Expectations

[MDsuperstar]

What are reasonable expectations for starting an internship tomorrow, as far as number of patients to carry, start with, responsibility? I'm being told that I will be starting with over 9 patients tomorrow! Seems excessive and wacky to me.

What are typical hours for a medicine month in a prelim/transitional year? I assume 7ish am or so, but being told otherwise. Trying to get an idea of what other people's experience is?

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[drcrispmd]

The only ones who can answer this are the upper levels in your residency. This is different for every residency. Where I did residency, when you were on inpatient IM you showed up whatever time you needed to so you could have all your patients seen and notes written and on the chart by 9am. Did your residency not have an orientation? did they not tell you what time to show up in the morning. 9 patients is a bit much for your 1st day of residency, but in a week that should not be a problem.

 

[rokshana]

no….10 is your limit so yes you are a bit on the high side there, but an intern can have 10 on their service and when you are on call you can admit up to 5 new patients…though of course you can have only a max of 10….so if you are on call tomorrow, then most you can admit is 1.

what time you need to be in is going to be program dependent, but you will need to be able to see all your patients before rounds…on you 1st day? you wanna be in WAAAAYYYYY earlier than 7ish (7 ish is for residents…).

you may have less months on service, but you won't be treated any differently when it comes to being a categorical intern….

in the ICU? you will probable need to be in even earlier (labs are usually available earlier in the ICU) and patients are more complicated.

did you not get sign out from the outgoing intern?

 

[gutonc]

What are reasonable expectations for starting an internship tomorrow, as far as number of patients to carry, start with, responsibility? I'm being told that I will be starting with over 9 patients tomorrow! Seems excessive and wacky to me.

What are typical hours for a medicine month in a prelim/transitional year? I assume 7ish am or so, but being told otherwise. Trying to get an idea of what other people's experience is?

The typical hours and expectations are what your senior/attending/chiefs says they are. The end.

If you're picking up a post-call or mid-cycle team, 9 isn't unheard of and will likely get better. Yes, it's going to suck. Yes, you're going to probably be there from 5 or 6a --> 9 or 10p tomorrow. Welcome to residency.

 

[MDsuperstar]

The typical hours and expectations are what your senior/attending/chiefs says they are. The end.

If you're picking up a post-call or mid-cycle team, 9 isn't unheard of and will likely get better. Yes, it's going to suck. Yes, you're going to probably be there from 5 or 6a --> 9 or 10p tomorrow. Welcome to residency.

I'm talking about normal. I don't go by this whole thing about "what so and so says" - especially when the resident and chief say something different, and I'm just a rotating resident, not a resident in that specialty. I have done residency before, just switching and I find it absurd that they would expect anyone, especially for those people who are new, to carry over 9 patients. It's bad for the intern and bad for the patients.

I'm trying to give this program a try, but I'm finding it frustrating already. *Deep breath* The residents seem overall happy and have good spirits, and a lot of them stay on as faculty, so I'm assuming it can't be that bad. But it's starting off frustrating. I also find it kind of annoying that they would think someone would have to be there at a specific time. Some people are faster/better than others, while some people are slower. When I did residency before, I would go in at 7-8am, and would be done by 1pm or earlier. What's the point of going in super early if you are efficient and fast?

 

[drcrispmd]

It does not matter what you did at your other residency.
They may round earlier. Their rounds may take forever.
Like I said, on our IM rotation in residency, the intern at to have all the patients on their column seen, notes written, orders in, and discharge started before rounds at 9am (and the intern on call was responsible for getting breakfast for everyone; we did table rounds).

Best bet is to go by what your senior resident is telling you. The resident who is directly above you. I agree, 9 is way too many on the first day for new interns. You should be able to handle it. Good Luck.

 

[MDsuperstar]

no….10 is your limit so yes you are a bit on the high side there, but an intern can have 10 on their service and when you are on call you can admit up to 5 new patients…though of course you can have only a max of 10….so if you are on call tomorrow, then most you can admit is 1.

what time you need to be in is going to be program dependent, but you will need to be able to see all your patients before rounds…on you 1st day? you wanna be in WAAAAYYYYY earlier than 7ish (7 ish is for residents…).

you may have less months on service, but you won't be treated any differently when it comes to being a categorical intern….

in the ICU? you will probable need to be in even earlier (labs are usually available earlier in the ICU) and patients are more complicated.

did you not get sign out from the outgoing intern?

