Have you ever wondered exactly what it means when a medical student is "on rotations"? We always claim that we're busy, but just what is it that we do all day? To answer these questions, here's a recap of one day from my inpatient pediatrics rotation.
5:27 AM: I pull out of the parking lot and start the now-familiar early morning commute down I-280 to San Jose. The good thing about the early start is that I have little traffic to compete with!
6:00 AM: The workday begins on the pediatrics unit at Santa Clara Valley. After taking a report from the night team about our patients, I spend some time browsing through the electronic charts of my four patients, writing down numbers such as vital signs and new lab results.
6:50 AM: At this point, I'm ready to "pre-round" on my list of patients, which means that I go see each of them and hear from the family how things are going. I try not to wake up the little ones who are asleep. Even so, one of them seems to have a sixth sense and starts crying as soon as I step in the room (I've learned not to take it personally!).
8:00 AM: Our senior resident comes by and gathers us in the conference room - it's time for our morning teaching session, led by one of the residents. Today, we're talking about pneumonia and the different bacteria and viruses that cause it in each age group.
8:35 AM: It's time for rounds to begin - the main event of the morning, where the entire team talks about each patient and the plan for the day at the bedside. Our team is large: three med students, three interns, two residents, one pharmacist, the charge nurse, and one supervising physician. As a med student, my job is to update the team on overnight events, vital signs, labs, and the plan for the day to the rest of the team. I do my best to cover everything, but I'm still interrupted a few times by the residents or the attending physician to clarify some points.
11:40 AM: Twenty patients later, we're just finishing up with our team rounds. It feels great to sit down for a few minutes. We quickly huddle and briefly review each patient to make sure that we agree on our "to-do" list for each one.
12:15 PM: We hustle down to the conference room; noon conference is starting, and I'm on the schedule to present with one of my med student colleagues. We're sharing the case of a newborn baby we took care of last week who was having episodes of difficulty breathing. We share the story and invite the residents and other students who are there to come up with their diagnosis - our very own "medical mystery!"
12:56 PM: After lunch, there's finally some self-scheduled time. I find a computer and work on my progress notes for the day before going around and seeing my patients again to make sure they are doing okay.
5:03 PM: The night cover team is here to take over, and we go through our list of patients and tell them what they need to know to take care of them overnight. Although most of the day team is done for today, today is my assigned call day, which means that I'll be staying with the night team for a few hours and helping them with any new patients who are admitted.
6:25 PM: The night team has split up to see some of the new patients, but the charge nurse is on the phone. Child Protective Services is here to get some information from us about one of our patients, who unfortunately has some unusual skin markings that have made us concerned for child neglect. One of the night residents and I go over the child's medical illness as well as the findings that made us worried.
7:24 PM We're called and informed that there's a new admission coming up to the floor: a 1-year-old girl who has been having events that are concerning for seizures. The night resident and I go to meet the girl and her family. I gather some information from the family and do my best to examine the little girl, who is clearly tired and quickly becoming grumpy. She looks very healthy, but we'll need to keep her overnight and start her on an anti-seizure medication.
9:05 PM: After discussing the new patient with the covering night physician and agreeing on the plan for the night, it's finally time to go home! It'll be a quick turnaround tonight. My alarm is already set for 5:00 AM tomorrow, and it's sure to be another eventful day.
Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category.
Nathaniel Fleming is a third-year medical student and a native Oregonian. His interests include health policy and clinical research.
Photo by StanfordMedicineStaff