Issues around internship in the masters

In addition to a curricular requirement for
completion of a master’s programme, an Internship can serve a variety of
purposes for different students.  Therefore,
students have a lot of queries about issues to consider before, during, and
after internships. There are variety of approaches in deciding about why,
where, and how of the internship, below are my reflections on internships based
on years of interactions with students in public health and healthcare administration
courses.

Purpose of
internship

While every student does an internship as a
part of the course, they have different purposes in mind. These purposes could
include a combination of a) getting practical exposure, b) becoming an actor
and getting into action, c) expanding education beyond the classroom and
curriculum, and d) exploring potential career options.  The students will get all of these to varying
degrees but will get some of these more than the other, depending on their
preferences, focus, and efforts. I explain these below in more detail.

Practical exposure: The foremost purpose of an internship is to
gain exposure to the working realities of the organizations through first-hand
and hands-on experience of day-to-day work.  Beyond technical aspects, the exposure is also
about administration and finance issues and the interpersonal dynamics of a
workplace.  This exposure also sets
students’ expectations from the first job by connecting the curriculum to the
job market and work environment. 

Becoming an actor and getting into action: The classroom learning introduces
the students to theories, insights, knowledge, and skills.  The students are the audience inside the
classroom.   The internship allows the passive
audience to become an actor through participatory observation and active learning.
 While classroom learning involves a lot
of listening, writing, and thinking, the Internship learning involves asking,
doing, and contextualizing as well.  By
becoming a bridge between class and market, such a shift prepares the students
to become a professional.

Expanding education beyond classroom and
curriculum: The
internship provides opportunities of connecting classroom learning to the
ground realities. While the experiences of an internship help consolidate and deepen
the existing knowledge, it can also bring new unknown lessons and offer new
knowledge. These new insights could be about providers, facilities, services,
schemes, and the communities.  This
experience enables students to think about the kind of work they would like to
do as a first job.  Students who are
clear about their aspirations may deepen their exploration of their areas of
interest. Some others who are yet to make up their mind about career options
can use an internship for wider exploration to finetune their aspirations.

Exploring potential career options: 
Lastly, an internship helps the students to get an idea of their first job
lest they choose a particular kind of organization or work. Some internship
experiences strengthen the choices and some others help in filtering out
options that one is not good at.  There
are no bad internships. A bad experience in an internship helps the student
screen certain kinds of work or organizations. This ruling out of certain
options is also a good outcome of an internship. For example, my internship in
an NGO helped me understand that I would be better at research than
implementation. 

Students
must ask themselves: In addition to fulfilling a course requirement, what else
am I looking for from my internship experiences? 

Finding
a host

Students need to understand that the internship
will certainly not make or break one’s career; it will only help the career
decisions. The host organization need not be your potential employer although
it can become one if there is a mutual interest and admiration.  While there are many ways to find a host
organization for an internship, clarity on three aspects viz. location, work,
and interest make the search easier and reduce the expectations mismatch, a
common reason for dissatisfaction.  

Location:  This is
a logistical consideration.  Students may
have a certain preferred location, out of personal or collective choice.  Some are free to work anywhere and some would
prefer something closer to their home city or state.  Some are comfortable only in urban spaces,
while others can be ready to explore rural and tribal spaces.  For some students, the location is dependent
on the choice of their friends and for some others, the parents are keen that
they spend two months at home.  It is all
fine as far as one knows their choice.

Work: The public health students get involved as an
intern in four kinds of work.  These are
a) community-related work with NGOs (local field NGOs like SEWA, SEWA Rural,
Gadhchiroli, Mamta, Karuna Trust, etc., national and international field NGOs
working with the government like JHPIEGO, Care, etc., and corporate social
responsibility organizations like Piramal foundation, Ambuja Foundation, HCL
foundation, etc.), b) health systems related work with the government organizations
(Municipal corporation, District offices, state offices, central offices, or Government
affiliated organizations like SHSRC, NHSRC, NHA, etc.), c) research related
work with academic institutes (IIPHG, IIHMR, IPH, IIT, TISS, etc.), and d)
specialized work like health insurance administration, health-related quality
assurance. health care consultancies, etc.).

Interest: This is about the thematic areas within
public health. The students may already have a certain interest in health
topics and want to dig deeper into them during the internship.  These could be diseases like Tuberculosis or
diabetes, risk factors like tobacco or diet, methods like health technology
assessment or systemic review, or niche areas like occupational health or
health financing. Some others who are freshers may not have this clarity and
that is ok too. 

Students
must ask themselves: how, where, and on what do I want to spend two long
months? Am I doing this internship because it is available or because this is
what I would love to do?

Considerations
during the internship

The last concern students often have before going to the internship is how to
maximize the utility of the internship. 
Following are some suggestions to make the most of the internship
experience.

