number of patients that you see

[obiwan]

on your rotations particularly surgery or IM, how many patients are you guys expected to see in the morning and write notes on... at my school its usually 2 patients

vs. how many patients on your SubsIs

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[SouthernSurgeon]

on your rotations particularly surgery or IM, how many patients are you guys expected to see in the morning and write notes on... at my school its usually 2 patients

vs. how many patients on your SubsIs

Really varied per rotation.

On general surgery usually 3-4 (essentially, I just followed every patient where I was in on the operation until they got discharged). On ortho, I'd get in ~45 minutes before my intern, and just start seeing people and writing the notes until he showed up - I'd usually have 3-4 patients done by the time he got there, and then see another couple while he saw the leftovers.

On medicine I would usually carry 3, but sometimes as many as 5.

On peds, usually only 2 (but there were a lot of students on the service and it was early in the year, so the expectations were lower).

On OB/Gyn the students were expected to split all the pre- and post- partum patients, so usually like 5-6 (but prerounding on OB was really basic).

Sub-I's - I haven't done them, but in general our students seem to take an equal workload as the interns, and the upper level resident checks up on their patients as back-up. If there are complex patients (eg - post op pt in the ICU on a vent and pressors, etc) the sub-I students usually follow them.

 

[Cerberus]

Medicine was a max of 5.
Surgery I usually just carried two during general surgery
OBGYN - as few as I could get away with

 

[TexasPhysician]

Gen Surg: Minimum of 3
IM: as low as 0 if we discharged them all. As much as 6.

 

[Buckeye(OH)]

Really depends on how lazy the co-students are.

Usually not less than 3 on any service.

 

[Jamers]

on your rotations particularly surgery or IM, how many patients are you guys expected to see in the morning and write notes on... at my school its usually 2 patients

vs. how many patients on your SubsIs

Depends on the rotation:

OBGYN: 4-5 a day
Geriatrics: 10+ a day
Surgery: 4-5 a day, 10+ on the weekends

 

[RxnMan]

on your rotations particularly surgery or IM, how many patients are you guys expected to see in the morning and write notes on... at my school its usually 2 patients

vs. how many patients on your SubsIs

For my inpatient IM experience, I was at a VA where I managed 2-4/day, depending on who was D/C'd. This was at the beginning of my 3rd year.
OB/Gyn: 3-5 (post-partum) + 0-2 (antepartum)/day
Psych: Depending on the day, full interviews on 4, or team meetings where we'd see the whole floor of ~15
FM/Outpatient IM: 8-12/day

 

[Doctor Bagel]

IM -- 2 to 4 but occasionally had 0 to 1. We were supposed to admit 2 patients each call and follow them.
Surgery -- just starting, but the email we got said we should start with 2 the first week and increase to 4 or 5 after that. We'll see.
Ob/gyn -- don't remember. We were generally supposed to see as many postpartums as we could on ob weeks. On gyn, it seemed like 0-4, depending.
Peds -- normally 2 to 3. We were generally supposed to admit 1 patient/day and 2 patients on call nights. Things were starting to slow down when I was there, so that didn't always happen. Also, pts generally left after one night.

 

[45408]

Medicine - usually 2, sometimes 3.
General surgery - whoever you saw in a case, and if they stuck around for a while, could end up being 0 or 5.
Trauma surgery - we pre-rounded as a team (without the attending), so however many you could see before they'd all been seen - usually only 2.

Peds - 2-3, max. I was on a floor with unbelievably sick children, so their plans were incredibly complicated. Things happened overnight on a regular basis, sometimes very significant things. Unlike Doctor Bagel, my peds patients stuck around forever - most of them on the floor at any given time were there for months.

OB/GYN - 4-5, because they're almost all healthy otherwise, so there's not much to say. Plus, you have to see whoever you had delivered, and if you're post-call, there's often a lot of them.

