I worked over 3,000 hours during intern year, with approximately 5 days off per month. When you are at the bottom of the totem pole, there is no shortage of work. With stress m… With so much to do and learn, a good night’s sleep was a luxury. I’ll be finishing my internal medicine and pediatrics residency this year. In my primary care office, I saw 147 patients across 18 clinic days (36 half days), not including a no-show rate of 11.9 percent. Year 1. Yet this was cake compared to the week I spent covering 60 to 120 ICU and ward patients overnight at the academic hospital. Peggy Bui is an internal medicine resident who blogs at Page Me Maybe. Critical Care – 4 weeks. The ... with 48h per week being the latest maximum [3]. On average, I worked 11.1 hours each day: 8.46 hours per day if I was on scheduled shift work such as in the emergency department or urgent care and 12.93 hours per day if I was on Inpatient Wards. The rotation structure is a hybrid of day/night and extended shifts, with 1-2 28 hour calls per 2-week block. Fortunately, “while the days are long, the years are short,” and intern year went by all too quickly in retrospect. Overall, these cases, along with alcohol withdrawal, pneumonia and GI Bleed where among the most common presentations I encountered during intern year. Selinexor OK'd for Myeloma, But Does That Make It a Good Drug? At the VA (Veterans Affairs) Medical Center, days are usually quieter with the exception of right after the holidays when many vets come in after urgings from their friends and family. In a few weeks, thousands of medical students find out where they have matched for residency. While the patients were complex at the academic hospital, the county hospital (the only level 1 trauma center in the area) was where I saw some of my sickest patients, coming in with shock and respiratory failure. Recognize the Trump that lies within each of us and try to heal him, Why states need to develop rural health outreach programs, The side effect of the COVID vaccine that no one is talking about, Thriving in residency: tips for your personal, financial, and professional lives, When your institution has a less than 1% hiring rate for Black residents [PODCAST], Maximizing COVID-19 vaccine equity and minimizing death in South Carolina and beyond, Vaccine Line Chaos; U.K. Strain Already Here? The Spectrum Health/Michigan State University College of Human Medicine Internal Medicine Residency program is a three-year program accepting 12 positions per year. The fewest number of pages I received in a given night was 43 (I remember because it was so rare and remarkable) and the most was upwards of 150. We offer 9 categorical positions per year and 4 preliminary positions (2 positions reserved for neurology preliminary trainees, accepted through the neurology department) with a total number of thirty-one residents. stream The complexity and diversity of diseases were the greatest at the academic hospital, with a high number of patients with end stage liver or renal disease, sickle cell crisis, and transplant or chemo-related complications. Per day, I earned approximately $121.80 after taxes (this includes a generous housing stipend that my program provided to offset our cost of living in an expensive urban city). Education Furthermore, it was not uncommon for patients to travel far to seek specialty care at the academic hospital given the hospital’s reputation as a research powerhouse. A 2nd wave is predictably common between 4:30 to 6:30 a.m., when many lab results start to trickle in requiring “MD aware.” As the morning approaches, several morning report reminders will appear for every intern whose pager I am still covering. 'Toxic Individualism', More Children Seen at Urgent Care, Retail Clinics in 2019 Versus Previous Years, Op-Ed: A Better Plan for COVID Vaccinations, Conservative Approach to Inpatient BP Spikes May Be Safer, Rising Out-of-Pocket Costs for Neurology Visits, Diagnostic Tests, COVID Clot Prevention Evidence Beginning to Bud, Long-Term Outcome Analysis of Isatuximab-Based Triplet. On average, I worked 11.1 hours each day: 8.46 hours per day if I was on scheduled shift work such as in the emergency department or urgent care and 12.93 hours per day if I was on Inpatient Wards.Since I spent 9 out of 12 months of the year doing inpatient rotations, this translated to approximately 60 to 80 hours per 6-day workweek for most of the year. At the hospital, I was the primary provider for 95 critically ill patients in the ICU. The pages were coming in so quickly that she sometimes did not have time to call one