A Day in the Life of an On Call Resident

I first heard of “residency” in college, but it wasn’t until third year of medical school that I had any knowledge about what being a resident actually entailed. Third year of medical school is eye-opening. For the first time, you’re out of the classroom and in the hospital (or clinic) working closely with patients.

If you’re lucky, third and forth years of medical school are exciting and loaded with learning from upbeat residents (I heard they exist…) and staff. If you’re unlikely, those years are essentially a combination of shadowing and scut work (and fear of somehow doing both of those things inadequately and getting a bad evaluation).

I wouldn’t say my clerkship experience was totally awful, but I’d take residency over it any day! I find that I frequently mention residency and “call” on this blog. And since I love reading others’ “day in the life” posts (like Fran’s about being a third year med student on a Family Medicine rotation), I decided to put together my own version. So here it goes.

5:57 – I wake up a few minutes before my 6am alarm with the worry that I forgot to set my alarm and I’m actually late. I pick up my phone and check the time… *phew.* I open my email because it helps me focus and wake up a little more. After a few minutes I actually motivate myself enough to get up.

6:02 – Getting ready is not something I look forward to most days. I brush my teeth and wash my face. I decide its a toner and serum kind of day and layer those on under my foundation and concealer. While my face is drying (or “setting” or something), I put some dry shampoo into my un-brushed hair and scrunch it up a little bit to give it that intentional beach-y look. Then I finish up my makeup with a light dusting of blush, a little lip balm, and a quick crimp of my lashes so I don’t look quite so dead. I put on some over-sized scrubs and compression socks and call it good.

quick and easy work hair and makeup

6:10 – Breakfast. Something I do look forward to. I always have some pre-made quinoa and oats in the fridge so I can grab it, throw in in the microwave and have a quick and healthy breakfast (I eat mine with cinnamon). So while that’s microwaving, I make a k-cup coffee and put it in a travel mug for the road. I’m not running late, so I let the dog out and sit down to enjoy my cereal. Then I put together some “call food” (palak paneer from yesterday and some fruits). After I finish, I slip on my go-to work shoes, let the pup back in and head out the door.

coffee and breakfast

6:35 – Off to work. I speed because I feel compelled to, even though I’m on time.

6:55 – Work. Time to sit down and check the list. I look up (and write down) vitals, labs, notable events and any other relevant info for each of my patients. Nothing too exciting happened and everyone seems to be doing ok. I check the ED list to see if there are any patients that are likely to be admitted right away. Nada. Always a good start to the day.

7:30 – I get the call pager. Then I go see my patients.

8:20 – Done seeing everyone. I decide to go to the cafeteria and grab some oatmeal for my second breakfast since I never know if I’ll actually get to go to lunch or not. Being hungry on call is the worst.

8:35 – I start working on regular everyday stuff. Orders, consults, notes, answering pages, calling family/nursing homes/pharmacies… I have some difficult discharges to work on today, so I’m working closely with our social worker and care coordinator to make sure things go smoothly.

9:00 – Time for rounds with staff. We go from patient room to patient room and confirm the plan for the day for each patient.

10:30 – Rounds finished already! I start working on stuff yet again. And eat my second breakfast, oatmeal and sugar free maple syrup.

second breakfast

10:37 – I get a call from the Nephrology fellow informing me that two patients are going to be admitted soon. I add them to my list and briefly look them up. I figure its probably best to finish with my old patients as much as possible before I get too involved in the (yet-to-be-admitted) new patients. So I continue what I was doing.

11:15 – My first patient hits the floor. I chart check him and head over to his room. Unfortunately, he doesn’t speak English and I have to sit around and wait for an interpreter before I can really proceed with the interview and make a plan for him. Eventually the interpreter comes and I interview and examine the patient. After I’m done I put in a ton of admission orders and get started on my note.

12:45 – Staff swings by to hear about my plan for this patient. He then goes to see the patient by himself and comes back to my work space to discuss. He thinks the plan sounds good (always nice).

1:05 – Lunch time. I go down to the cafeteria to grab some rice for my palak paneer and some veggies for dinner. Then I go back up to my work space to eat and continue working.

2:27 – My next patient hits the floor. I chart check him quickly and go see him. He’s a pretty basic admission so I finish my interview, exam, orders and note quickly.

3:15 – Next coffee. Soooo sleepy.

3:35 – I get another call from the Nephrology fellow telling me about the next two admissions. I start looking them up.

4:15 – Admission #3 hits the floor. See patient. Examine patient. Make a plan. Do orders. Write notes.

5:10 – Admission #4 arrives. Same thing.

5:50 – Staff comes by to chat about the other new patients. We confirm the plans and the staff goes home for the day. I’m left to finish up some work. And eat my veggies.

dinner

7:00 – I finish all of my work and check the ED for any other potential admissions. I see a lady down there that’s “likely to admit,” so I start looking her up and writing her note. I try to see patients as early as I can and not leave work for the oncoming night team, if possible.

7:34 – A “medical emergency team” code is called on the overhead pager system. I stop what I’m doing and run over to the area of the possibly coding patient in the SICU. (All on call medicine teams have to go to codes.)

7:38 – I’m just arriving to the SICU when the overhead pager now announces that the code is cancelled. Ugh. I can’t decide if I’m happy the code was fake or sad I wasted my time running that whole way for nothing.

7: 45 – I get back to my work room. I check to see if my “likely to admit” patient is assigned a bed yet. She’s not. Instead of being an over-achiever and going to the ED to see and admit the patient, I start wrapping up what I’ve already done and write signouts for the night team. It was a fairly easy call, but I still want to leave as soon as I can.

8:00 – My relief arrives. I give the oncoming resident my signouts and tell him what I know about the patient in the ED, just in case she’s admitted (she was). I finish up the rest of my notes probably quicker than I should.

8:45 – Time to go home. I stumble out the door and to my car. It’s still light out!! I love summer.

a day in the life of a resident

9:15 – Home. I relax for a few minutes and check some emails and whatnot before getting ready for bed.

9:45 – Sleep. Post-call days start early.