Is it OK to hate rounds?

[G0S2]

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I am definitely more IM-minded than surgical. I enjoy medicine and like thinking through differentials and treatments. One thing I can't stand, however, are marathon rounds. Is it OK to feel this way and do IM? I asked some MS4's who are going into med this Q and, in general, they enjoyed rounds. I like to be efficient, to the point, solve the problem and move on. Maybe I am scarred from the 5 hour rounds on one of my med rotations.

 

[DarthNeurology]

I am definitely more IM-minded than surgical. I enjoy medicine and like thinking through differentials and treatments. One thing I can't stand, however, are marathon rounds. Is it OK to feel this way and do IM? I asked some MS4's who are going into med this Q and, in general, they enjoyed rounds. I like to be efficient, to the point, solve the problem and move on. Maybe I am scarred from the 5 hour rounds on one of my med rotations.

Rounds grow on you as you learn more medicine, i.e. it is like sitting around and talking about baseball for four hours if you are baseball fan, . . . likewise many MS IIIs get bored by rounds because they don't understand the nuance and finer points of what is being discussed.

 

[muscles]

No you don't have to like rounds - with some attendings, they can be almost unbearable. I was very close to going into another field because I finally decided I couldn't take 3-4hrs of rounding a day. However, the more I started thinking about it, there are too many other great things about IM to turn my back on it simply b/c I don't like how some attendings do rounds. I have made a promise with myself, however, that when I am an attending one day, I will run efficient rounds...

 

[G0S2]

It certainly is attending dependent. My first 4 weeks was great with a seasoned attending who was brilliant and efficient. Second 4 weeks, new attending who graduated from residency months earlier who discussed every facet of minutia during rounds. I wonder if I will enjoy it more once I am making decisions and placing orders.

 

[Danbo1957]

Five hours is a long time for rounds. 😴

Rounds do/should get shorter and more to the point as you move up the food chain. Sometimes, though, certain presentations will lend themselves useful for a teaching purpose or to highlight a particular medical process. A good attending knows when to keep it real...

 

[lemonade02]

i don't like rounds and i'm going into IM, you're not alone. rounding is not what makes IM. think of rounding as just a time to showcase what you've done. its not the essence of the field by any means.

 

[abefromann]

I think it's important to remember that there really isn't a specialty without its negatives. It seems that 'rounds' are what people complain about the most, regarding IM (and I tend to agree). Sometimes rounds are interesting (as a student) but often it's when the attending will actually teach, at the bedside or outside the room. Rounding with an annoyed attending who's just blowing through the patients and getting presented to by only the resident is not that helpful for teaching.

 

[orientedtoself]

another incarnation of bad rounds- rounding with a medical student who has no idea what he/she is doing, takes forever on their presentation but misses the important points, and tells you about every itch or twitch the patient has ever had on review of systems. . .

to go into medicine, i think you have to enjoy rounding to a certain point. it doesn't mean you have to enjoy excessively long or painful rounds. but, these aren't surgical rounds here.

 

[abefromann]

The ancient Greek adage "Know thyself" applies exquisitely here.

I like derm rounds -- boo yahhh

 

[Geri_Gal]

You are not alone. You do not have to love rounds to love IM. ...And when you leave academia, you leave long rounds.

 

[analgold09]

Whether the rounds are walking or sit-down makes a huge difference.

I could probably handle up to 3 hours rounding, as long as I am seated. Talking as a group outside patient doors in a busy hospital hallway (with pissed off transport people yelling "make way") diminishes my capacity to one hour max.

 

[DarthNeurology]

Whether the rounds are walking or sit-down makes a huge difference.

I could probably handle up to 3 hours rounding, as long as I am seated. Talking as a group outside patient doors in a busy hospital hallway (with pissed off transport people yelling "make way") diminishes my capacity to one hour max.

I have gotten accustomed to standing during rounds when before it hurt a lot, maybe it is like ice-skating and your feet get used to it. Anyway, I have done electives that have you rounding literally ALL day, i.e. cardiology, and I would consider 3-4 hours rounds, i.e. in a.m. as no big deal and the norm for internal medicine. However, I have found that I really love rounds as it is time to interact with attending physicians and see how they treat the patient and to go over questions of management, so I guess I am in the minority as I would find IM terribly isolating without rounds as an attending physician or resident. I think you have to eat a big breakfast you aren't hungry or anything during the rounds. The only bad rounds where with this one IM attending who rounded for a long time, but he was really slow or something and didn't connect with us as a group, i.e. the group of students and residents.

 

[elwademd]

i think a problem with typical internal medicine rounds is efficiency, or lack thereof.

when you're a student or a new/green intern, lots of "rounding" means lots of learning... but not necessarily contributing to the care of the patient or getting work done (other patients seen, talking with consultants, following up test results, following up lab results, etc.). i suppose one could argue that somethings learned on rounds while they may not be beneficial to your patient that day, may, in fact, be beneficial to some patient some day in the future.

the problem, in my mind, is that constantly having long rounds breeds inefficiency, so that the day is strung out, and it takes a lot longer to get things done.

i prefer rounding with a point. i.e., if we're going to talk about hyperkalemia, lets leave it to the likely causes in the patient, rather than all of the potential causes of hyperkalemia, and then a 10 minute presentation on something that isn't happening in the patient.

i think that rounding for hours on end breeds inefficiency, and this, in turn, leads some to be discouraged by internal medicine. you can be succinct and to the point without compromising patient care.

 

[G0S2]

i think a problem with typical internal medicine rounds is efficiency, or lack thereof.

when you're a student or a new/green intern, lots of "rounding" means lots of learning... but not necessarily contributing to the care of the patient or getting work done (other patients seen, talking with consultants, following up test results, following up lab results, etc.). i suppose one could argue that somethings learned on rounds while they may not be beneficial to your patient that day, may, in fact, be beneficial to some patient some day in the future.

the problem, in my mind, is that constantly having long rounds breeds inefficiency, so that the day is strung out, and it takes a lot longer to get things done.

i prefer rounding with a point. i.e., if we're going to talk about hyperkalemia, lets leave it to the likely causes in the patient, rather than all of the potential causes of hyperkalemia, and then a 10 minute presentation on something that isn't happening in the patient.

i think that rounding for hours on end breeds inefficiency, and this, in turn, leads some to be discouraged by internal medicine. you can be succinct and to the point without compromising patient care.

Here, here.


That's is what I would see a lot of.......Upset residents going back to the team room with a heap of stuff to do after rounding for hours. I loved the weekend coverage docs b/c on rounds they would say "just give me the quick version and tell me about the important problems with this pt and what we are going to do." Rounds on the weekends for 20 pts would take 2 hours max and things would get done. I also learned a lot and had more time to read on my own.