09 November 2015

Residency Update: Intern Year Rotations

Scott has a new rotation scheduled every month of his intern year. So far he has done internal medicine, Ob/gyn, and community medicine. This month he will be in surgery. Each new rotation comes with a different type of schedule and new attending physicians.

Internal medicine, working in the hospital to admit patients primarily from the emergency room to stay in the hospital for monitoring, meant shift work for Scott. He worked three or four 10-12 hour day shifts in a row, then three or four 10-12 hour nights. When Scott worked night shifts he would come home between 9:00-11:00 am and sleep until 5:00 pm when he would need to get up for his next shift. Not many sleeping hours! Then he would get a day off in between night shifts and day shifts to adjust. He didn't seem to mind doing this for his first rotation, though he felt like he needed caffeine to stay up during the night. 

In internal medicine, interns are given the task of admitting most of the patients, which takes a bit of time to document symptoms, discuss the patient's medical history, create a treatment plan, and begin administering medications. The hospital here is LARGE, so Scott was admitting 4-5 patients a night, which meant there was no down time to sleep. It was pretty much go-go-go until his shift was over, but then he would need to sit down and write in all the patient charts and give his morning report to the day team before coming home. One day a week, Scott would work in the family medicine clinic too. It was a busy month where I rarely saw him awake. Like I said, though, he didn't mind this as a first rotation. His only complaint was that he rarely attended church over these first two rotations.

His next rotation had him delivering babies. Shift work again, but this time it really did him in. I've never seen him so tired. It was a similar schedule of hours, days, nights, day off, clinic. I'm not sure what made this second rotation so much worse, whether it was the back-to-back months, fewer days off to prepare for family coming in town, or maybe it was labor and delivery. In any case, by the end of the month when family came to visit, he looked pretty haggard. To graduate from this family medicine residency, Scott needs to have delivered 30 babies. He delivered 15 in his first rotation.

Last month was a month where Scott was not on-call, so he could take vacation days. This could not have come at a better time! The schedule for community medicine was 9:00 am to 5:00 pm, or sometimes just a few hours in the morning. He was working in free clinics around town, following physicians to home visits, and completing residency projects. For vacation time, Scott had scheduled to take long weekends all month long, which may have been more restful for him than taking a full week off. He was back to normal again after his first long weekend, which was a relief to me. He also had time to do sports medicine coverage at night for local games.

Last month was a bit more like we would expect his future career would be like - clinic hours, some weekend night game coverage. I could definitely get comfortable with that!