My midyear postgraduate internship at the West Visayas State University Medical Center wasn’t just the next step in a checklist. It was survival. It was trying to hold everything together when things around me—and inside me—were falling apart.

I picked WVSUMC not just because it was connected with my alma mater. I picked it because I already knew the system. I knew the corridors, the elevator glitches, the staff moods. I knew where to buy the cheapest coffee at 3 a.m. I thought that kind of familiarity might help.

It didn’t make things easier.

But it did give me something to hold on to.

[lwptoc]

The Weight of the White Coat

People think internship is a lighter load than clerkship. In some ways, it is. But the pressure feels heavier. Because now, people expect you to know things. The margin for error shrinks. You’re no longer “the student.” You’re the one they call when something’s going wrong, and they expect you to do something.

You read the census. You endorse the cases. You do follow-up rounds. You chase labs. You handle endorsements. Sometimes, you finish at 6 p.m. and still feel like the day hasn’t even started.

And all this while reviewing for the board exams.

Every rotation had its own flavor of exhaustion.

Surgery, OB-Gyne, Ortho — They called them the “cutting specialties,” and they drained me. Assisting in long surgeries meant standing still for hours, sometimes in silence, sometimes in sweat, just praying not to contaminate anything.

Internal Medicine — Easily the most mentally and emotionally exhausting. The ER was relentless. The patients just never stopped coming. I never had a shift without overtime.

And yet, I knew I had it easier than those before me. No 36-hour shifts. No pre-pandemic chaos. But that didn’t remove the fatigue that settled in my bones.

You’re Not Just Tired. You’re Changed.

Looking back, some moments felt small but cracked me open.

Like forgetting a case summary right in front of a consultant.

Or being asked a question you should know, but your brain just blanks out.

The shame doesn’t end in that room. It follows you home. It whispers when you’re about to sleep. It tells you you’re not enough.

I started saying things like:

• “I’ll read on that.”
• “Sorry, I don’t know.”

But eventually even those lines started feeling like masks I wore to hide the truth: I felt stupid. I felt slow. And I felt like maybe I didn’t belong in this profession at all.

But There Were People Who Made It Bearable

There were mentors who didn’t just teach—they healed.

One IM consultant reminded me, constantly, that listening to the patient’s story is just as important as reading the lab results. She taught me how fear, faith, and uncertainty show up in vital signs. And how a kind tone can sometimes do what meds can’t.

My FCM mentors? They saw the patient as more than a disease. They taught me to ask about their family, their daily life, their dreams. That mattered more than I expected.

My Psychiatry mentors? They showed me what it really meant to listen—not just with your ears, but with your full attention. No rushing, no interrupting, no trying to fix things too soon. Just staying present. They taught me that sometimes, the most healing thing you can offer is a space where someone feels truly heard. And that kind of listening takes effort. You listen while thinking, while feeling, while holding back judgment. You carry their sadness with care, knowing that what they need isn’t always answers—but understanding.

Some consultants even waived their fees. Imagine that. In this economy. Just so a family could breathe.

Those were the people who reminded me why I entered medicine in the first place.

And Then There Were the Patients

There are some patients you never forget.

Like that sweet pediatric patient we managed for peritoneal dialysis. She had been there for months by the time we rotated in. She smiled through everything. Even after every failed procedure, every postponed discharge.

Or the other pedia patient whose name I forgot—but whose veins I kept puncturing again and again. I did her IV 4–5 times a day. Until one day, I was the only intern on duty and suddenly heard that the pedia intern is being summoned. She crashed. I ran. I helped with CPR. My hands worked before my brain caught up.

There were many cases, many faces. But those two still visit my memory often.

You Don’t Just Train to Heal. You Train to Withstand.

Internship taught me things books never did.

I learned how to:

• admit I was wrong.
• ask for help.
• function on zero sleep.
• walk away from a patient’s death and still face the next one like nothing happened.

There were mistakes—minor ones, thankfully. Misfiled orders, delayed instructions, moments of confusion. But I learned to own up fast, correct them faster.

Sometimes, that’s all you can do.