Allow oneself to make mistakes and learn from them:
  The performance anxiety as a junior person in
an organization is natural. Such anxiety makes the person do things that
otherwise one may not do. So, it is important to deal with performance anxiety
productively. One way to do this is to allow oneself to learn by doing and making
mistakes while doing it. Take chance, take risks, get immersed, and enjoy. This is the only chance to make mistakes without having to pay a big price for it. Make the most of it by taking chances and making mistakes to learn from. The
organization also knows that they have hired an intern and not a staff.

Interns are not staff: 
You have been allowed to work as an intern.  Don’t expect to be treated like a staff
member. Do not expect the perks, benefits, or space that staff would have at
the organization.  In addition to
learning about subject technicalities, an intern must learn to critically observe
the organization, its environment, and dynamics as well. For this, it is important to cultivate humility and attitude of learning new things in new environment. 

Should be seen but no heard: Spend the first two weeks like the youngest newly married bride in the patriarchal family. Invest your time, space, and energy to scan, observe, make mental notes, be cautious, do as asked to, offer proactive help, etc. If you do that, you can invest well so as to demand attention in the last two weeks when you want to complete your own learning agenda.

Have your own agenda: Things to do, concepts to learn, experiences to have, skills to practice etc. These would be in addition to tasks that you are asked to do and information that you come across. Keep updating this list of agendas and check from time to time. Try to finish them when you have invested well and can demand attention.

Match your expectations: The host and the intern need to
match their expectations to avoid dissatisfaction and agony.  The organization will have a “doing” agenda.  The interns must engage to complete certain
tasks assigned to them. Students
must prepare, and finalize with the help of the host, a checklist of expected
learning. It is always good to revisit the list to avoid expectations mismatch.

Choose your prism:  Whatever organization or work, one is free to
choose one or more prisms for the learning purpose.  These prisms could be community, facility, or
providers.  An intern must widen
perspectives of these important elements, in addition to the primary focus of
the host organization.  For this to
happen, the intern must remain an insider-outsider to the organization operating
as an audience, a participant, and an observer all at the same time.  

Network: Last and most important consideration during
the engagement as an intern is to leave a lasting impression of who one is and
what one aspires to become.  This
impression can go a long way in widening the student’s access to the small
world of public health and healthcare administration in which everyone knows
everyone, most of the time.  The interns
must showcase their abilities and attitudes;  some will be hired for what they can do, and
some others will be appreciated for how they do what they do. 

Write a lot: Write about everything that you do, experience, think, feel, ponder, get confused with, question, etc. Make a habit of writing few pages everyday so that you have a lot of material when you sit to write your report.

 

Students
must ask themselves:  What can I give to
the organization during my internship and what can I take from it? Am I making
this experience a liberating one or a confining one?

  Considerations
during the internship

At the completion of internship, the last concern the students have have is about preparing a report and defending a review. Some tips for review and report writing are below.

1. Be honest and own up all your involvement and express them in your report and then summarize them in the review. Do not try to impress but express for your reviewers to have a feel of it. Your report will be good enough for your juniors to read and learn from.
2. While the institute may give you a broad framework and a structure, the report should have
• A brief introduction of the organization (In your own words and not copying from the website) including an organogram to indicate where you would see yourself if you join it as a first job. This section will have details of work, human resources, finance, etc. of the organisations in addition to the typical vision/mission etc.
•  A note on your objectives of an approach to internship. Why and how did you choose this organization, what you aimed/aspire to do/learn/experience there (i.e. before joining them) This is like a methodology of research paper or report.
• Detailed descriptions of all that you did, get involved in, learnt, faced, resolved, and experienced during your two months of engagement. This can include activities undertaken, training/workshop attended, tasks/events helped in, tools/materials developed, notes/minutes/reports written or contributed to, visits undertaken, literature review carried out, research tools developed, assistance provided and other stuff. This is the space to inform you about the magnitude and range of work that you could do in two months. Do not be shy and modest; elaborate on all your involvements. Daily diary would be helpful in writing these details. In this section, you will also elaborate a project you may have undertaken on your own.
• Learning and challenges will come next. In this chapter you will elaborate in detail what came in your way of meeting objectives you mentioned in the second section above. Write even the smallest challenges you face and elaborate on how you overcome them. The learnings can be elaborated as technical skills, soft skills, and exposures and experiences that may have long-term implications. You can also write here the relevance of classroom learning during your internship.
• Conclusion would have a summary of tasks and learning and takeaways, especially for your juniors who may read your report next year.
3. The review presentation would be a summary of the report. you can have core summary slides and many additional slides that would be hidden. These hidden slides may be used to respond to queries that your reviewers may have. I, as a reviewer, am interested in examining clarity in why did you go there?, What were your doing and learning agenda?, What did you do there? Was is adequate for two months? How did you do it - challenges and approaches? What did you learn in these two months that you did not know earlier? and How do you connect the overall experience to larger scheme of two year MPH?
4.  Lastly, your seniors were as naive during their internship as you are now (some may have been dumber than you). So, do not see them and their reports as a role model. Use them as a guide and not a bible.