Residency doesn't start until July 1, so of course i did not *get sign out from the outgoing intern." I will be doing 0 work until July 1 in the morning. Why on earth would anyone think that any normal resident do any work before then?

And I said over 9 patients, so I am being given more than 9 patients apparently, which I think is crazy. And yes as you mention, the cap is 10 so I can't admit anyone. So seeing a mininum of 3 patients an hour, in less than 4 hours I'll be done. What the heck am I going to do the rest of the day? I'm very fast and efficient. I think I'm going to propose if we can come in at whatever time we need to finish our notes by rounding time.

 

[MDsuperstar]

It does not matter what you did at your other residency.
They may round earlier. Their rounds may take forever.
Like I said, on our IM rotation in residency, the intern at to have all the patients on their column seen, notes written, orders in, and discharge started before rounds at 9am (and the intern on call was responsible for getting breakfast for everyone; we did table rounds).

Best bet is to go by what your senior resident is telling you. The resident who is directly above you. I agree, 9 is way too many on the first day for new interns. You should be able to handle it. Good Luck.

It's actually MORE than 9 and I agree with you. It's not reasonable, and it provides 0 learning objectives and as my chief says, the goal here is to be educated, not just be a work horse. I think I may bring it up.

 

[colbgw02]

It's actually MORE than 9 and I agree with you. It's not reasonable, and it provides 0 learning objectives and as my chief says, the goal here is to be educated, not just be a work horse. I think I may bring it up.

That should work out.

 

[gutonc]

It's actually MORE than 9 and I agree with you. It's not reasonable, and it provides 0 learning objectives and as my chief says, the goal here is to be educated, not just be a work horse. I think I may bring it up.

Be sure to let us know how that works out for you.

If you're just an off-service intern, they'll write you crappy evals that will probably not matter. Be a douche. Whatever.

If you're a prelim looking to proceed into an advanced specialty and you behave this way throughout the year, expect to either be fired or not given your internship certificate, nuking your advanced spot.

I realize you're a "superstar" but even Yeezus gets bitch-slapped on occasion.

 

[MDsuperstar]

That should work out.

Why not? Why shouldn't I bring up things to my chief? I will in no way violate anything. If I'm capped already tomorrow, and I'm on call in a couple of days, then I will be totally violating caps within the first week. If I have more than 9 patients, I cannot admit anyone else per cap rules. Why on earth would I violate anything?

 

[MDsuperstar]

Be sure to let us know how that works out for you.

If you're just an off-service intern, they'll write you crappy evals that will probably not matter. Be a douche. Whatever.

If you're a prelim looking to proceed into an advanced specialty and you behave this way throughout the year, expect to either be fired or not given your internship certificate, nuking your advanced spot.

I realize you're a "superstar" but even Yeezus gets bitch-slapped on occasion.

I have my advanced spot, I'm not concerned about that. I feel sad you are suggesting I should start off by violating rules. Don't you think that's douchy of the resident to expect interns on their first day to carry more than 9 patients? She should be picking up the slack initially.

 

[rokshana]

Residency doesn't start until July 1, so of course i did not *get sign out from the outgoing intern." I will be doing 0 work until July 1 in the morning. Why on earth would anyone think that any normal resident do any work before then?

And I said over 9 patients, so I am being given more than 9 patients apparently, which I think is crazy. And yes as you mention, the cap is 10 so I can't admit anyone. So seeing a mininum of 3 patients an hour, in less than 4 hours I'll be done. What the heck am I going to do the rest of the day? I'm very fast and efficient. I think I'm going to propose if we can come in at whatever time we need to finish our notes by rounding time.

sorry…mylast day of orientation was getting sign out (and your pager) front the out going intern…certainly would not want to come in on the 1st day of intern year and not know which are my patients, how many are my patients and what the heck is going on with my patients…(and the resident might not start doing anything til July 1st…but you're the intern…..

and if you have been a residency before, then 9 patients shouldn't be a big deal…a fresh out of 4th year who has managed at most 5 pts, but for someone who has even done now month of internship should be able to handle 9 patients….

and, lol, you apparently haven't done an IM service? you will have plenty to do….1st you have to see everyone BEFORE rounds…and rounds are usually at 9 am at most places (after the 8a morning report where you are NOT seeing patients) and last til 12 noon…just in time for noon conference…but you need to be able to have all the discharge paperwork for those pts going home, because the aim is to have them out by 12 noon…

good luck…gotta feeling you are in for a bit of a rude awakening tomorrow….