Behind the Scenes: The Other Life I Was Juggling

Not many people knew this, but while I was trying to survive internship, I was also running a full-time business.

Actually, three.

• I was the go-to guy for custom stamps—both flash-style and Trodat, the ones doctors and clinics need. It started as a side hustle and became something more. We supplied healthcare professionals from all over.
• Alongside that, my wife and I ran a small printing and binding service. Prescription pads were our specialty. We also printed event programs, calling cards, and stickers.
• And then there was her baking business. Cheese rolls. Ensaymada. The kind that melts in your mouth. I helped where I could—packing orders, taste-testing (sometimes too much), handling deliveries.

These weren’t just hobbies. They were lifelines.

They paid the bills. They helped me breathe.

Until my wife had to leave for Canada. The businesses couldn’t carry us anymore.

So I Was Alone Again

She left three months before I finished internship.

Suddenly, the days felt longer. The house felt colder. I stopped cooking real meals. Some nights, I didn’t even eat.

I’d talk to her through screens. We’d schedule dates. Attend online services together. I especially found comfort in the Jewish services of Central Synagogue, which I watched quietly while processing my sadness.

I was still taking antidepressants. And I was still drowning in doubt.

But somehow, I kept showing up.

Review? What Review?

People ask me what my study strategy was.

Honestly? I had none.

There were weekly review sessions at the hospital. I attended some. But I didn’t have a structured plan. I didn’t even know if I’d take the boards right away.

What helped, in the end, were the patients themselves.

Each case I encountered became a study material:

That pneumonia patient made me revisit pulmonary pathophysiology.

That CKD pedia patient forced me to re-learn nephro.

That thyroid case led me back to endocrine pharmacology.

It wasn’t neat. But it was real.

And it stuck.

Imposter Syndrome? Present.

There was never a time during internship that I didn’t feel “less.”

Some days, I’d mutter to myself: bobo ko, dull ko, mango-mango gid ko ya.

Even when I knew I was trying my best.

Even when mentors praised me.

It didn’t matter. The voice of self-doubt was always louder.

But slowly, through repetition and presence, I started pushing back.

I reminded myself:

I survived clerkship.

I’m doing the work.

I’ve helped real people.

That has to mean something, right?

The Burnout Came Quietly

It wasn’t dramatic.

It crept in.

You just start sleeping more than you should. Or eating more than usual. Or crying in random places—like in front of the OR locker.

There were mornings I just stayed in bed, staring at the wall. I wasn’t even tired. I just didn’t care.

That’s how I knew I needed help. Again.

I clung to the small things—video calls with my wife, offering discounts for my stamp and printing business, holding on to patients’ smiles, attending Sabbath services online.

It all helped. But barely.

Still, I kept going.

I Was Becoming a Doctor. Even When I Didn’t Know It Yet.

There’s this strange in-between that internship forces you into.

You’re not a student anymore.

But you’re not quite a full doctor yet either.

You’re somewhere in the middle—uncertain, tired, but moving.

And somewhere in that limbo, something clicked.

I started believing I could become a good doctor.

Not because I knew everything.

But because I cared. Because I listened. Because I stayed.

Even when everything in me wanted to leave.

What I’d Tell My Intern Self Now

You’ll be okay.

You’ll cry. You’ll fail. You’ll forget things you should know. You’ll be told you’re not good enough.

But you’ll also get up.

You’ll find kind mentors. You’ll find the strength to admit you don’t know. You’ll see lives change because of something you did—even something small.

And yes, you’ll still doubt yourself. But one day, you’ll wake up and realize: you made it through.

You’re not perfect.

But you’re getting there.

Final Thoughts

Internship didn’t make me strong. It revealed how weak I could be—and how much I could carry anyway.

It reminded me that healing isn’t just for patients. It’s something we all need. Every day.

If you’re reading this while going through your own internship or preparing for the boards, here’s what I’ll say:

You don’t need to do it all at once.

But you do need to keep showing up.

That’s how foundations are built.

One day, one rotation, one broken IV line at a time.

This post is part of a series of posts about my struggles and victories to become a licensed physician. I hope you liked this second part. Please check out its other parts soon. Thank you!