The Challenges and Level of Preparedness Among Interns as They Transition Through the Medical Profession: A Cross-sectional Study at Georgetown Public Hospital Corporation in 2022 – 2023
Introduction
Background/Introduction: Internship, the one-year period following completion of MD or MMBSentails an intern working within hospital departments where there isexposure to practical aspects of clinical practice and groomed wholisticallyinto a competent physician capable of managing patients. (Giri et al.,2012). “This period is known to be challenging” (Sturman et al., 2017),with Goldace et al. (2003) highlighting an overall 40% of graduates feelingunder-prepared for their post, underscoring the need for emphasis onpreparedness for practice. Sturman et al., 2017 deemed it paramount thateducators, colleagues, and administrators understand the junior doctors’perspectives on these transitions and formulate realistic expectations.Improving new junior doctors’ preparedness for practice is believed topositively influence the doctors’ and their patients’ outcomes. (Monrouxeet al., 2018). GPHC has long served to train new medical professionals via its internshipprogram, admitting medical graduates from various medical schools over theyears, making it an ideal site for this study.
Objectives
Objective: To highlight the challenges experienced by and the perceivedlevel of preparedness for practice of new medical interns.
Method
Method: Study design – Cross-sectional. Participants – Medical interns who have completed their internship programat GPHC from 2022 to 2023. Outcome measures – Perceived level of preparedness and challenges faced.
Results
Results: Forty-six (46) interns participated, predominantly females (65%), withmales (34.8%). Their mean age was 26.21 years with a mode of 25 years.Ethnic distribution was female respondents of Afro-Guyanese descent(40%) and mixed descent (36.7%). Indo-Guyanese descent (43.7%) weremost male respondents. The top 12 highest mean scores indicated that respondents were betterprepared in multidisciplinary collaboration, professionalism, practicalprocedures, paperwork, professional development and self-direction. Thehighest mean score was achieved by an item in professionalism (4.76). Thelowest mean scores ( inadequately prepared) were complex communication,clinical judgement, paperwork and history and physical examination, withthe lowest scoring item scoring 2.4. ‘Preparedness for practice’ meant having “adequate knowledge and skillfor the job” and “confidence to apply knowledge gained to patient care”;22.73%, respectively.
Conclusion
Conclusion: Interns perceived being prepared in multidisciplinarycollaboration, professionalism, practical procedures, paperwork,professional developmentand self-direction. And unprepared for complexcommunication, paperwork, history, physical examination and clinicaljudgment. Majority of interns perceived “preparedness for practice’ tomean”adequate knowledge and skill for the job” and “confidence toapplyknowledge gained to patient care.” The most shared challenges were inadequate orientationandunempathetic seniors. The majority recommended implementing orientation sessions tofacilitate adaptability to a new department.
Recommendations
Recommendation: Vertically integrated curriculum implementation. Mentorship program. Adopt an “active student participation program”. Implement Orientation booklets tailored for each department, addressingexpectations and responsibilities. Bridge the gap between seniors and juniors.