Best place to do internship?

Originally Posted by frootloop

I think what China is saying is that if you already know people within that hospital, it's going to be easier to get onto a training program there. Working there is a pretty good way to get to know bosses/people who can get you onto the training program you want.

yeah that makes sense

All internships are accredited by the same body; so theoretically they should offer an equal balance of advantages and disadvantages. Nonetheless, yes, obviously: if you're looking at going for a training job and you're already a known entity with an established reputation and presence, that will (and does) work in your favour. Ergo, if you want to train and work in the city, you will have the inside edge if you start there and stay there.

How about if you don't really know what you want to specialise in? Eg. You've narrowed it down to 4 or 5 options by the end of med school but can't really decide before you do internship and pick one. Would you be better off in one of the really big hospitals in Sydney to help increase the likelihood of rubbing shoulders with people who will help you get into the training program of your choice later on?

I suppose you should look at more than just your training prospects. Some of the big hospitals aren't particularly nice places to work, despite the professional advantage you gain by being known by people of influence. The smaller networks tend to be friendlier and less busy - which, although it has its downsides (ie a narrower casemix and expertise base), can do wonders for your mental health.

What do the specialist colleges value when selecting applicants for training positions though? Is it really all about knowing people? Because what I've been told about small hospital is that as an intern you get exposed to a bigger variety of experiences (as there are less people around to do the jobs needed), and in a smaller environment it's easier to connect with the doctors aka the 'people in high places'. Being exposed to more things, and having gained a broader skills base, wouldn't interns from smaller hospitals get a bit of an edge on the ones from big hospitals?

Being an intern at somewhere like The Alfred would be an eye catcher in a resume, but to what extent would it really be a quality professional experience?

Originally Posted by muso94

What do the specialist colleges value when selecting applicants for training positions though? Is it really all about knowing people? Because what I've been told about small hospital is that as an intern you get exposed to a bigger variety of experiences (as there are less people around to do the jobs needed), and in a smaller environment it's easier to connect with the doctors aka the 'people in high places'. Being exposed to more things, and having gained a broader skills base, wouldn't interns from smaller hospitals get a bit of an edge on the ones from big hospitals?

Being an intern at somewhere like The Alfred would be an eye catcher in a resume, but to what extent would it really be a quality professional experience?

This was more on the lines of what I was asking, just didn't put it quite so eloquently. Now, for the responses....

I'll state my obvious bias in that I'm working in a smaller hospital. Chinaski's point about those being friendlier and less busy is accurate to me. The casemix I see is likely narrower, however, I am an intern, and I remember terms such as transplant surgery and melanoma surgery at RPA. Sure such a big hospital has a wide casemix, but some of it terms are very specialised where as the general medicine term I'm doing sees all variety of gastro/resp/cardio/neuro conditions. I'm not a medical student anymore but I'm still very junior so I'm happy seeing a wide range of general stuff rather than a diverse case-mix of specialised things.

I'm sure chinaski is right about training pathways and being known at the hospital but, that said, interns are still pretty low on the radar of most specialists who'll might make the decision to employ you... unless, perhaps like Kyle, you already have a good idea of what you want to do and it is something that is fairly specialised.


So, in that sense, I'm inclined to say big tertiary hospitals are a good idea for those people who want to do something fairly specialised and know exactly what that is, but for the rest of us, there's no rush. There might be some benefit from being an intern at a tertiary hospital for training programs but I struggle to see that benefit being particularly significant.

I'm only a few weeks in to internship at a classic Big-Impersonal-Tertiary-Care-Hospital but I have to say I'm enjoying it.

I'm starting with emergency which probably isn't indicative of a ward based job but I'm enjoying the support. The interns don't work in this E.D. when there's not a consultant on (at least not now, not sure if it changes in later terms) and I've enjoyed knowing there's always at least a consultant and 2 regs for each half of the ED which means I don't have to wait too long to discuss patients with somebody. I haven't felt like it's restrictive or I've gotten less hands on experience, I've gotten to do an LP already (although I got to do a couple as a student) and a bit of suturing and gluing, and when we're on the acute side we pick up all kinds of patients, so I've already been assigned to patients who are cat 1 and 2 coming into resus (albeit with somebody senior looking very closely over my shoulder).

From an ED perspective it's also nice to have just about everything onsite until midnight (organising a CT and a neurosurg consult is not as scary when you don't have to call anybody in to do it), so far the only people I've ever had to call at home have been the geriatricians.

In terms of being a nice place to work it seems ok for now, there's no confrontationalism about paying overtime (yet), you claim it through the intranet rather than face to face, rostering isn't particularly*inflexible, most people have gotten most terms that they wanted, teaching is good and pretty well protected, and the RMOA is very active socially which is nice, although to what extent these reflect the particular culture at this hospital rather than being a feature of large hospitals generally I can't say.

The biggest disappointment so far has been the library which is absolutely crap-tacular, with a tiny out of date collection, that's badly organsied, with scanty coverage at best of whole specialties, ridiculously tight loan arrangements and dungeon like facilities. The likes of Campbelltown and Blacktown hospital libraries leave it for dead. The library at Mount Isa Base Hospital had a collection maybe four times as large and much, much more up to date. On the other hand if the biggest problem I have with the hospital is the state of the library that probably says good things.

It's possibly a bit less friendly in that I don't know the name of all the interns in my year yet, and even the bosses don't all know each other, but I wouldn't say it's unfriendly either, it's no less polite or professional dealing with other staff than any other hospital I've been at. I think "impersonal" might be a better word.

The ward based people seem to be enjoying themselves although the experience they're getting tends to be fairly specialised, there's certainly no general medicine team, which from a learning perspective is actually a bit of a shame! On the other hand a respiratory, endocrine or renal term probably offers a broader range of patients here than at other hospitals.

I'll leave talking about career implications to people who actually no what they're talking about, but so far, no regrets about preferencing the big scary hospital first.

I know this isn't where this thread is going... but the working conditions will have a huge impact on your own quality of life. In some places it is not uncommon for interns to work til 8am-10pm on a regular basis.

Originally Posted by Season

I know this isn't where this thread is going... but the working conditions will have a huge impact on your own quality of life. In some places it is not uncommon for interns to work til 8am-10pm on a regular basis.

It's a valid point, probably better to "try out" (well, sort of) a few places during placements so you have more of an idea?