 

[JStub]

on your rotations particularly surgery or IM, how many patients are you guys expected to see in the morning and write notes on... at my school its usually 2 patients

vs. how many patients on your SubsIs

Our school doesn't dictate how many we see and its completely up to the institution that we are rotating at. For IM it was 2 to 3 and surgery zero (just shadowed a resident and scrubbed into cases)

 

[BobBarker]

ICU we covered 4-6 a day usually. General medical floor, there are 3 students and we split the notes up and cover every patient admitted to our service. Usually between 5-8 each. Weekends when there is one less person up to 10. Seems like a lot compared to what you guys are saying. We aren't just note monkeys either...

 

[Law2Doc]

on your rotations particularly surgery or IM, how many patients are you guys expected to see in the morning and write notes on... at my school its usually 2 patients

vs. how many patients on your SubsIs

In my experience, med students up to 3 patients during rotations, up to 6 in sub-Is.

 

[45408]

ICU we covered 4-6 a day usually. General medical floor, there are 3 students and we split the notes up and cover every patient admitted to our service. Usually between 5-8 each. Weekends when there is one less person up to 10. Seems like a lot compared to what you guys are saying. We aren't just note monkeys either...

Depends on how your day is structured. I could easily see many more people on some rotations, but when you have required conferences, grand rounds, lectures, preceptor clinic days, etc., you don't have time.

 

[BobBarker]

We arrive at our leisure before morning report. I usually see my first patient just before 7:00 We generally complete at least 2 notes before MR starts, many times more. We have morning report daily from 7:30-8:30. Then we eat breakfast, then complete our notes. All notes done by 10. Get discharge papers ready, scripts written for your patients that are going home. Start rounding at random time which with lunch break usually lasts all day. Rinse and repeat. No clinic, and no AM required activities except for morning report.

 

[obiwan]

on average how long does it take for you guys to see your patient in the morning and write a note?

 

[BobBarker]

Probably about 10-15 minutes. Sometimes less. Never more. I will physically see 2-4 patients. Then go get their charts and get the computer up and get to writing. Some of my classmates do the opposite. They lab round and make a note skeleton with all objective findings etc on it and then fill in the subjective after talking to the patient.

 

[smq123]

Probably about 10-15 minutes. Sometimes less. Never more. I will physically see 2-4 patients. Then go get their charts and get the computer up and get to writing. Some of my classmates do the opposite. They lab round and make a note skeleton with all objective findings etc on it and then fill in the subjective after talking to the patient.

10-15 minutes for a medicine note?

And if you're getting 5-8 patients each...but you're only physically seeing 2-4 patients?

 

[Droopy Snoopy]

on average how long does it take for you guys to see your patient in the morning and write a note?

Beginning of the year this might be 30 min or longer, by spring it's closer to 10 min depending on the rotation. At my school at least expectations for patient load go up correspondingly. IM in July they started us off with 1 patient mainly because the resident didn't want us taking up 45 min each on rounds every day bumbling through our presentations. You get the hang of doing things so it goes up to being on par with interns by sub-I time. Most I've ever carried was 10 on M4 IM rotation, 8 on M3 surgery on the weekend, but usually it's more like 3-4.

 

[SouthernSurgeon]

on average how long does it take for you guys to see your patient in the morning and write a note?

Pre-preround (i.e. look up all data like labs and I/O in the charts) - 10-15 minutes total

Preround (i.e. physically see and examine the patients) - 5-10 minutes per patient

Note writing - really depends on the service. Surgery - 15ish minutes. Medicine - 30+ minutes. Any service that uses paper notes (we usually use the EMR, but a few rotations you get to write paper notes) - 5-10 minutes.

 

[SouthernSurgeon]

10-15 minutes for a medicine note?

And if you're getting 5-8 patients each...but you're only physically seeing 2-4 patients?

Yeah...I'm confused too.

