Change in Pace

I've just started my four week neurology rotation at San Francisco General Hospital. It's a big change from psychiatry. The hours are longer, the atmosphere is more intense, the expectations are higher. The teams are made up of a senior and junior resident and the three medical students and we manage a significant ward census and patient turnover. The attending is fantastic and has a strong dedication to good teaching. The bread-and-butter cases here are mostly stroke and substance abuse.

The day begins with pre-rounding on our patients at around 5:30 or 6. Work rounds begin at 7 with the residents seeing every patient and deciding on the to-do list and orders. Attending rounds are at 10 when the attending card-flips and then sees new patients or discusses a particular case in depth. The afternoon consists of getting all the work done for our patients, admitting new patients, and discharging old patients. We usually end from 5-7 in the evening. Call is every fourth night and goes until about 10pm. The structure is really similar to medicine and brutal.