Gastroenterology and Liver Inpatient Service

6:00 AM - Alarm number 1. Snooze.

6:10 AM - Alarm number 2 and my wife asks, "Can't you just set one alarm and get up then?" Nope, I need two. Quick shower followed by scrubs if I'm on call, or my best attempt at GQ if I'm not.

6:20 AM - Enjoy a few minutes to read the NY times updates with a slice of toast at the kitchen table. If on call I may login to MiChart (EPIC) at home and take a quick glance at the H&P's for the night admits (maximum of five). Meanwhile, the Nespresso heats up brewing the perfect cup of cappuccino. Then it's just a ten minute drive to the hospital and a five minute walk to the team room on 5B. Guess no time for a Lebron James chalk toss this morning.

6:45 AM - Each senior has their own style. I like to review everyone's vitals, labs, and any late consult recommendations from the day before, but allow my interns the space to remain the point person for their patients. Sign out is precisely at 7 and punctuality is prized as we all value relieving the night team and allowing for safe transitions. The attendings (one for lumen and one for liver) arrive around 7:15 to 7:30 and the night intern presents only the highest acuity patients before heading home by 8.

8:00 AM - Team A rounds with one of the attendings while Team B rounds with the other, and then we switch. Thanks to the MiChart transition I am now able to bring my iPad on rounds, allowing me to reference vitals and labs if needed, and submit orders on the go, increasing our team's efficiency.

11:00 AM - Morning Report occurs daily at 11:00 AM, is required of seniors, and is always a favorite. This consistent requirement encourages efficient rounding to enable residents to attend morning report.

11:45 AM - Touch base with the interns, ensure all consults have been called, and run the list, before taking over their pagers at 12:30 so they can attend intern report (Tuesdays and Thursdays).

1:30 PM - The team is back together and the afternoon all depends on whether we're on call or not. If on call we continue to work through admissions until call ends at 5. I hold the admission pager until signout at 7, but admissions that get called after 5 ultimately go to the night team. If not on call, I try to teach or do physical exam rounds with the medical students. If we're lucky, we may even finish early and signout (earliest is 3 PM on weekdays), which frees the afternoon for heading to the gym, cooking dinner with my wife, or catching friends for a drink at the Beer Garden (a favorite open air option in downtown Ann Arbor)!

Stephanie C Royer

Amit Gupta

University of Michigan

Gastroenterology and Liver Inpatient Service - Class of 2015