 

[rokshana]

Why not? Why shouldn't I bring up things to my chief? I will in no way violate anything. If I'm capped already tomorrow, and I'm on call in a couple of days, then I will be totally violating caps within the first week. If I have more than 9 patients, I cannot admit anyone else per cap rules. Why on earth would I violate anything?

caps are not weekly….they are daily…if you aren't on call for a couple of days….sheesh! you should have most of your original patients gone i n 2-3 days!

the adage of the squeaky wheel…not a good one in residency…but go ahead and as gutonc said…let us know how that goes...

 

[rokshana]

I have my advanced spot, I'm not concerned about that. I feel sad you are suggesting I should start off by violating rules. Don't you think that's douchy of the resident to expect interns on their first day to carry more than 9 patients? She should be picking up the slack initially.

ummm….9 pts….doesn't violate squat!
and your resident (who today is still an intern) has ALL the patients on the service…to max of 20… her job tomorrow is to make sure you don't kill anyone.

 

[MDsuperstar]

sorry…the last day of orientation was getting sign out (and your pager) front he out going intern…certainly would not want to come in on the 1st day of intern year and not know which are my patients, how many are my patients and what the heck is going on with my patients…(and the resident might not start doing anything til July 1st…but you're the intern…..

and if you have been a residency before, then 9 patients shouldn't be a big deal…a fresh out of 4th year who has managed at most 5 pts, but for someone who has even done now month of internship should be able to handle 9 patients….

and, lol, you apparently haven't done an IM service? you will have plenty to do….1st you have to see everyone BEFORE rounds…and rounds are usually at 9 am at most places (after the 8a morning report where you are NOT seeing patients) and last til 12 noon…just in time for noon conference…but you need to be able to have all the discharge paperwork for those pts going home, because the aim is to have them out by 12 noon…

good luck…gotta feeling you are in for a bit of a rude awakening tomorrow….

Of course I have done IM service. I don't know where you did your medicine months, but it certainly did not work like that where I did. Like someone else said, where I did medicine you could come in at whatever time was needed to round with attendings, which varied from attending to attending. I have NEVER come in earlier than 7am, and don't think my census ever dropped from 8 or so. And no, we certainly did not need to have notes ready by rounding (why would we?) or discharge papers out by noon (again why would we?). Again I'm not a categorical intern, thanks goodness, so we are not required to attending morning report or noon conference.

What the heck would you be doing from noon to end of day at 4 or 5pm if that was the case? Both in my previous and current program only admit during call days, so what the heck would you be doing all day if everything was done by noon? I was so efficient that I would have hours available during the day with nothing to do.

 

[MDsuperstar]

ummm….9 pts….doesn't violate squat!
and your resident (who today is still an intern) has ALL the patients on the service…to max of 20… her job tomorrow is to make sure you don't kill anyone.

Read my post - I said numerous times (more than 9), and I am on call in a couple of days. Not sure how to make that any more clear. As we both know, 2nd year for categorical medicine peeps is super cush when it comes to wards, as they don't do squat but "look over" intern notes. I have yet to kill anyone, so your condescending attitude is unnecessary. Clearly I have been through this rodeo before.

 

[AMEHigh]

This post is weird.

Have you never rotated on a medicine service before? Why aren't you going by what the other residents and/or interns in this program are telling you?

In my experience 7am is way too late to see 9 patients before morning report or sign out unless your program does things later than most other hospitals. In all of the hospitals I've been through morning report has been somewhere between 7-8, so residents generally need to have seen all of their patients by then with notes written or nearly close to complete before that time. Hence, get in at whatever time before then that it takes you to get everything done.

Good luck with showing up at 7.

 

[MDsuperstar]

This post is weird.

Have you never rotated on a medicine service before? Why aren't you going by what the other residents and/or interns in this program are telling you?

In my experience 7am is way too late to see 9 patients before morning report or sign out unless your program does things later than most other hospitals. In all of the hospitals I've been through morning report has been somewhere between 7-8, so residents generally need to have seen all of their patients by then with notes written or nearly close to complete before that time. Hence, get in at whatever time before then that it takes you to get everything done.

