Intern Survival Guide 2013-14 - the UNC Department of Medicine

Typical Intern Day/Expectations/Tips:1. Pre-round on your patients (time when you arrive depends on the number of patients and theircomplexity; typically around 6:30).2. BEFORE 7 AM: Visit the night resident in the KICKU you signed out to the previous night to learnabout cross cover issues that arose. If they are not there they are likely admitting a patient or takingcare of a sick patient on cross cover. Go ahead and head to the floor and send them a page. Once youchat with them, sign your pager back over to yourself.3. Pre-round on your patients (this should be completed by 7:30):- Check and record vital signs- inquire of patient if there were any problems with his/her night- perform directed physical exam- Run labs and review radiology reports (not all important lab information can be gleaned fromthe rounds report! You have to look in webcis.)*** Work out a system for organizing this information for rounds, and use it every morning, everypatient. It is more information than any of you are used to processing. Every successful intern has asystem. Period. Some people carry a folder/binder, some carry the H&Ps of each patient and write dailyinformation on the backs everyday and have a running tally of the hospital course at discharge. Somehave devised print outs that they fill in each morning so that their information is always organized in thesame concentrated format. This will improve your presentations drastically. If you don’t know where tostart, ask your resident what system they use. Then modify it to fit your brain.4. 7:30 - 7:45: Team Huddle. You should have pre-rounded on your patients by this time. Meet withyour resident and discuss any immediate concerns from the morning. This is the time for the team toidentify consults needed / those ready for discharge as long as the team is stable. This way the internscan start work in these areas during morning report.5. 7:45 - 8:30: Morning report. For interns: call consults discussed with your resident, ready discharges,etc. If your service is light and there is no work to be started on, you should attend morning report.6. 8:30 - 10:30: Work Roundsa. Give report to your resident about each of your patients in the following format:- Patient’s subjective report overnight- Vital signs- Pertinent physical examination- Relevant labs and studies and medications (esp antibiotics and day in regimen e.g. CeftriaxoneDay 5 of 7)- Assessment and plan by problem list