Inpatient FM services, what's your census like?

[MedicineZ0Z]

In terms of total size and patients per patient along with patient complexity.

We usually run 7-9 patients per intern here. Good number of zebras hit our census. Patient complexity is high and things like insulin drips, amio, etc we have on a daily basis.

Curious what other programs are like in this regard. Not something I ever asked about on the interview trail.

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[MedicineZ0Z]

Interns usually carry about 5 on our inpatient service, give or take a few depending on how many months of medicine we have under our belt, if we're on long call for admissions that day, etc. Similar complexity as you're describing, decent amount of zebras. Open ICU as well - we almost always have a few patients on our list in the unit we're primary for, and those get spread out pretty evenly among the residents each month.

This may be typical, but we also still have inpatient responsibilities the few half days a week when we have clinic, nursing home stuff, etc. So for instance if I'm assigned to clinic one afternoon I still have to handle pages, orders, emergencies, etc for my admitted patients in between all that, I can't just sign out to somebody else and forget about it.

Interesting.
I'm in an academic center and we don't have an open ICU actually. We just handle patients that may be ICU level in community settings on the floor.

 

[ciestar]

Interns usually carry about 5 on our inpatient service, give or take a few depending on how many months of medicine we have under our belt, if we're on long call for admissions that day, etc. Similar complexity as you're describing, decent amount of zebras. Open ICU as well - we almost always have a few patients on our list in the unit we're primary for, and those get spread out pretty evenly among the residents each month.

This may be typical, but we also still have inpatient responsibilities the few half days a week when we have clinic, nursing home stuff, etc. So for instance if I'm assigned to clinic one afternoon I still have to handle pages, orders, emergencies, etc for my admitted patients in between all that, I can't just sign out to somebody else and forget about it.

Obviously not an intern but ive rotated at a program twice and interns (2) on service at capped at five each. The census itself is usually 10-15.

They do get to sign out on clinic days as there is a second and third year resident there to cover.

 

[MedicineZ0Z]

I'm at an unopposed community program. The open ICU thing terrifying at times but really good experience, I've had at least one REALLY sick patient each month I've been on our medicine service so far and it's been good learning. Thankfully our ICU docs really enjoy teaching and are very accessible if we have any concerns or questions.

Who does the procedures, especially since it's open icu?

 

[TheOther]

We start at 5 per intern, cap at 7 at the end of our first block, no census cap, average around 8-10 per list. Really complex patient population with plenty of zebras, tons of social work/counseling, and we have a semi-closed ICU (intensivist always here, but residents follow/co-manage our patients).

 

[SLC]

We capped at 8 per intern for community patients, but we’d go over cap for our own FM clinic patients, or for a few community FM docs that we admitted for.

 

[Roxas]

Unopposed community program. Open ICU. No official cap to my knowledge but interns carry 4-6, senior residents 6-10.

We are fortunate that most of our hospitalists love teaching and are happy to help us, especially with ICU pts.

 

[hallowmann]

...We usually run 7-9 patients per intern here. Good number of zebras hit our census. Patient complexity is high and things like insulin drips, amio, etc we have on a daily basis....

Interns start at 7, but go higher depending on experience. Cap is now technically 16, but we never cap for peds, clinic direct admits, bounce backs, or "VIPs" (staff, family of staff, and others). I've never been on with more than 20 though, and team is 2 juniors and a senior, but lately we've had a lot of understaffed blocks with just an 1 junior. Night float is a junior and senior, but the senior also covers OB/newborn.

Acuity and complexity are similar to what you described. Insulin drops, amio, etc. are all a regular occurrence on the floor. I remember one time getting a patient for "simple" pneumonia. Turned out to be an individual with a disorder that had only 800 confirmed cases worldwide, who also had pneumonia. It was an interesting night.

 

[MedicineZ0Z]

Interns start at 7, but go higher depending on experience. Cap is now technically 16, but we never cap for peds, clinic direct admits, bounce backs, or "VIPs" (staff, family of staff, and others). I've never been on with more than 20 though, and team is 2 juniors and a senior, but lately we've had a lot of understaffed blocks with just an 1 junior. Night float is a junior and senior, but the senior also covers OB/newborn.

Acuity and complexity are similar to what you described. Insulin drops, amio, etc. are all a regular occurrence on the floor. I remember one time getting a patient for "simple" pneumonia. Turned out to be an individual with a disorder that had only 800 confirmed cases worldwide, who also had pneumonia. It was an interesting night.

Interesting, so pretty thorough training. Academic center or community? Is off-service training equally as good there?

 

[Merely]

In terms of total size and patients per patient along with patient complexity.

We usually run 7-9 patients per intern here. Good number of zebras hit our census. Patient complexity is high and things like insulin drips, amio, etc we have on a daily basis.

Curious what other programs are like in this regard. Not something I ever asked about on the interview trail.

the program I rotated at as a student had interns covering like 3-4 per day lol..9seems like a lot

 

[SXMMD]

Similar picture at our program to what's been described by others. Total census avg is around 20/day, interns carry 5-8 on avg, more as the year goes on. No true hard caps but seniors step in as we start approaching 10 per intern. Open ICU but we are fortunate to have great specialist support. Midwest unopposed program. Acuity is pretty high. We cover OB and Peda overnight in addition to adult floors/icu

 

[hallowmann]

Interesting, so pretty thorough training. Academic center or community? Is off-service training equally as good there?

Academic. Off-service depends on the service. Inpatient, you usually function like a junior on the other services (e.g. surgery, peds, psych-CL, cards). Outpatient is outpatient, you and the attending.