 

[BobBarker]

Sorry, can see how that was confusing. I will go see 4 of my patients, then write all of their notes. Not see a patient, find the chart, find the computer, write a note. After that bunch is done I'll go see 2 - 4 more patients, then find a computer, grab their charts, and write all of their notes. Hopefully, that was more clear.

 

[45408]

on average how long does it take for you guys to see your patient in the morning and write a note?

Depends what they're in for. Peds = good half hour. I had one patient who had one or more medical problems with every body system she had.

OB/Gyn - I can see 4-5 post-partum patients in an hour and write notes on all of them.

Surgery - 10-15 minutes to see and write a note.

My notes are usually longer than the residents' notes, and I sometimes made notes to myself about things to mention on rounds.

 

[mcrandi]

it actually depends, you cannot fix an amount

 

[Kedan]

It depends on how many students are on and how many patients are around, but the general rule is every patient on the ward must be seen. The max I've done is 10 for senior IM, our equivalent to a sub-I. I was at the county hospital and it was only the 2 senior students, by the time we got to 10 the intern dismissed us. There were another 16 or so patients that neither of us saw.

 

[Law2Doc]

Beginning of the year this might be 30 min or longer, by spring it's closer to 10 min depending on the rotation. ...

Agreed -- prerounding takes forever when you first start. 30+ mins/patient is common, because you don't know what you need and whatever you don't do is what you'll get pimped on. That's why they start you out with so few patients. By the end you will be able to carry more patients than they give you, will be pimped a lot less, and will be doing a better job in a fraction of the time.

 

[Pontifex Maximus]

OB, where I was we never really "carried" anyone except for gyn, of which we maybe had one.
Peds, 1-3.
Neuro, 1.
Medicine, usually around 3. When we were really slow, 1 or 2.
Surgery, on general was about 3. On trauma it has been 2.

 

[Droopy Snoopy]

If you can follow 5 patients and you're peers are following 2 guess what, everyone is going to think you rock.

Maybe, but showing up the fellow M3s on your team by carrying 2-3x their patient load is also a good way to get arsenic slipped into your morning coffee. Save it for your sub-I.

 

[smq123]

Maybe, but showing up the fellow M3s on your team by carrying 2-3x their patient load is also a good way to get arsenic slipped into your morning coffee. Save it for your sub-I.

Agreed.

 

[SouthernSurgeon]

Maybe, but showing up the fellow M3s on your team by carrying 2-3x their patient load is also a good way to get arsenic slipped into your morning coffee. Save it for your sub-I.

Agreed x 2.

Also, as alluded to in Foley's post, I think one of the biggest mistakes third years make is thinking "carrying more patients = makes me look good". They end up overextending themselves, running around like a chicken with its head cut off during prerounds, and not really knowing enough about the patients they are carrying to present well on rounds. That doesn't impress anyone.

 

[Rendar5]

Medicine was ~2-3 avg.

Medicine sub-I was maxed out at 7 patients where I was. Carried an avg of 4-5. Had duties for those patients exactly the same as interns did.

 

[surrender903]

For my sub i, we were capped at 5-6 patients a day. I got there and saw my patients around 545 and would see patients until lecture at 730. Then we would continue seeing patients/round/floor work until 12. Afternoons were floor work till 130 then lecture till 230 then floor work/dissapear into a corridor until 4.

rinse repeat x 4 weeks. call was 4 times in a month with one of those calls being on a weekend.

 

[pangaea99]

On medicine i've been with two different preceptors with very different practices.

Medicine First 6 weeks: 5-6 patients a day except the last week ~3-5 a day. Most days had at least 1 H&P (interview, write short note, dictate), max was 3 on my first day of medicine

Medicine Second 6 weeks (now): 2-4. 1 H&P q1-2 days

Surgery: 1-3 (everyone i scrubbed on) max 4

ObGyn: 1-3 (everyone i scrubbed/attended delivery)

Peds: 1-3 and 1 H&P q2-3 days (no dictating)

Psych: 4-5, 1H&P qweek

Family Med: 4-5, 1H&P q1-2 days