A Day In The Life

Hello! My name is Brandon Meyer and I am a first-year pediatrics resident at C. S. Mott Children’s Hospital at the University of Michigan in beautiful Ann Arbor. One of the most common questions interviewees seem to have is “What is a typical day for a first-year resident on the inpatient service?” I hope this can shed some light on what the true experience is like!

6:00 or 6:30 AM to 8:00 AM – Pre-Rounds: I arrive at the hospital by 6:30am (or 6:00am 1 day in every 4) for sign out from the night team. The night team gives me updates on any overnight changes on my patients. I also get sign-out on any new patients admitted to our service. After talking with the night team, I look over my patients’ vital signs and review their labs and imaging studies using MiChart, which is an Epic-based EMR. Next, I make my way to each patient’s room. I briefly talk with the patient, their parents, and their nurse about how their night went and how they’re doing this morning as well as examine the patients.  I then come up with their plans for the day. Often, I will have a third-year medical student following my patients with me, so this is a great time to talk with them about a plan so that they are well-prepared to present on rounds. After pre-rounding, I will often run my plan by my senior resident, who is a great resource for any questions I may have and can offer advice about the plans for my patients.  

8:00 AM to 9:00 AM – Morning Report (weekdays only): After pre-rounding, I join my co-residents for coffee and bagels (or donuts if we’re really lucky) at morning conference. This is one of my favorite parts of the day! Conferences are located on the 12th floor, close to the team workrooms. The view from our conference room is one of the best in the state! The room is surrounded by windows that look out over the river and trees that Ann Arbor is so famous for. Morning conferences are typically case-based, resident-driven, and very interactive. Residents ask questions and work through the case together while the attending physicians are there to help guide the course and highlight key learning points.

9:00 AM to 11:00 AM – Rounds: After morning conference, I head back to my team room to meet the rest of my team and start rounds. The team includes the attending physician, fellow (subspecialty rotations), senior resident, interns, sub-interns, third-year medical students, our resident assistant, and often a clinical pharmacist and dietitian. The team travels to each patient’s room and gathers at the patient’s bedside along with each patient’s nurse. We practice family-centered rounds, so that our patients and their families can be fully involved in the plan of care. Any issues or concerns are addressed with everyone present, so we can all be on the same page. Often, our senior resident, fellow, or attending will highlight key teaching points while on rounds. It is very nice to round directly with our specialists, as this lets us have in-depth discussions about complex care and helps to develop a sense of collegiality among the residents and the entire pediatric faculty group.

11:00 AM to 12:00 PM – Work-Time: After rounds, I call consults, complete orders, follow-up on patient studies, and discharge patients home. Throughout the morning, our Resident Assistants stay incredibly busy by taking care of many administrative tasks. They are great resources that allow us residents to focus on patient care, while they handle tasks such as obtaining prior authorizations for medications and scheduling follow up appointments for our patients. The RAs are truly one of the best parts about training here!

12:00 PM to 1:00 PM – Noon Conference (weekdays only): These conferences are generally lecture-based topics covering the core pediatric curriculum. The topics range

from subspecialty,to general care, to hospital improvement and initiatives. A catered lunch is provided every day! This is great for resident wellness, as it ensures that we take a break, take time to eat lunch, and gives us another opportunity to spend time with our fellow residents. Resident education is a big priority here, so our senior residents try to make sure we attend conference every day.

1:00 PM to 5:30 PM – Afternoon Work: In the afternoons, I continue managing my patients, following up on labs and studies, and completing clinical plans. I write my daily
progress notes and send them to be reviewed and signed by the attending. I also admit or transfer new patients to my service and guide medical students through patient encounters. Often if I’m feeling a little tired after lunch, I’ll head down to our Pediatric Resident Lounge to grab coffee, candy, and snacks! At some point during the afternoon, I try to make my way around to see each of my patients one more time to give updates and see if any new issues have come up. One day per week I leave the hospital at noon to go see patients at my outpatient continuity clinic. About twice a week, I have the opportunity to head home early from my inpatient service (sometimes by 3 or 4pm!) when my work is completed.

5:30 PM - Evening Sign-Out: The night team comes in at 5:30 PM to take sign-out and assume care of my patients. I make sure to give them a brief synopsis of the patient’s condition and daily progress. I highlight key elements of the plan for them to complete and monitor overnight. Once I sign-out to them, I am able to head home to spend the evening with friends and family.