{"id":179152,"date":"2025-05-15T16:42:19","date_gmt":"2025-05-15T14:42:19","guid":{"rendered":"https:\/\/www.erasmusmagazine.nl\/en\/?p=179152"},"modified":"2025-12-19T11:27:49","modified_gmt":"2025-12-19T10:27:49","slug":"with-a-white-coat-comes-enormous-responsibility-how-doctors-guide-medical-interns","status":"publish","type":"post","link":"https:\/\/www.erasmusmagazine.nl\/en\/2025\/05\/15\/with-a-white-coat-comes-enormous-responsibility-how-doctors-guide-medical-interns\/","title":{"rendered":"With a white coat comes enormous responsibility: how doctors guide medical interns"},"content":{"rendered":"

Medical interns wear a white coat and are therefore seen by patients as doctors. This brings a significant responsibility, not only for them but also for the doctors who supervise them. “It all boils down to one question: would you want this young doctor by your bedside?”<\/p>\n

\"\"

\n\t\n\n<\/svg>\n<\/span>\n\tImage by:<\/span>\n\n\t\t\t\n\t\t\t\t\t\t\tHanneke Rozemuller<\/a>\t\t\t\t\t<\/span>\n\t<\/p>\n<\/figcaption><\/figure>

\u201cThe main goal for the final internship, in my opinion, is to take that last step from intern to junior doctor\u201d, says Joyce Wouts, a doctor in the emergency department at the Admiraal de Ruyter Hospital in Goes. Students can only choose the emergency department for their final internship. Throughout the year, two students from Rotterdam do their twelve-week medical internship at this department. \u201cWhen they start, they are already familiar with being at the bedside of a patient. Now they need to learn to make decisions more independently.\u201d Wouts wants them to assess a patient\u2019s complaints on their own, think about a plan, and present it to her. \u201cAfter that, they need to do it entirely on their own; we build that self-confidence.\u201d<\/p>\n

Every year, nearly four hundred students begin their internships as part of the Rotterdam medical programme. The medical internships \u2013 along with the master\u2019s research \u2013 are the final hurdle, two years designed to turn a student into a good doctor. How do supervisors do that?<\/p>\n\n\t

\n\t\t
\n\t\t\t
\n\t
\n\t\t\u2018I encourage them: speak out, take that on board, remember this, learn from it\u2019\n\t<\/blockquote>\n\n\t<\/figure>\n\t\t<\/div>\n\t<\/div>\n

\u201cWhat makes a good doctor is often very subtle. Next to the official requirements that the intern must meet, of course. That subtlety is very important\u201d, explains Anneke Dijkman, a gynaecologist at the Reinier de Graaf Gasthuis in Delft. She is the final assessor for the Rotterdam gynaecology interns, usually two or three at a time, whom she supervises for five weeks. \u201cDuring your internships, you develop your own style. Doctors are the role models from whom you learn, both positively and negatively. I often ask: what did you take away from this day? What did you notice today while observing me? Sometimes an intern says: \u2018I had a clash with a specialist who was unkind. I don\u2019t want to handle cases like that.\u2019 I encourage them: speak out, take that on board, remember this, learn from it. This way, you consciously develop your own style.\u201d<\/p>\n\t

\n\t\t

This article is part of an investigative journalism project on why it is so difficult to expel unfit medical students from the <\/span>program<\/span>me<\/span>. To do so, journalist Tessa Hofland spoke with eighteen people involved, <\/span>mainly doctors<\/span> and supervisors of <\/span>medical interns<\/span>, and delved into laws and regulations, plans, <\/span>research<\/span> and articles on the subject. <\/span>Do you w<\/span>ant to know more, or do you have questions, <\/span>comments<\/span> or tips<\/span> about this project<\/span>? <\/span>Please c<\/span>ontact <\/span><\/span>the author<\/span><\/span><\/a>.<\/span><\/span>\u00a0<\/span><\/p>\n\n\t<\/div>\n

Overwhelming<\/h2>

Doctors always guide interns alongside their primary task: caring for patients. For some departments, this poses a greater challenge than for others. As a physician in the emergency department, Wouts gets a good sense of the interns when they are on duty together. If she has a week of night shifts \u2013 which is frequent \u2013 it becomes considerably more challenging. \u201cIdeally, we have two people here who can make final assessments, but due to staff shortages in the department, that isn\u2019t currently possible. With varying shift patterns and substitute doctors, it can be tough to keep an eye on things.\u201d<\/p>\n

\"\"\n\t\t\t\n\t\t\t\t\n\t\t\t<\/svg>\n\t\t<\/button>

\n\t\n\n<\/svg>\n<\/span>\n\tImage by:<\/span>\n\n\t\t\t\n\t\t\t\t\t\t\tHanneke Rozemuller<\/a>\t\t\t\t\t<\/span>\n\t<\/p>\n<\/figcaption><\/figure><\/div>

On the gynaecology ward at the Sophia Children\u2019s Hospital, the situation is very different. Gynaecologist Suzanne Peeters guides five interns there. The working hours are more regular, and appointments can be prepared in advance, often by the interns themselves. Peeters finds it important that supervisors immediately have a conversation about learning objectives and build a trusting relationship with the student. \u201cYour internships are overwhelming because you enter a department where some quite intense things happen\u201d, Peeters explains. \u201cSo, you can certainly be impressed by that at the start of your career.\u201d<\/p>\n

An intern must get to know many new people and absorb a great amount of knowledge and skills in a short period, often at different locations. The Delft gynaecologist Anneke Dijkman often observes how new interns can feel lost when they begin in a department. \u201cSometimes it takes longer for someone to feel comfortable and be able to ask questions or learn effectively. The sooner you address this, the more willing someone is to speak up about what they want to learn.\u201d<\/p>\n

Goodbye to grades<\/h2>

Since September 2023, interns are assessed in a new way. The most significant change is that no grades are given anymore. Previously, a single grade was given for each internship. Now, several short forms must be completed for each task or required learning objective. A committee reviews these forms multiple times. If they repeatedly observe the same concerns from doctors, a student may receive additional assignments or even be required to temporarily halt their internships.<\/p>\n\n\t

\n\t\t\n\t\t
\n\n\t\t\t\t\t\t\t

Read more<\/h2>\n\t\t\t\n\t\t\t