A Day in the Life of a PGY1 Internal Medicine Resident: On Internal Medicine Wards

I am not a morning person. I don’t know why I decided to go into medicine, but here I am.

Just kidding, I love medicine. To all you non-morning people out there, don’t worry! Residency is doable.

When I get to the hospital, I receive “sign out” from the overnight resident.  Sign out is what happens before and after every shift. Residents from the previous shift update the incoming shift on all the events that happened throughout the day or night, what is going on with each of the patients, or any outstanding “to do” items (like following up on important labs, etc).

After sign out, I go “round” on my list of patients (my program allows interns to have a maximum of 8). Rounding means checking charts, seeing patients, doing a physical exam etc. This usually takes about an hour depending on how complex the patients are. After I am done with that, I come back to the resident room and start typing up my notes. My senior resident also rounds separately and when they get back to the resident room, we discuss our patients if we need to review the plan or if I have any questions.

There are also always medical students rotating on wards so when my medical student is done seeing their patients (usually 2 patients as a third-year medical student) I take a little break from note writing to discuss their patients with them and help them prepare their presentation for the attending.

I grab breakfast from the cafeteria (or sometimes a fancier breakfast is provided by the program at morning report) and get ready for some learning. Morning report is an interactive case based learning session meaning that a resident puts together a case that is good for learning and we go through it and participate, ask questions etc.

Morning report happens Monday-Thursday with Fridays off at my program.

This time is variable and attending-dependent but this is usually the time most of my attendings like to round. Attending rounds can be “bedside” or “table” rounds. Bedside is when the entire team goes in a group to each patient room and sees the patient together, usually discussing the patient outside the room beforehand. For table rounds, the attending sees the patients ahead of time on their own and everyone gathers in the team room to discuss the patients and formulate assessments and plans.

During rounds, I am finishing up notes, putting in orders as we go, and checking to see any new labs or updates.

I grab lunch and head to noon conference (sometimes a fancier lunch is provided here too!). Noon conference is a lecture given by an attending or resident on a subject. It is different than morning report, which is more of an interactive case presentation. This is more lecture-like.

The afternoon is dedicated to patient tasks like following up on labs, calling consults, making sure patients got their imaging, going to see patients who are very sick again, responding to pages, etc. We also see patients who are just getting admitted to the hospital. The time you are done admitting patients depends on whether or not your team is on call. The on call team takes the later patients after 5:30 PM or so.

This time I am the one giving sign out to the incoming night resident. I give them a brief summary of the patients, tell them what needs to be followed-up, who needs to be watched more closely etc.

Even after a long day, I still try to drag myself to the gym at least 3x per week. This is an important one for me since I feel like it just keeps me overall sharp and happy despite the long inpatient internal medicine ward hours. I try not to go home after work and go straight to the gym so I cant get lazy.

This is my time to eat dinner, watch some good Netflix, study a bit, or prepare any presentations or work on any research.

I personally like to get a solid 8 hours so I try to go to bed by 10 PM. The wards weeks are really long and can be very exhausting so I like to make sure I get a good night’s sleep.

Obviously, every day is a little different. Sometimes I have more downtime during work, sometimes less. Sometimes I don’t get to the gym, sometimes all I can do when I get home is watch TV. Overall, the wards weeks are busy but I love where I am and what I do.

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