A Day in the Life of an R1 on the Inpatient Medical Service
7-8 a.m. - Team sign-out
The day team consists of two interns and one senior resident in addition to medical students. Every morning, they meet together to get sign-out from the overnight team of one senior resident and one intern. Throughout the inpatient month, the intern builds sign-out skills, ultimately taking the lead during this time.
8-8:30 a.m. and 9-9:30 a.m. - Pre-rounding
Each day, R1s will follow an average of five to eight patients. They use pre-rounding time to discuss events with the nurses, review flow sheets, examine their patients, and talk to families.
8:30-9 a.m. - Morning report
At morning report, the chief residents lead residents and attendings in review and discussion of an interesting case from the wards. On Friday morning, the night team presents a patient they admitted that week.
9:30-10:15 a.m. - Intern/senior planning time
After completing prerounding, interns review new findings and refine their assessment and plan with their senior resident. The numerous accessible computer work stations allow for easy review of laboratory data in the electronic medical record and radiology on the PACS system.
10:15 a.m.-12:15 p.m. - Family-Centered Rounds
Each team rounds with general pediatric and subspecialty attendings. Patients and their families, nurses and social workers join the medical team to plan care for the patient. Teaching by the senior resident and the attending is an important part of rounds. The team coordinator facilitates rounds and performs administrative duties for the team throughout the morning.
12:30-1:15 p.m. - Noon Conference (Monday, Tuesday, Wednesday, Friday)
Faculty members from various disciplines present topics in a variety of formats. Lunch is provided. Evaluations are collected in order to improve the following year's curriculum.
12:15-1 p.m. - Intern Support Group (Thursday)
Once weekly, senior residents take their interns' pagers so that the R1s can participate in this session. The group is facilitated by a social worker, and the time is an opportunity for interns to confidentially share their experiences and partake in delicious snacks!
1:15-6:30 p.m. - Patient care
R1s follow up on issues or tests ordered on their patients. They meet and admit new patients with supervision by the senior resident.
2:30-3 p.m. - Bedside teaching
In addition to bedside teaching on rounds, there is dedicated time in the afternoon for team attendings to teach on topics relevant to the team's current patients.
4:30-5:30 p.m. - Check-in Rounds
Interns check in with all the nurses they have been partnering with throughout the day to make sure the day's goals for the patient are being met and assure there are no outstanding issues prior to evening sign out. One of the team's interns will leave for the day after check-in.
6:30-7 p.m. - Team sign-out
Care is transitioned back to the night team.