0600 h: I leave for the hospital.
0620 h: I arrive on the ward, print a list of the patients, and copy down any new results (bloodwork, imaging, etc.) onto the list.
|one benefit of starting early: watching the sun rise as I wander from ward to ward|
0730 - 0830 h: I join the other residents in the conference room for a teaching session by the senior resident.
|senior resident teaching|
|getting through paperwork...and getting better at remembering to drink water!|
Most days our team discharges four or five patients home. This requires writing discharge prescriptions and a discharge summary, which must be dictated over the phone for transcription onto the electronic chart. Most patients will follow up with their family doctor after leaving the hospital, so I make sure I give the family doctor a phone call and fax over any pertinent information. Many patients are on warfarin, a blood thinner that requires a lab test to guide its dosing, so it's important that I clarify who will follow the patient's bloodwork and adjust their warfarin dose once they leave the hospital. Down to the little things like how the patient will physically get home, there is lots to be considered when discharging a patient. Fortunately we have wonderful unit staff to help sort everything out!
In general internal medicine there is a lot to be learned and seeing something first hand in a patient is probably the best way to remember it -- and we have plenty of patients, so lots of good learning! The days are pretty packed, but time passes quickly, and eventually I get everything crossed off on my patient list (it's a mess of scribbles by the end of the day!). The nice thing about working on a team is that with several minds put together it's harder for things to slip through the cracks. I have two other junior residents on my team, which is really great; we cover each others' patients when someone is post-call or at an academic session (and after my past two more isolated rotations, it's fun to have some company!).
Here are the learning/reference resources I use everyday in general internal medicine (nothing too exciting here...just the standard ones we all carry around).
Pocket Books (also available as ebooks):
- Approach to Internal Medicine by David Hui
- Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine by Marc Sabatine
- UpToDate -- A huge evidence-based database, well-organized for quick information finding. I'm lucky that my program pays for residents' subscriptions.
|...and of course good old Google to find gems like this|