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Day in the life of an intern - Iko Razon

Welcome to the University of Michigan! My name is Angelico (a.k.a "Iko") and I am a Med-Peds intern. As an intern, you will spend a lot of time on inpatient services. Based on feedback from previous cohorts after the new Children's Hospital opened, our Pediatrics program switched things around. At first, it was a little different from what people are used to, but it makes a lot of sense for work flow.

Each of the four general inpatient teams – Maize, Blue, Gold, and Silver – also cover a subspecialty service – Pulmonary, Nephrology/Rheumatology, Neurology / Genetics, and Gastroenterology, respectively. There are also two inpatient teams that only cover subspecialty patients – Endocrinology / Cardiology and Hematology / Oncology. Each team has a senior resident, a couple of interns, some third year medical students, a sub-intern, a resident assistant, and maybe a fellow. Silver is an exception and has more senior residents instead of interns.

Each team admits their own subspecialty patients every day. The four general inpatient teams take turns taking early or late call every other day. On most days, interns show-up by 6:30 am to receive sign out from the night team. The early team comes at 6 am to get holdover admissions from the previous night, capping at 8 new patients. Then, it's pre-rounding time!

Morning report is at 8 (which I am usually able to make) and ends by 8:40 or 8:45 to give some time to jot down that important factoid for your presentation or re-check a vital sign before rounds at 9. Since we might have a mix of general and subspecialty patients, we do have to round with different attendings. Fortunately, everyone knows this and makes sure to keep things going – it's helpful to have a resident assistant to keep on top of logistical tasks!

We're usually done rounding before noon conference with time to get in important orders. Every other Thursday, I have my continuity clinic so I grab some food, listen for a couple a minutes, and drive over to see my first patient at 1 PM.

The afternoon is for following up on consults, writing orders, and finishing notes. When not on late call, we can sign out to the late team at 2 PM (or the night team at 5 PM) and go home! Okay, when I first started, it took me more than a couple of hours to finish work, but it eventually clicks. The late team continues to admit general patients until 5 PM and then signs out to the night team. Working late call is very manageable since there's always a ton of help. An extra senior comes in the afternoon to float around the different teams. They're immensely helpful, especially when your regular senior resident has the day off!

When I get home, I have time to cook dinner, catch happy hour with co-residents, or explore Ann Arbor (I think Zingerman's is considering adding me as a line item). Lather, rinse, repeat. Inpatient can get very busy, but it has a healthy blend of general pediatrics and tertiary/quaternary-level care. Med-Peds has a VERY strong presence on both sides, and it is rewarding to feel like a part of multiple communities.

Iko Razon

Angelico "Iko" Razon

University of Michigan

Med-Peds Resident - Class of 2018

E-mail: arazon@med.umich.edu