Career ambitions - hints for gunners

• Some medical students can get a little hung up about what preparations they should make in anticipation of entering a particular specialty training program
• Although it may be useful to have engaged in some relevant research or specific medical elective to gain further recognition, this should not come at the expense of being a good house officer
• The most important priority for the clinical unit is that you can actually do the JOB for which you were employed
• Therefore, the best preparation you can make is simply just to pay attention to being a generically good student and intern.
• There is no point in spending hours polishing your CV, hovering around the operating theatre or procedural suite, or dressing in an Armani suit with an old school tie, if your ward patients aren't being looked after. Consultants know the difference between a greaser and a good, earnest intern.

Primary duties of the house-officer

• Know your patients and medical histories perfectly at moment's notice
• Thorough pre-operative work-up and preparation. Medications optimised. Medical consults arranged.
• Anticipating peri-operative problems. Let the anaesthetist know before-hand.
• Attend to daily medical needs
• Careful post-op care - fluids, analgesia, antibiotics, drains, DVT prophylaxis etc
• Have information ready at hand e.g. labwork, imaging
• Order tests and follow-up promptly
• Get consults early
• Early discharge planning, good communication, arranging social issues and accommodation early
• Keep your seniors briefly of new developments (or obstacles) in timely manner
• Show initiative in medical decisions. Don't wait to be told to do something.
• Be reliable, don't lie if you don't know the answer, don't go beyond your bounds of knowledge to show-off, be prepared to say you don't know, get help promptly

The more you understand the specific issues related to the type of care that is involved in the unit, the more you can contribute to its function.

Only once you can handle the 'scutwork' adequately, then you can then join your senior colleagues in the more specific work that it entails.