back before more pages came in. • 3-year ACGME-accredited Categorical Internal Medicine Residency Program • 25 residents per year, 75 residents total • A “4+1” training model that allows residents to spend one week fully dedicated to continuity of care for their primary care patients in between four-week … No other time in your life can you find a resident room buzzing at 2 in the morning because “Guys! I spent that time training for and running my first half marathon, painting and upcycling furniture, and celebrating with friends and family. Internal Medicine (or FM service) 8 weeks. The longest I worked consecutively without a day off was 15 days. Maximum Hours of Clinical Experience and Educational Work per Week: 1. My medical school had a tradition of putting each 4th year’s name in an old doctor’s bag. When I say “1,” I mean the ratio of doctors to patients is 1 of me to 60 to 100 patients whose care I am responsible for during the night. San Francisco VA Medical Center admissions: The VA was also where I saw the highest proportion of classic “bread and butter” Medicine cases like CHF and COPD exacerbations. Does it really work? Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories. I worked most federal holidays and even after explaining to my mom several times over the years, she still gets bewildered when I tell her, “Yes I AM working Thanksgiving … no, hospitals DON’T close just because it’s Christmas.”. Hospital-Based Medicine, After the parties, celebrations, and last-minute 4th year getaways is when the real work begins! Completed her residency in Obstetrics & Gynecology at the University of California, San Francisco in 2015. Cheers, tears, champagne would flow as one announced their fate, and the last student called up to the microphone would get money as consolation for the long wait. hours per week (4x 12 hour shifts each week) Allergy / Immunology Ambulatory Internal Medicine Bariatrics and Nutrition Breast Clinic Cardiology (inpatient or outpatient) Critical Care ELECT* - Surgical, Transplant Dermatology Emergency medicine Endocrinology Gastroenterology Genetics Geriatrics Hematology/Oncology (inpatient or outpatient) The sponsoring institution must establish the internal medicine residency within a department of internal medicine. Image credit: Shutterstock.com, Peggy Bui, Tagged as: Hours will also include all moonlighting activities as defined in the relevant section. Pediatrics- ambulatory – 4 weeks. (Detail) I.A.2. The VA team structure consists of 3 medicine teams, each with an attending, 1 resident, and 2 sub-interns (or 1 intern during the months without sub-interns). In retrospect, it had that “Harry Potter sorting hat” type of flair to it that was both nerve wrecking and magical. As a result, I had a high number of failure to thrive admissions, where we sought long-term placement for our veterans who could no longer care for themselves. The Internal Medicine Residency Program will schedule resident assignments in compliance with all applicable ACGME requirements. ... A rigorous didactic schedule is built around four hours of protected didactic time per week and includes book club, journal club, board review, and attending lectures. We hope to develop caring physicians that will serve those types of communities in the future and hope that you can join us in this endeavor. Per my wrist monitor, I used to wake up 7 to 10x per night during medical school, and during intern year this increased to approximately 15 to 18x each night, with the occasional 27 to 29x. The Residency Experience. Before, it was routine for residents to spend 100 or even 120 hours a week in the hospital (and, yes, there are only 168 hours in a week), with single shifts stretching to 48 hours and beyond. In keeping with ACGME standards, each resident has one day free of patient related activities per week (on average). I discovered hikes, restaurants, and learned the local secrets of my new city. Medical school in a pandemic: Privileged or slighted? The Internal Medicine Residency Program at Cleveland Clinic Florida is a comprehensive three-year training program. In addition to clinic hours, an internist may also see patients in a hospital on daily rounds, or on an on-call basis. She’ll be taking unpaid maternity leave for at least five months and is on my health insurance. Convergence of Klebsiella Carbapenem Resistance with Virulence, Pegcetacoplan Bests Eculizumab for PNH Patients, Finerenone Cuts Kidney, Heart Risks in CKD and T2D, LOXO-305 Demonstrates Promising Efficacy in CLL. 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