Summer Internship: Getting to the Heart of the Matter

Anubhav Nangia (SAR’15) became a valued team member when he interned this summer at a cardiovascular testing center at Brigham and Women’s Hospital. Photos by Cydney Scott

Internships often play a critical role in job hunting as employers increasingly seek graduates with some real-world experience. A 2012 Marketplace and Chronicle of Higher Education survey found that employers place more weight on experience, particularly internships and employment during school, rather than academic credentials, when evaluating a recent graduate for employment.

With that in mind, BU Today reached out to five undergrads who interned this summer, asking them about their experience. We are featuring a different story each day this week.

Name:

Anubhav Nangia (SAR’15)

My internship:

I worked at the noninvasive cardiovascular imaging center at the Carl J. and Ruth Shapiro Cardiovascular Center at Brigham and Women’s Hospital in Boston.

How I landed the internship:

I was recommended for it by a professor, applied, and was promptly accepted. I’d emailed the center’s supervisor, who said to come in for an interview, and I said, sure why not? I was accepted after a couple of days.

A typical day on the job:

I’d arrive at the center by 7:45 a.m. When a physiologist was ready to test a patient, I would get the person from the waiting room and prepare him or her for the test. I performed standard treadmill tests, stress echocardiograms, and cardiopulmonary stress tests. Once I had obtained the patient’s consent, I would ask questions to document the medical history and enter the information into the computer.

I prepared patients for electrocardiograms (ECG), which involves the placement of electrodes on their chest and abdominal region. After briefing the physiologist on the patient’s history, we’d interpret the baseline ECG together. This was by far the most challenging aspect of the internship. Each ECG is unique, and the basic information I had learned about ECGs at school had not prepared me for the extensive analysis I performed at the center.

The test is always performed under the supervision of a physiologist. I had to constantly eye the ECG for any changes, while printing a 12-lead every three minutes, taking blood pressures, monitoring the patient’s progress, and documenting observations on the reports. It gets very hard to take a blood pressure after about nine minutes of exercise due to the surrounding noise and the patient’s movements. I had to communicate with the patient constantly to try and push him or her to maximal effort. The test stopped either at the request of the patient or when a physiological sign or signs that I was looking for has been attained. Those signs would depend on the patient’s history. Patients are monitored for eight minutes following exercise, during which blood pressure and ECG are constantly monitored. It took me time to get adjusted to maintaining a watch on so many aspects of the test.

Once the recovery period had ended, I would unhook the patient from the apparatus and help the physiologist with the final report. This required further interpretations of the ECGs obtained throughout the test. The entire process—from getting the patient to finishing the report—usually took about an hour.

Career skills I acquired:

I strongly believe the following new skills I acquired will benefit my future in the health care industry.

I am now very good at taking relevant, detailed patient histories. I learned that casual conversation with patients puts them at ease and helps them to be thorough in the details they provide. A good history saves time for the physiologists.

Although I learned about electrode placement in theory in class, the practical side is quite different. Each patient has a unique body structure, which means that the electrodes must be adjusted to ensure a good voltage for the ECG. Since the patients’ blood pressure is taken manually and not digitally, it took a few attempts before the physiologists agreed that I was ready to take them on my own. I am now comfortable prepping any patient and have a good instinct for gauging the quality of the placement.

I have become good at taking blood pressures during exercise. Due to the surrounding noise of the machinery and patient’s movement, this was hard to learn. Thanks to the physiologists who hopped onto treadmills during their free time, I am now confident in my ability to measure the blood pressure of a patient at any stage of exercise.

I can efficiently use the software involved in stress tests at the Brigham.

My most remarkable achievement has been the ability to interpret ECGs independently. From knowing just the basic anatomy of an ECG to understanding terms like premature ventricular/atrial contractions, left/right bundle branch blocks, fusion beats, and so forth, I have come a long way. I am sure that this knowledge will benefit me immensely in medical school, should I go down that track.

What it internship taught me about the real world:

I have developed an understanding of what it feels like to work in health care. Every patient who visits a hospital is unique. Health care professionals must do their best to ensure that patients feel relaxed and safe under their supervision. Their reaction to, observation of, and communication with, patients is crucial to the success of a clinical encounter.

Health care workers must not bring the stress of their personal lives into the workplace; it can negatively impact a patient’s experience. A couple of times during my internship, I was stressed out due to family issues. Luckily for me, I noticed right away that my personal troubles had wiped the smile off my face entirely. I made a conscious effort never to let such things bother me again.

I learned what it is like to work in a professional setting. Colleagues have certain expectations of each other with regard to workload, work ethics, and more, and it is important for everyone to align with them. Mutual respect in the workplace is imperative.

Contrary to popular belief, it is okay to make mistakes. The colleagues I worked with became my friends and mentors. I never hesitated to ask questions.

It is important to make the most out of every opportunity provided to you. Although I was required to work only 10 to 14 hours a week, I ended up working 21 a week to gain additional experience.

Biggest mistake I made:

Sometimes, it is hard to take a blood pressure when the so-called Korotkoff sounds cannot be heard clearly. For one such patient, when I was taking a blood pressure during the recovery period, I underestimated the systolic pressure. This mistake caused the physiologist to be confused for several minutes, and we assumed that the patient was having a hypotensive response postexercise. But when the physiologist took additional blood pressures, she realized that my measurement was probably inaccurate.

Most frustrating thing about the internship:

Nothing about the experience frustrated me per se; I enjoyed my time at the center thoroughly.

My proudest accomplishment:

The ability to interpret ECGs independently. It takes a lot of training, and I am proud to have learned the necessary techniques and definitions so quickly.

Most important lesson I learned:

Never hesitate to ask questions.

My most surprising or unexpected experience:

The first time I was asked to take blood pressures of patients during exercise, I did not find it hard. All the physiologists were surprised and excited that I was able to learn to take them so quickly.

What I learned about the real world that inspired or frustrated me:

When you work in a health care setting, everyone helps each other. You are never alone. You become part of a team trying to deliver the best possible service to patients.

Overall grade and whether the internship lived up to my expectations:

Grade: A.

The internship lived up to, and in fact exceeded, my expectations. My initial ambition of working in the health care industry was strengthened. I got incredible amounts of hands-on experience with patients and cherished the opportunity to participate in their treatment regimens, even if it was in a relatively small way. I was treated like any other employee at the center and was expected to perform to similar standards. Supported by an incredibly welcoming staff that was eager to teach, I now feel like a competent exercise physiologist.

If I had it to do over, I’d…

Probably work longer hours to get the opportunity to learn even more.

My advice for others seeking an internship:

Apply to internships that you are truly interested in. Do not work at a place simply because you want to boost your résumé. It will seem like a burden for you more than anything else. Be cordial and respectful at your job site. Try to meet as many people as possible. You never know when someone will turn out to be a great resource for you personally or professionally.

And don’t be afraid to ask questions. It is expected that interns are only getting their feet wet. You are not meant to be an expert in any way.

Tomorrow, part four of our summer internship series: Live from Lincoln Center.