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A Day In The Life Of...

deschutes

Thing
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  1. Attending Physician
    Floating this to remind myself...

    yaah said:
    Surg path days here (for me)

    6:30-8, take care of issues, organize for the day, check emails, etc
    8-9 conference
    9-12 signout
    12-1 lunch
    1-2 conference
    2-5 gross specimens, preview slides for next day, deal with clinicians calling and paging me, troubleshoot histology issues, etc
    5-6 maybe another conference
    6-until I'm done finish previewing, grossing specimens (usually between 7-9pm, sometimes done at 5pm, sometimes there until midnight).

    Signout varies from 1 hour to more than 6 hours depending on the volume and the attending. You are interrupted on certain services for frozen sections or clinicians concerns. You are not looking at a microscope ALL day, but do for a few hours.

    Clinical path rotations:
    8-10 conferences
    10-12 hang around the lab, read stuff, troubleshoot, etc etc
    12-1 lunch
    1-5 same as from 10-12.

    I should say though, there are a bunch of teaching sessions that go on during the day in clinical path rotations, some are related to signout of certain tests, others are simply educational. You get interrupted for things here and there. Generally you also give presentations once or twice a week that you have to prepare for.

    Autopsy depends on whether there are autopsies, obviously.
    from http://forums.studentdoctor.net/showpost.php?p=2650210&postcount=3
     

    deschutes

    Thing
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    1. Attending Physician
      Hemepath days here at the U (for me):

      8am - 9am: Conference (most days)
      9am - 10am (or 11, depending on your luck): Head to the day hospital/BMT clinic/inpatient unit to do bone marrow biopsies - you get on average 2 a week of the "we do"s. "They do"s are taken care of by clinicians/PAs/NPs/Peds OR, and this number is increasing, I'm told.
      10/11am to lunch: Trephine sections back from previous days cases. This takes priority for signout.

      The current day's cases (i.e. blood/aspirate smears) are ready about 2 hours after the scheduled BMBx, so we start working on them late morning and throughout the afternoon. Preliminary Dx signout happens throughout the afternoon.

      Blood smears for morphology are scattered in throughout the day.

      There's usually half an hour for lunch between finishing a case and starting another.
       

      deschutes

      Thing
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        Bloodbank (at the U)

        8 - 9: Conference most days: residents' conference, grand rounds, bloodbank breakfast meeting, CP conference etc.

        Most CP rotation days are relatively unstructured; you deal with whatever seems most urgent/emergent at the time.

        Bloodbank tasks here throughout the day generally comprise:

        1. Transfusion reactions - if there were any overnight
        2. Donor/apheresis centre - write orders for stem cell collection/pheresis patients, obtain consent for procedures, are patients bleeding or having numbness/tingling etc.
        3. Stem cell infusions - which I realize is a momentous moment (for lack of a better phrase) for the patients, but for the BB doc's part comprises taking the patient through what to expect, and then standing around making conversation for an hour or so depending on how many units the patient is getting. And no you can't bring a book. You can however take the hour to write your half-page infusion note.
        4. Appropriateness Reviews - which you will probably never see an attending doing. This is where you get to play Platelet Police and evaluate current platelet transfusion parameters, requests for irradiated products, requests for special products like cross-matched/HLA-matched platelets, washed red cells, granulocyte infusions. By "evaluate" I mean all means necessary (EMR/chart review/phonecall), the fastest generally being to walk up to the floor to see the paper chart and talk to the clinical team. Having another resident with you, while not necessary for the completion of your quest, generally makes things more pleasant. Two people make a "team", you get to b*tch endlessly about how you love your job, and you can say things like "We're from Transfusion Medicine."
        Normally you start the 3-month rotation at the VA, then Hennepin County MC, then the U. In actuality the breakdown of the 3 months looks like this:

        2 weeks VA
        2 weeks U

        2 weeks HCMC
        2 weeks U

        4 weeks U.

        The time at the VA is great - benchwork, getting to understand the antibody panels and how/when/why the tests are done. I haven't been over to the county hospital (it's a trauma centre) so I have nothing to say about that - we're on call for that month (telephone call).
         
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        yaah

        Boring
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        Aug 15, 2003
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        Fixing in 10% neutral buffered formalin
        1. Attending Physician
          Hemepath here:

          7-8am (at least for me) review clinical histories of patients we are looking at today, get things organized.
          8-9am departmental conference
          9-10 am: Preview fluids/peripheral smears with rest of residents and students on hemepath (usually 10-20 cases, sometimes more, including CSFs, pleural fluids, peripheral smears)
          10-11:30 or so; signout fluids with attending.
          11:30-1pm or 1:30 - lunch and time to preview bone marrow aspirates and biopsy sections which have come out during fluid signout (procedures done the day before). If there are a lot, sometimes we preview and count the aspirates the night before or earlier in the morning. The techs will count a few of the aspirate smears.
          1pm-whenever (usually 3-4pm) sign out bone marrow biopsies, lymph node biopsies, additional studies on previous cases that came back today (Impox, etc).
          4pm onward : Finish up things, preview tomorrow's stuff if necessary and if available, often talk with clinicians who are coming by.

          All day: Interrupted by clinician pages and lymphoma workups (Lymph nodes from the OR or whatever that we have to triage).

          It's a busy day, not incredibly stressful but almost all of the day is full of stuff to do. Here we do not do any bone marrow biopsies. The fellows learn how to do them, and the residents can if desired.

          We also sometimes spend time on flow or consult cases/transfer cases (pts being sent here for treatment or second opinion all have their prior path reviewed) and the day is different on those. We also have weekly conferences, interdisciplinary, tumor boards etc.
           
          B

          b&ierstiefel

            Well I just did a week of Gyn Biopsy rotation and typically my day went like this:

            8 to 12 pm: Signout
            12-5 pm: Carry the Gyn frozen pager.

            Surg path (it varies really but it might go something like this):
            8-12 pm: Sign out cases.
            12-6 pm: Grossing and fielding calls from impatient clinicians.
            6-?: Previewing cases. Usually on days when we gross, we don't have too much to preview compared to the next day.
            At various times in the day: Conferences sprinkled here and there. Don't really go to a lot of them because I don't feel like it and I'm getting bored of the free food that we get.

            Autopsy:

            On days when I'm first up for autopsy:
            Arrive at work at 8 am. Read or finish up previous cases from the week before. Help out the other resident who is covering frozens.

            On days when the other resident is first up for autopsy:
            Arrive at work at 7:30 am. Cover frozens until 5 pm. These days are usually busy.
             

            pathstudent

            Sound Kapital
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            Mar 17, 2003
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              hey is that Beerstiel%[email protected] poster the dude formerly known as Andy who trained at the Brigham?? What happened to him? Anyone?
              Greatest sdn post ever was the one where you were advising him on how his life would turn out in whether he chose academics or private practice. It was like classic SNL funny.
               
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