In Part 2 of the Intern Mini-Series, Drs. Edleda James (PGY-3) and Nick Cummins (PGY-3) continue their deep dive into intern year, focusing on the remaining core rotations and how to truly thrive during them. They reflect on experiences in EMS, anesthesiology, ultrasound, and pediatric emergency medicine, highlighting what each rotation offers, key skills to prioritize, and resources that make the learning curve more manageable. The conversation expands beyond rotations to include practical advice on studying for Step 3 and the ITE, managing time and energy, and maintaining wellness during demanding months. Throughout the episode, they emphasize perspective, relationship-building, and self-compassion as essential tools for navigating residency and growing into a confident emergency physician.

EMS

Where you learn how emergency care begins and gain deep respect for prehospital medicine.

Pearls:

EMS clinicians are your coworkers and learning their workflow improves ED handoffs.
Ride-alongs highlight the physical, logistical, and cognitive challenges of prehospital care.
Dispatch centers teach you how calls are triaged, mapped, and prioritized.
Critical care transport offers insight into mobile ICUs and interfacility transfers.
Relationship-building pays dividends later when you see the same crews in the trauma bay.
This rotation can spark interest in EMS fellowship or prehospital leadership.

Anesthesiology (with Ultrasound)

A controlled environment to refine airway skills and a time to learn foundational ultrasound skills.

Pearls:

You get out what you put in- be proactive about getting your reps.
Don’t just intubate: learn preparation, medication setup, and backup planning.
Bag-valve-mask technique is a life-saving skill. Practice seal and positioning.
Use the OR’s controlled setting to build muscle memory and troubleshoot difficulty.
Show up early to walk through meds and equipment before the patient arrives.
Ultrasound training is robust and longitudinal. Image review and feedback matter.

Pediatric Emergency Medicine

A high-volume, high-acuity pediatrics experience that builds confidence with sick and well children.

Pearls:

You’ll see everything from critically ill, medically complex children to low-acuity complaints.
You’ll often be the primary resident communicating with consultants so document clearly.
Child Life Specialists are invaluable for patient comfort and family support.
Suture techs teach more than technique. You can observe how they calm and engage children.
Pediatric clinical pathways (asthma, abdominal pain, ortho injuries) are excellent learning tools.
Skills learned here translate directly to community ED practice.

Studying & Exams (Step 3 and ITE)

A short but eye-opening rotation that changes how you think about poisoning and drug exposures.

Top Resources:

Rosh Review
Tintinalli’s Emergency Medicine (goal: ~3 chapters/week), OSU library digital access
UWorld Step 3 QBank

Pearls:

Plan early for Step 3. Intern year is often the best window.
EMS, OB, Tox, and Ortho may be better study months than anesthesia/ultrasound.
Consistency beats cramming for the ITE.
Pair studying with enjoyable activities (walking, climbing, downtime).
Didactics count and active participation is real studying.
EM physicians often have a natural advantage on Step 3 due to focus on acute care.
Be honest about your learning style and build routines around it.

Wellness & Thriving as an Intern

Your chance to get hands-on with labor and delivery.

Top Resources:

Employee Assistance Program
GME Counseling
GROW (Gearing Residence for Overall Wellbeing)
Program leadership, chiefs, and senior residents
RAFFT mentorship and community
Peer support and co-resident friendships

Pearls:

Perspective matters. Every rotation is short and intentional.
Be open to correction; you are not expected to know everything.
Ask for expectations and recommended resources early.
Build relationships with nurses, techs, CRNAs, and staff. It improves care and joy.
Maintain hobbies, therapy, movement, and sunlight when possible.
Plan trips and social events when schedules allow.
Lean on your people. Residency is hard, but you don’t do it alone.

Final Takeaways

It is okay to not be okay. Asking for help is part of becoming a good physician.
Intern year is challenging, humbling, and finite. It is shaping you into the emergency physician you are becoming.