top IM residency prograns with easier schedules

[Dwan]

Not what I said at all. You are putting words in my mouth and creating a strawman.

What I'm saying that you should at least make sure your patients are stable/managed before you head home. Make sure your patients are signed out appropriately so that whatever team can know what is going on. This should be done ideally before you clock out, but if you have to stay a little longer then you stay a little longer.

Going home at 5 when a patient is critical, but not being managed or signed out appropriately is not acceptable.

There aren't many interns at top 20 programs lazy enough to clock out on a critical patient.

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[chessknt]

Not what I said at all. You are putting words in my mouth and creating a strawman.

What I'm saying that you should at least make sure your patients are stable/managed before you head home. Make sure your patients are signed out appropriately so that whatever team can know what is going on. This should be done ideally before you clock out, but if you have to stay a little longer then you stay a little longer.

Going home at 5 when a patient is critical, but not being managed or signed out appropriately is not acceptable.

You think when I respond to rrts or codes on the floor I have signout or the patient is appropriately managed by whatever surgeon is pounding them with fluids? You think I send the surgeon angry emails demanding these things? You think im going to expect a hospitalist admitting a hyponatremia patient at the end of his shift stick around for 4 hours to make sure the sodium is going the right way?

No I take care of the patient when they need it and I'm on call.

 

[aafisahar]

You're right every doctor should stay in the hospital at all times to ensure nothing bad happens to their patients. A single doctor couldn't cover multiple patients on a rotating schedule to let all the others get out early to improve overall quality of life, that's just crazy town.

no that's not what he said and intern year isn't the time to sign out early anyways.

 

[neoexile]

You think when I respond to rrts or codes on the floor I have signout or the patient is appropriately managed by whatever surgeon is pounding them with fluids? You think I send the surgeon angry emails demanding these things? You think im going to expect a hospitalist admitting a hyponatremia patient at the end of his shift stick around for 4 hours to make sure the sodium is going the right way?

No I take care of the patient when they need it and I'm on call.

You aren't gonna get sign out on everything, but you should get it on the most critical patients. Codes happen. Rapids happen. Often no one sees it coming and all you can really do is see what medications they are on and labs which are ordered. Physical exam of course is crucial. Sometimes you get lucky with a good note. However, the idea is that you try to anticipate which patients are gonna be the most critical and give the person who is coming on shift notice of that. You aren't gonna anticipate everything, but you need to do your level best to try.

I would expect the hospitalist to SIGN OUT that a sodium has to be followed up on that patient and what we think the sodium is due to and what the appropriate action can be.

I'm gonna also say that early sign outs CAN be appropriate if all your patients are stable for the day and you want to go home. I've sent my interns home early multiple times, because all the management was done and in place. I'm also usually available for questions after hours as well.