“So, what exactly do you do on internal medicine?” I’ve gotten this question a fair amount of times. The surgeons do surgery, and the family practitioners see patients in clinic, so what do IM doctors do all day? To clear things up, here’s a typical day on the medicine wards.
7am: Start the day off by pre-rounding on your patients. This means logging on to your patient’s medical record to check on any overnight events, follow up on any new vitals and labs, and start making a checklist for what needs to be done for the coming day.
8am: Time to see your patients in the hospital. You might check up to see how they are doing, perform a pertinent physical exam, as well as give them updates and answer any questions they might have.
9am: Now that your pre-rounding is done, its time for attending rounds. This is the main part of the day – you formally present your patients, and discuss the plan you have formulated for each one of them. How rounds are run can very greatly depending on attending style – for example, you could do walking rounds, going to each patient’s room, or you might do sitting rounds in a workroom. The attending will provide feedback and changes to your plan, as well as offering teaching points to the team.
12pm: Time for noon conference, when faculty or guest lecturers give presentations on different topics in medicine. This is a chance to put work aside for a bit, gain new knowledge, and most importantly, get some lunch.
1pm: The afternoon is the time to get all the work done that was discussed in rounds. You’ll be calling consults for some patients, discharging others home, following up on studies and labs, and updating family members. This is also the time to get all your progress notes done for all of your patients, detailing the updates of the day and changes to the plan. In addition, your team may be “on call” that day – meaning, admitting new patients to your team. In this case, you will periodically get paged down to the ED for any new admissions. You will perform a full history and physical for these patients, formulate a plan, then put in the admission orders for them.
5pm: After your work is done, you sign-out your patients to the night team, which involves explaining the pertinent to-do’s for your patients that night, like following up an x-ray or making sure they take a certain medication. Then you’re ready to go home!