Good luck with showing up at 7.

Tell me - what would you do for the rest of the day then if you have everything done by rounding? Never have I been in before 7am, and rounding has never been an issue. I don't see what the heck you'd do all day if you were done. You are clearly not admitting daily, and even if you were, you would have nothing to do most of the day if you are done by 9am with everything.

 

[AMEHigh]

Of course I have done IM service. I don't know where you did your medicine months, but it certainly did not work like that where I did. Like someone else said, where I did medicine you could come in at whatever time was needed to round with attendings, which varied from attending to attending. I have NEVER come in earlier than 7am, and don't think my census ever dropped from 8 or so. And no, we certainly did not need to have notes ready by rounding (why would we?) or discharge papers out by noon (again why would we?). Again I'm not a categorical intern, thanks goodness, so we are not required to attending morning report or noon conference.

What the heck would you be doing from noon to end of day at 4 or 5pm if that was the case? Both in my previous and current program only admit during call days, so what the heck would you be doing all day if everything was done by noon? I was so efficient that I would have hours available during the day with nothing to do.

Everywhere I've been the afternoon is a time to do all the follow ups and then there are often admits.

Often have to wait for specialties to see patients, collaborate with them, order more tests, wait for blood work, work on discharge papers, make phone calls, etc. Especially with ICU patients it seems that there is always something to do throughout the afternoon.

I find it really odd that you were completely done with your patients all the time by 12 with nothing else to do. Is this real life?

 

[SouthernSurgeon]

I'm talking about normal. I don't go by this whole thing about "what so and so says" - especially when the resident and chief say something different, and I'm just a rotating resident, not a resident in that specialty.

Red flag #1

I have done residency before

Red flag #2

I'm trying to give this program a try, but I'm finding it frustrating already.

Red flag #3

I also find it kind of annoying that they would think someone would have to be there at a specific time.

Red flag #4

I will be doing 0 work until July 1 in the morning. Why on earth would anyone think that any normal resident do any work before then?

Red flag #5

And yes as you mention, the cap is 10 so I can't admit anyone. So seeing a mininum of 3 patients an hour, in less than 4 hours I'll be done. What the heck am I going to do the rest of the day? I'm very fast and efficient.

3 patients an hour? Your definition of fast and efficient is different than mine.

Red flag #6

I think I'm going to propose if we can come in at whatever time we need to finish our notes by rounding time.

Red flag #7

Why not? Why shouldn't I bring up things to my chief? I will in no way violate anything. If I'm capped already tomorrow, and I'm on call in a couple of days, then I will be totally violating caps within the first week. If I have more than 9 patients, I cannot admit anyone else per cap rules. Why on earth would I violate anything?

Red flag #8

I have NEVER come in earlier than 7am

Red flag #9

And no, we certainly did not need to have notes ready by rounding (why would we?) or discharge papers out by noon (again why would we?).

Red flag #10


...

I'm sure there are several others that I missed.

 

[MDsuperstar]

Everywhere I've been the afternoon is a time to do all the follow ups and then there are often admits.

Often have to wait for specialties to see patients, collaborate with them, order more tests, wait for blood work, work on discharge papers, make phone calls, etc. Especially with ICU patients it seems that there is always something to do throughout the afternoon.

I find it really odd that you were completely done with your patients all the time by 12 with nothing else to do. Is this real life?

Not talking about ICU. Medicine and ICU are 2 different things. And yes to your question - everyone in my program worked like that, and there were other even cushier transitional/prelim programs.

 

[HooliganSnail]

Residency doesn't start until July 1, so of course i did not *get sign out from the outgoing intern." I will be doing 0 work until July 1 in the morning. Why on earth would anyone think that any normal resident do any work before then?

And I said over 9 patients, so I am being given more than 9 patients apparently, which I think is crazy. And yes as you mention, the cap is 10 so I can't admit anyone. So seeing a mininum of 3 patients an hour, in less than 4 hours I'll be done. What the heck am I going to do the rest of the day? I'm very fast and efficient. I think I'm going to propose if we can come in at whatever time we need to finish our notes by rounding time.

What is this cap of 10 for interns stuff????

