Rounds occur every morning, and on some services, every evening. This is when your team will review the patient’s condition, check any new lab work or diagnostic imaging, and write orders to be fulfilled over the next twelve hours. It’s important to see each patient, and when you are the medical student on the team, you should make a point of going up to the floor early and pre-round. Make sure your patient is stable. Check their labs and write them down for your resident. That will save the resident valuable time, and will be appreciated as strong teamwork. “Strong work” is one of the highest compliments given by residents to students.
During rounds, be prepared to present your patient to the resident and attending. Have a system. You will learn what is expected. Follow that format. Patient name, brief history, subjective complaints, physical exam and diagnostic tests should all be part of your presentation.
Taking Notes That Count
You will be asked to write progress notes. Write them in a systematic way. Good handwriting has become important. Sloppiness is not tolerated. You will be asked to write orders for the resident to co-sign. If you have questions, it is critical that you ask. After all, this is not a game. You are caring for real patients.
Because you’ve prepared by reading about your patients’ conditions, you will be well equipped to answer the inevitable questions asked by the attending as you make your way down the ward. Expect to know everything – you will be expected to know about their disease process, their medications, and their side effects. You need to understand the treatment plan. You will be calling upon your knowledge of pathophysiology from the M2 year. You will start to put it all together.
Patient care in a teaching hospital is about teamwork, and you can shine by being a part of the team. You are not the star player, so don’t forget that. You are there to help your resident, and you should try to make your resident shine. Be sure to give your resident all the information you can collect before you round. You should volunteer for all of the scutwork on your patients – it will be assigned to you anyway.