and unite the shared experience these interns undergo. 

In the first poem, we see the commonly shared emotions of relief for many interns as their first year as physicians ends. For me, this signaled the end of a year full of many failures, struggles, and lessons learned through practicing medicine. In particular, it was a relief to know that I would not have to restart a brand-new rotation every four weeks. This was no more evident than when I transitioned from the pediatric clinic to the family medicine inpatient wards. The stark contrast from performing annual well child exams one day to managing heart failure exacerbations and strokes in adults took a toll on me. I felt like I was underperforming in comparison to my pediatric and family medicine intern counterparts. I felt like in these transitions from rotation to rotation I had no time to breathe. I was forced to “put my head down” while just trying to survive the daily grind. At the heart of this daily struggle lies the uniting experience for every TY intern. These same feelings of inadequacy were many times the talking points during didactics. It was always refreshing to hear others commiserate about similar difficulties on shared rotations. In many ways, the grueling transitions paradoxically fostered a shared sentiment that united our TY class. I eventually got used to the frequent transitions and almost welcomed them as the year went on, but I remained absolutely thankful for the month of June and the end of a long year. 

In contrast to this relief of the first cinquain comes the sobering reality of change within the second. Specifically for TY interns, this means that they go on to differentiate into their particular specialties such as dermatology or physical medicine and rehabilitation (PM&R) — my desired specialty. These residencies in particular do not necessarily have a designated intern year and for many applicants, they apply for a TY intern position. Given how customizable and diverse the year can be, the experience is inherently different for all., As a future PM&R resident, I was always looking to see how every single rotation could relate back to my future specialty. However, this was particularly tough during rotations like OB/GYN and adolescent medicine where the daily clinical duties of performing speculum exams and treating eating disorders respectively did not have that much crossover (if any) with PM&R. This is not to say that I did not enjoy the rotations themselves (because I did), but rather finding the pertinent learning was a very difficult daily task. I consistently was worried that my knowledge was atrophying away given the lack of PM&R rotations. This is my biggest fear before I begin my PGY-2 year. So while I am looking forward to starting “bigger and better things” with residency, I hope that my lessons learned this year help to make me that much better as a Physiatrist. In many ways, this is another shared sentiment that was felt amongst all TY interns. Regardless of our residency goals we all looked forward to the “better things” associated with PGY-2, but remained apprehensive that our intern year had adequately prepared us for the training to come. 

The third poem subtly underscores the emotions of sadness that come with graduation. This was no more apparent than during our annual retreat. During this day we were given an excusal from all clinical duties to attend. In discussion with some other interns, they felt like “they did not know the names or faces of some of these people” and that “this may have been the first time I ever talked to this person.” These thoughts were a commonly shared sentiment amongst us all and it made me feel almost ashamed of how little I actually knew about these people. Sure I could have used the excuse of “being on different rotations and not having time to socialize” — but we all had that excuse. This lack of fundamental social interaction underscored the awkwardness many of us had with each other. My lack of investment in the social lives of my fellow TY interns is my only regret from my intern year. Sadly for many, this is just another stepping stone to completing residency while for others (like me) this can be a somber time realizing that this is just a transition period. Regrettably, this third cinquain likely epitomizes what it means to be a TY intern the most. Despite the shared sentiments identified in the first two cinquains, a transitional year is just that — a transition. Despite how little or how much I (or my peers) invested into the program, we were all going to leave in the end. For the TY program, there is no PGY-2 and there is no residency program and although we may be united, it is only for that one year.    

In stark contrast to the emotional and reflective buildup of the first three poems, the fourth poem places the reader back into the reality that the academic year is set to begin again in the following month of July. This realization can actually be quite surreal as when I saw the incoming class of interns about to step into the shoes that I just filled 12 months ago. This abrupt cessation of emotion is the most indicative of the transitional intern year because as soon as I got comfortable with my current rotation it was already time to move on to the next one. The fast-paced diversity of the year allows for a heterogeneous experience that can vary from intern to intern but also creates the identity of what it truly means to be a TY.

Image credit: ocean by Doug Lewis is licensed under CC BY 2.0.

Ervin Anies, MD Ervin Anies, MD (6 Posts)

Resident Physician Contributing Writer

Walter Reed National Military Medical Center

Ervin (Erv) is beginning his general intern year at Walter Reed National Military Medical Center and recently graduated from the Uniformed Services Univerity of the Health Sciences in May 2022. While in medical school, he was the co-director for the on-campus peer-led curriculum aimed to foster conversations about diversity, bias, discrimination, and inclusion in both medicine and the military. His interests include medical education, promoting diversity, and utilizing the arts to augment the healing nature of medicine.