 

[Top Gun]

I'm a bit confused as to what your complaint is, to be honest. First, you say that 9 patients is excessive, but then you go on to say that you are fast and efficient, and will be done in a short time? If you're so fast and efficient, then why do you think 9 patients is excessive? Oh, and first rule of intern year: never complain.

 

[MDsuperstar]

That's offensive. Sorr

Red flag #1



Red flag #2



Red flag #3



Red flag #4



Red flag #5




3 patients an hour? Your definition of fast and efficient is different than mine.

Red flag #6



Red flag #7



Red flag #8



Red flag #9



Red flag #10


...

I'm sure there are several others that I missed.

That's offensive. Sorry I was at a cush, private hospital with a system that was effective and did not waste time.

 

[SouthernSurgeon]

That's offensive. Sorr


That's offensive. Sorry I was at a cush, private hospital with a system that was effective and did not waste time.

How is it offensive?

You have warped expectations and an attitude of entitlement. You need to shut up and get to work.

 

[MDsuperstar]

I'm a bit confused as to what your complaint is, to be honest. First, you say that 9 patients is excessive, but then you go on to say that you are fast and efficient, and will be done in a short time? If you're so fast and efficient, then why do you think 9 patients is excessive? Oh, and first rule of intern year: never complain.

It is for first year interns for one. Do you disagree? My main problem is that we are being asked to be there excessively early, vs. at a time where we can finish things based on our efficiency.

 

[MDsuperstar]

What is this cap of 10 for interns stuff????

team cap is 20 patients, with each intern is no more than 10.

Are you unaware of rules? Interns can no longer do 24 hr call and can only do a max of 16 hrs, with at least 10 hrs in between shifts.

 

[AMEHigh]

Not talking about ICU. Medicine and ICU are 2 different things. And yes to your question - everyone in my program worked like that, and there were other even cushier transitional/prelim programs.

Ok forget I said that part. Everything still applies. Regular floor patients still have specialists that usually come a little later in the morning that you have to follow up with or collaborate with, phone calls to make, discharge paperwork to work on, labs to follow, orders to put in, etc. Patients and their needs are regularly changing, so I'm really confused as to how you could have all your work done so early. Even if you're super effective that doesn't change the fact that your patient might get hypertensive and you have to do something about it.

Nurses never page you? You never had to put in any new orders? You never had to wait for blood work or tests to make a decision?
Do patients at super cushy private hospitals not change throughout the day?

But anyway, go ahead and show up at 7 even though people in your program told you differently and see how that goes for you.

 

[MDsuperstar]

How is it offensive?

You have warped expectations and an attitude of entitlement. You need to shut up and get to work.

I don't see how - this is how it worked for me in the past, and I did very well and was very well regarded. Not sure why you would think that overworking your residents is a good thing.

 

[colbgw02]

OP, when did you do your first internship?

 

[MDsuperstar]

Ok forget I said that part. Everything still applies. Regular floor patients still have specialists that usually come a little later in the morning that you have to follow up with or collaborate with, phone calls to make, discharge paperwork to work on, labs to follow, orders to put in, etc. Patients and their needs are regularly changing, so I'm really confused as to how you could have all your work done so early. Even if you're super effective that doesn't change the fact that your patient might get hypertensive and you have to do something about it.

Nurses never page you? You never had to put in any new orders? You never had to wait for blood work or tests to make a decision?
Do patients at super cushy private hospitals not change throughout the day?

But anyway, go ahead and show up at 7 even though people in your program told you differently and see how that goes for you.

You are a med student, so you should not offer any words as you have no clue.

Clearly I have been through this before and showing up at 7 am or 8am worked just fine for me and my colleagues.

 

[SouthernSurgeon]

I don't see how - this is how it worked for me in the past, and I did very well and was very well regarded. Not sure why you would think that overworking your residents is a good thing.

Asking someone to show up at work at a designated time is not overworking them. It's actually a very basic requirement of many jobs.

There are a number of reasons why they might need you to show up then. The most obvious is that someone else has to cover those patients until you show up, so every minute you are late is a minute that extends their shift beyond the designated time.

Your attitude is horrible, and will likely cause you issues on the wards.

 

[Top Gun]

It is for first year interns for one. Do you disagree? My main problem is that we are being asked to be there excessively early, vs. at a time where we can finish things based on our efficiency.

