I remember the moment I opened the envelope. The paper in my hands, the faces around me — my wife and closest friends from medical school. My family wasn’t physically there but I felt their anxious love from a thousand miles away in Maryland — the crab nation, as we like to call it. My fingers trembled as I unfolded the letter. I had matched at my number one choice: Johns Hopkins Bayview. It wasn’t just a hospital. It was a place with a legacy, where medicine was taught not just as a science but as a public trust. Joy. Relief. A deep, quiet satisfaction. I was going home.
There’s something surreal about learning where you’ll spend the next several years of your life in a single moment. You imagine the hospital corridors, the early morning rounds, the unfamiliar faces that will soon become your colleagues and friends.
As a first-generation college student who worked my way through school, that moment carried weight. The Jack Kent Cooke Scholarship had opened doors to Cornell University and then to the University of Nebraska Medical Center — two lifetime opportunities. I was grateful for the training, for the mentors and for the foundation they gave me. But no amount of preparation could fully quiet the mix of curiosity, excitement and healthy nervousness that came with stepping into the unknown.
Now, nearing the end of residency and preparing to start my final year — what a friend jokingly called my “super senior year” — I find myself reflecting on that intern year. I’ve seen both sides now and here’s what I wish someone had told me:
Intern year isn’t about brilliance. It’s about showing up — on time, every day — and doing the work. You see your patients. You write your notes. You chip away at your list. Some days stretch endlessly and others disappear in a blur. The first time I placed an important order without running it by my senior I felt a strange mix of pride and anxiety. Had I missed something crucial? That feeling never really goes away — and it keeps you on your toes. Over the past two years, I’ve come to understand that medicine isn’t about perfection. It’s about meticulous, thoughtful practice and openness to learning from every mistake.
Professionalism and communication matter more than almost anything else. Knowledge helps, but your ability to collaborate, handle uncertainty and talk to patients and colleagues defines your success.
There will be nights when you’re paged to make a decision and you don’t feel ready. You are a trainee for a reason. Recognize your limits and trust that you’re not alone. Your senior, attending or someone more experienced will be there to support you. If they’re not, find them.
Work smart and hard. Efficiency is a learned skill. Find the best dot phrases. If your hospital uses AI-generated notes, congratulations. But no shortcut replaces the ability to think critically, anticipate problems and prioritize effectively. The best interns aren’t the ones who know everything; they’re the ones who ask the right questions and get things done.
Every senior you work with will leave a mark. One will model how to navigate difficult conversations. Another will manage chaos with calm. Another will teach in ways that stay with you. One day, without realizing exactly when it happened, you’ll notice that you’re no longer the intern trying to keep up. You’ll be the one others trust.
Most of all, have grace — with your patients, with your team, and with yourself. The work never truly ends, but neither does the learning. Somewhere along the way, you’ll realize medicine is less about knowing all the answers and more about staying curious, staying humble and staying engaged in the small moments.
Intern year is demanding. It gets easier. You will grow. You will build confidence. And one day, you’ll look back and realize just how far you’ve come.
Image Credit:”Stethoscope” (CC BY-NC 2.0) by KNDY です
“Contributing Writer
Johns Hopkins Bayview
Sagar Chapagain, MD is an internal medicine resident physician in the General Internal Medicine/Primary Care track at Johns Hopkins Bayview Medical Center. A Jack Kent Cooke Scholar, his written work on health policy, health care disparities, and higher education policy has been featured in national and regional publications. Follow him on LinkedIn for updates.