There you are: it’s your first day of rounds on internal medicine, and the attending turns to you to ask about your patient. You’ve rehearsed what you’re going to say countless times, and yet you’re still diaphoretic, tremulous, and tachycardic. How can you succeed and deliver a cohesive and succinct presentation that will earn you kudos and honors?
When presenting for the first time, it is better to err on the side of being very complete and thorough. One mistake I made early on was to base my presentations off my residents. The problem with that approach is that residents can filter through all the patient data and pull out only the pertinent information to talk about, while we often cannot. Therefore, you should start out by doing a fully detailed patient presentation, then pare it down based what you learn and what your attending expects. You might make a few eyes glaze over initially, but it’s better than forgetting to talk about critical information.
It’s also important to know about the different types of presentations you will be expected to give while on a patient care team. There’s the full standard H&P, for new patients admitted or transferred onto your service. There is also the daily progress presentation, for patients who you have been carrying for more than a day. Here, you’ll only need to talk about overnight events, new history/physical/labs, and updates to your assessment and plan. You’ll also need to be able to give presentations when consulting other services. When calling a consult, it’s best to start out with posing your question first, so your listener knows why you are calling. Then, present a quick “one liner” for your patient – a 30 second summary of the most important parts of his/her past medical history, diagnosis, relevant labs/imaging, treatment plan, and hospital course. This one liner will also be useful when presenting old patients to new attendings, discussing patients with colleagues, among other uses, so know it well!
As you may have figured out by now, presenting is an acquired skill that takes a lot of practice to become comfortable with. In the meantime, the best way to prepare is to learn everything about your patient, figure out what information is important to talk about, and rehearse what you’re going to say beforehand. You can even grab a resident to practice with if he or she is willing. And in no time at all, you’ll be a star on rounds.