You're perfectly welcome to show up at whatever time you like. In my internship, there certainly was no set time to arrive. But I'm still puzzled as to why you think its douchey for your resident to assign you more than 9 patients , and, in the same breath, complain that you're being asked to come in excessively early when you can finish all your work within 4 hours.

 

[MDsuperstar]

Asking someone to show up at work at a designated time is not overworking them. It's actually a very basic requirement of many jobs.

There are a number of reasons why they might need you to show up then. The most obvious is that someone else has to cover those patients until you show up, so every minute you are late is a minute that extends their shift beyond the designated time.

Your attitude is horrible, and will likely cause you issues on the wards.

The person on call is responsible for patients until the day team comes. When I have been on call, I was responsible for patients until the team came on at 7am. why should the on call person be lazy? Surprising coming from you.

 

[AMEHigh]

You are a med student, so you should not offer any words as you have no clue.

Clearly I have been through this before and showing up at 7 am or 8am worked just fine for me and my colleagues.

I will say that I'm thankful that I've never had to work with a resident with an attitude like yours. I've seen residents take advice/suggestions from medical students on a regular basis, especially if the resident is new to the service and the medical student has been on the service for a week or 2. Therefore the student might understand how the service runs a little better even if they are just a lowly little medical student.

Good luck to you.

 

[MDsuperstar]

You're perfectly welcome to show up at whatever time you like. In my internship, there certainly was no set time to arrive. But I'm still puzzled as to why you think its douchey for your resident to assign you more than 9 patients , and, in the same breath, complain that you're being asked to come in excessively early when you can finish all your work within 4 hours.

My resident has no clue that I'm not a typical intern so she is assuming that this is my first day of clinical work as a doctor. Do you think that a first year intern has any clinical skills to carry MORE THAN 9 patients on their first day? Certainly not. In time, sure, but not on their first day.

And I would have less of a problem if they said hey come in at whatever time you come, just like in your residency. But we are being required to come in really early which I'm not very ok with. You clearly think it's perfectly ok for your residency program for residents to come in whenever. Why is it not ok for me to think the same?

 

[MDsuperstar]

I will say that I'm thankful that I've never had to work with a resident with an attitude like yours. I've seen residents take advice/suggestions from medical students on a regular basis, especially if the resident is new to the service and the medical student has been on the service for a week or 2. Therefore the student might understand how the service runs a little better even if they are just a lowly little medical student.

Good luck to you.

Like I said, you are a medical student, and if you think your residents care what you think or actually take your advice, no offense but you are clearly mistaken and misinformed.

 

[KnuxNole]

What are reasonable expectations for starting an internship tomorrow, as far as number of patients to carry, start with, responsibility? I'm being told that I will be starting with over 9 patients tomorrow! Seems excessive and wacky to me.

What are typical hours for a medicine month in a prelim/transitional year? I assume 7ish am or so, but being told otherwise. Trying to get an idea of what other people's experience is?

That sounds ridiculous. 9 patients on your first day as a PGY-1? I guess if it's a direct handoff, it can happen....a sure fire way to hit the ground running!

Definitely ask your upper level. On a ward month, your senior will be the go to person and life saver. Usually, you start off small and build your way up.

7am seems reasonable for a start time for an inpatient ward month. Usually, I show up an hour before, just because there are so many patients to see before rounds and I like the cushion. Definitely try to show up a few minutes earlier, and usually on the first day the senior will go over expectations, the run down, etc. If you know the name/contact info for your senior, I would contact them now.

 

[rokshana]

Read my post - I said numerous times (more than 9), and I am on call in a couple of days. Not sure how to make that any more clear. As we both know, 2nd year for categorical medicine peeps is super cush when it comes to wards, as they don't do squat but "look over" intern notes. I have yet to kill anyone, so your condescending attitude is unnecessary. Clearly I have been through this rodeo before.

then lord knows why you would voluntarily leave such a slack ass, cush IM residency program…mine certainly wasn't a malignant program and overall was the same experience that most of my friends in other IM programs had…

and more than 9 can only mean 10 for an intern…not a big difference, especially if you are doing the intern thing again…

and as a person who actually did a 2nd year in IM, its not as "cush" as you may think…esp the 1st day of being one.

some attendings want the notes done, so they can cosign them as they go through rounds…

 

[Smurfette]

team cap is 20 patients, with each intern is no more than 10.

