Wards: Internal Medicine

EDC. It’s been too long.

I’ve been doing ward medicine for 3+ weeks and have appx 1.5 weeks more to go. It’s been a rocky transition. I won’t go into details here, but just know that being a medical student vs. Intern is just completely a different world and that the team dynamic really makes or breaks the experience.

Otherwise, ward medicine has been something else. The learning curve is a beast, the hours are rough, and maintaining your sanity is a daily challenge. Right now, I’m on Medicine Red (one of the 4 resident teams) at the hospital. My team consists of one senior resident (R2), a c0-intern (R1), and a medical student (MS3). We alternate Attending Physicians every two weeks and right now are super lucky to have an excellent Attending to work with. The schedule is intense. We all, easily, average more than 80 hrs/week. If I leave the hospital by 4pm, it has been a successful day – but this has only happened once. Yesterday.

Here’s a quick run down of a typical day:

  • 6:15 am: arrive to the hospital, head to the team work room and print out patient lists
  • 6:30 am: head to the 4th floor, get sign out from the overnight team on my patients, grab the pagers, and code pagers if we’re on call
  • 6:45-8 am: pre-round on my patients. Currently have 5 pts (thank gravy!!!) and I know them all pretty well, so this doesn’t take too long.
  • 8 – noon: round with Attending and Sr. resident; which are regularly interrupted by other meetings:
    • 8:50 am: social work rounds
    • 10 – 11 am: Morning Report w/ the other Medicine/Neuro/Endo teams
    • noon – 1 pm: Case Report/Teaching/lecture, etc w/ lunch
  • 1 pm – 6:30 pm: discharge pts, consult other docs, put in orders, write notes, see pts again if needed
  • 6:30 pm: sign out pts to the overnight team; if we’re done early sign out to the on-call team.

If we’re on call, we accept patients from noon – midnight. The time is very strict, on my last call we got two new admits at 11:15pm and 11:30pm. This basically results in nobody sleeping. Regarding the call schedule, we’re on a Q4 system – so every 4th night we’re on call. The post-call day we have to round on our new admits, write notes, do orders, etc and sign them out to the day team and get out by 11 am. Then go home and sleep.

It’s overall been a great rotation and I’ve learned a lot but am regularly reminded of my knowledge gaps. I love having “my patients” and taking care of them. I’ve had a couple of really sick patients and being their point of contact and getting them better and out of the hospital is a really gratifying feeling.

I miss all of you and would love to hear what a break down of your days is like and how residency is going for everyone. 🙂

Dr. Nari, a tired Intern.

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