I was just wondering if anyone would share their day in the life of a family medicine intern. I know it really depends on the program and also what rotation you're on, but I completed my intern training back before there were the work hour restrictions for interns and we had almost 30 hour shifts Q4. I'm going back into residency training after a 4 year break so just curious as to what to anticipate...THANKS!
day in the life...
- Thread starter roseG
- Start date
- Joined
- Jan 5, 2007
- Messages
- 2,565
- Reaction score
- 2,962
Let's see -- FM Residency is just like riding a bike --- except the bike's on fire...and you're on fire....because you're in hell ;->
Seriously -- really depends on what your residency is like -- mine was toxic, the attendings were not signed off on hospital procedures yet insisted on running an inpatient service and were determined that we had to be "equal" to IM -- in one instance the attending actually had a patient transferred to the IM service stating that they were too sick to be on the floor with bilateral PNA -- the IM chief resident was told to accept the patient and then turned around and rather than sending them to the ICU, handed it to one of his floor teams who handed it to an intern who dealt with the problem -- the FM team hung their heads in shame after that one ---
So -- day in the life -- on inpatient, you can expect 12 hour shifts, we used a night float so after the floor work was done, we tagged an intern to stick around for any admissions until 6PM -- anything that came in after that went to the nightfloat coming on at 7pm. You were expected to get there early enough to round on your 7-10 patients and have your orders/notes done in time for attending round at 9AM. Rounds were until 11 or 12 depending on how busy the service was and the PGY2 handled the admissions that came in during rounds -- they would go eyeball the patient, put in the bed request, start basic orders -- diet was the big one that would get you hammer paged by the nurses -- but the intern had to do the H&P and flesh out the treatment plan. Sometimes the attending would go see the patient so that they didn't have to come back later. Floor work would last until 3 or 4 and usually one intern would go home "early" on alternate days --again depending on service. You usually worked every other weekend day -- between you and the PGY2 you covered the entire service and rounds were generally at the same time.
Other rotations were not as busy -- you could expect to be there until around 7pm and get there around 630am -- if you had clinic, it sucked because the patients were all county hospital patients who wanted to be fixed but not take responsibility for their health -- getting them to even take medications was a difficult exercise.
We were an opposed residency so we were last in line for procedures and any training -- the answer always was "Well, we have to train our own residents first" -- with the exception of the Emergency Medicine department. They trained everyone the same, the upper levels were great about getting you a decent experience -- heck, I drained a peritonsillar abscess right there in the trauma bay with the Chief Resident observing -- it was hard, however, to get true trauma experience as the scene was mobbed with EM residents, Trauma residents and medical student straphangers -- the med students were a pain in the ass -- they all wanted to "see the cool stuff" and added zero to the operation and got in the freakin' way --
Some rotations were lighter -- like surgery -- we had a community surgeon who actually told us that his was a chill rotation, he wanted us to learn how to suture and close wounds but that was about it -- frequently went home after lunch -- nice roation and all but really didn't learn much.
ICU was exhausting but interesting -- again, procedures went to the IM guys -- we did it as PGY2's but were functioning as interns -- call was Q3 so it was a rough month -- but I learned a bit and actually considered transferring to IM and then doing an ICU fellowship because they taught you so much and it was a really good learning environment --
If I had to do it again, I'd go to an unopposed residency, make sure that the FM attendings knew what the hell they were doing and that the attendings that we rotated with were required to teach -- by that I mean none of this," Well, you're in the hospital and if a community attending gets called in for his patient, it's up to them whether or not they teach you."....
I've rambled but I hope this helps.
Seriously -- really depends on what your residency is like -- mine was toxic, the attendings were not signed off on hospital procedures yet insisted on running an inpatient service and were determined that we had to be "equal" to IM -- in one instance the attending actually had a patient transferred to the IM service stating that they were too sick to be on the floor with bilateral PNA -- the IM chief resident was told to accept the patient and then turned around and rather than sending them to the ICU, handed it to one of his floor teams who handed it to an intern who dealt with the problem -- the FM team hung their heads in shame after that one ---
So -- day in the life -- on inpatient, you can expect 12 hour shifts, we used a night float so after the floor work was done, we tagged an intern to stick around for any admissions until 6PM -- anything that came in after that went to the nightfloat coming on at 7pm. You were expected to get there early enough to round on your 7-10 patients and have your orders/notes done in time for attending round at 9AM. Rounds were until 11 or 12 depending on how busy the service was and the PGY2 handled the admissions that came in during rounds -- they would go eyeball the patient, put in the bed request, start basic orders -- diet was the big one that would get you hammer paged by the nurses -- but the intern had to do the H&P and flesh out the treatment plan. Sometimes the attending would go see the patient so that they didn't have to come back later. Floor work would last until 3 or 4 and usually one intern would go home "early" on alternate days --again depending on service. You usually worked every other weekend day -- between you and the PGY2 you covered the entire service and rounds were generally at the same time.
Other rotations were not as busy -- you could expect to be there until around 7pm and get there around 630am -- if you had clinic, it sucked because the patients were all county hospital patients who wanted to be fixed but not take responsibility for their health -- getting them to even take medications was a difficult exercise.
We were an opposed residency so we were last in line for procedures and any training -- the answer always was "Well, we have to train our own residents first" -- with the exception of the Emergency Medicine department. They trained everyone the same, the upper levels were great about getting you a decent experience -- heck, I drained a peritonsillar abscess right there in the trauma bay with the Chief Resident observing -- it was hard, however, to get true trauma experience as the scene was mobbed with EM residents, Trauma residents and medical student straphangers -- the med students were a pain in the ass -- they all wanted to "see the cool stuff" and added zero to the operation and got in the freakin' way --
Some rotations were lighter -- like surgery -- we had a community surgeon who actually told us that his was a chill rotation, he wanted us to learn how to suture and close wounds but that was about it -- frequently went home after lunch -- nice roation and all but really didn't learn much.
ICU was exhausting but interesting -- again, procedures went to the IM guys -- we did it as PGY2's but were functioning as interns -- call was Q3 so it was a rough month -- but I learned a bit and actually considered transferring to IM and then doing an ICU fellowship because they taught you so much and it was a really good learning environment --
If I had to do it again, I'd go to an unopposed residency, make sure that the FM attendings knew what the hell they were doing and that the attendings that we rotated with were required to teach -- by that I mean none of this," Well, you're in the hospital and if a community attending gets called in for his patient, it's up to them whether or not they teach you."....
I've rambled but I hope this helps.