Are you unaware of rules? Interns can no longer do 24 hr call and can only do a max of 16 hrs, with at least 10 hrs in between shifts.

Caps do not apply to all fields; it does apply to IM. I've been on services with only 2 interns and over 40 patients.

I know I'm jaded, but...ahem...you guys have really taken the bait hard from someone who just registered today

 

[MDsuperstar]

That sounds ridiculous. 9 patients on your first day as a PGY-1? I guess if it's a direct handoff, it can happen....a sure fire way to hit the ground running!

Definitely ask your upper level. On a ward month, your senior will be the go to person and life saver. Usually, you start off small and build your way up.

7am seems reasonable for a start time for an inpatient ward month. Usually, I show up an hour before, just because there are so many patients to see before rounds and I like the cushion. Definitely try to show up a few minutes earlier, and usually on the first day the senior will go over expectations, the run down, etc. If you know the name/contact info for your senior, I would contact them now.

Exactly. Finally a voice of reason. And like I said, it's over 9-it's actually 11 patients.

 

[rokshana]

You are a med student, so you should not offer any words as you have no clue.

Clearly I have been through this before and showing up at 7 am or 8am worked just fine for me and my colleagues.

sounds like the med student has a more realistic idea of a IM service than you do….and as for coming at 8 as an intern????!!!!

i know interns that have been fired for that...

 

[MDsuperstar]

Caps do not apply to all fields; it does apply to IM. I've been on services with only 2 interns and over 40 patients.

I know I'm jaded, but...ahem...you guys have really taken the bait hard from someone who just registered today

Thank you for actually having knowledge and realizing that IM has caps. Another voice of reason.

 

[MDsuperstar]

sounds like the med student has a more realistic idea of a IM service than you do….and as for coming at 8 as an intern????!!!!

i know interns that have been fired for that...

Then you were at a crappy, malignant program that probably has a ton of FMGs/IMGs. Like many others have said, in a normal program, it does not matter what time you come in as long as you get your work done.

 

[rokshana]

Like I said, you are a medical student, and if you think your residents care what you think or actually take your advice, no offense but you are clearly mistaken and misinformed.

frankly I'd take AMEhigh on my team over you…he sounds like he would be eager to work, learn, and assume responsibility as he is capable of doing so…you on the other hands sound like a slacker who will basically do just the minimum and never one to be able to count on...

 

[MDsuperstar]

frankly I'd take AMEhigh on my team over you…he sounds like he would be eager to work, learn, and assume responsibility as he is capable of doing so…you on the other hands sound like a slacker who will basically do just the minimum and never one to be able to count on...

It figures you would say something condescending and demeaning. No intelligent person would make any type of appraisal of someone else without actually knowing anything about them. And I would never take a foreign grad with attitude issues like yourself so I'm glad I'm not part of that awful world of medicine that you live in.

 

[rokshana]

Then you were at a crappy, malignant program that probably has a ton of FMGs/IMGs. Like many others have said, in a normal program, it does not matter what time you come in as long as you get your work done.

i believe you are the only one here that has said its ok to come in whenever you feel like it…most here have said, listen to your senior and 7 or a bit earlier is not unreasonable...

 

[KnuxNole]

Residency doesn't start until July 1, so of course i did not *get sign out from the outgoing intern." I will be doing 0 work until July 1 in the morning. Why on earth would anyone think that any normal resident do any work before then?

And I said over 9 patients, so I am being given more than 9 patients apparently, which I think is crazy. And yes as you mention, the cap is 10 so I can't admit anyone. So seeing a mininum of 3 patients an hour, in less than 4 hours I'll be done. What the heck am I going to do the rest of the day? I'm very fast and efficient. I think I'm going to propose if we can come in at whatever time we need to finish our notes by rounding time.

It's not unheard of to get signout from the past resident. If that is the expectation, you have no choice but to do it!

Residency is NEVER, EVER about arguing in regards to expectations. It's: get the job done, do your work, get that money, go home.

 

[DrBowtie]

I have my advanced spot, I'm not concerned about that. I feel sad you are suggesting I should start off by violating rules. Don't you think that's douchy of the resident to expect interns on their first day to carry more than 9 patients? She should be picking up the slack initially.

What was suggested was that your advanced spot requires successful completion of an intern year.