WEEK AS A DOCTOR IN CLINIC: How Many Hours? (Medical Resident Vlog)
Hey guys. I’m Siobhan, a first year medicine resident. Today is the first day of a new rotation and I’m actually on a block of clinics. Which means that rather than seeing patients who have been admitted to hospital, I get to see patients who are coming to clinic for subspecialist appointments. So every half day, so at morning and afternoon of the week I get to go to a different specialist’s office and see patients. So a specialist who is seeing patients for a heart problem or a lung problem, kidney problem. Just recently I did a video about how many hours I worked in the hospital. I figured that we could compare in this video how many hours we work in the clinic during a typical week. And to be honest I’ve never calculated it, so we’ll figure it out together. I’m guessing it may be less, but who knows…. We’ll see! It’s Monday morning 8 a.m. This morning I’m going to be in a hepatology clinic, so a clinic that specializes in liver problems. So we’ll see what that’s like and then this afternoon I’m in a gastro-enterology clinic. Lots of big words. So that means that it’s anything to do with the GI tract. Anywhere from the mouth, swallowing, esophagus, going to your stomach, down to the intestines, out the other end and all of that. It’s 8:45 now, I just got to the hospital. I know I said I wasn’t gonna be in the hospital, but these clinics are actually in the hospital. So I’m not doing inpatient medicine, but I’m still seeing patients in the hospital, just in the clinic. So new hospital, I just want to get there a little bit early and then meet my supervisor for the first time and then we’ll go over which patients I’ve got to be seeing, show me which room I’m going to be in and then I’ll read up about the patient a little bit before I go and see them. So you can see what one of these typical clinic rooms are like. A lot of you have probably been in doctors offices like this. The only difference is that we have some specialized posters up here, because this is about gastro-enterology, so you’re seeing colitis and different illnesses illustrated up here on the walls that you may not see in family doctor’s office, so there you go. This is where I work. Heading home now. Left the hospital around 4:00 p.m. So earliest I have left the hospital ever on inpatient, that’s for sure. And it was nice to get to see patients who are not as sick. Got to see some real success stories, like hepatitis C being completely cured, someone’s life being totally turned around by that, so pretty amazing. I still feel like there’s a lot I need to read about, because there are things that I don’t normally see in hospital, that I haven’t encountered. So I’m gonna go home and study, I’m motivated to do that. So it’s 7:00 p.m. now, I just finished working out and had some dinner. And it was so hard for me to pry myself away from watching tv. Yeah, I’m completely addicted to Stranger Things. I don’t know if you guys have seen it, but I’m on season 2. And I usually, you know, let myself watch some Netflix when I’m having dinner. And so I was watching and then the time just flew by I ended up watching two or one and a half episodes. Anyway, it is so good, but I’ve had to turn it off. It’s just so intense, I actually… Like my heart rate’s going up. Anyway, so my goal now is to do a little bit of reading and studying. So I love this book. It’s called ”Rheumatology Secrets”. So I’m in the middle of reading a chapter about rheumatoid arthritis, so my goal is to finish that tonight. And then I need to read a little bit about cardiac arrhythmia, so like when your heart does funny beats, because tomorrow morning I’m doing a clinic that specializes in cardiac arrhythmia, so you know I wanna do a refresher. It’s 8:50 now. Just heading up to the cardiology clinics in one of the hospitals. I was running late this morning, because I watched like three episodes a Stranger Things last night. It is so addictive and it’s so good. So anyway, I’m leaving for Halloween night, I’m leaving the last episode. So that’ll be for tonight, my reward. So here at cardiology clinic for today in the clinic room. Not as many posters as the gastro-enterology room, but it’s got exactly what you need. Just getting ready to see the first patient. So basically I pull out their file and start looking through the previous lab work they’ve had. If they’ve seen any other specialist I’d like to read through those notes and just have an idea in my mind before they even walk through the door what the issues are, what things I want to make sure I ask about, what I don’t want to miss, so it’s sort of like developing a game plan before they come in. I just finished up in the cardiology clinic, it’s 12:45 now. It was so interesting, I saw a lot of different variety; some young patients with genetic changes, older patients who needed peacemakers put in and now I’m just heading down to a different clinic. Luckily it’s in the same hospital and I’ll be going to an endocrinology clinic, so all the different hormones. Tomorrow. Morning guys. So it’s 7:45 this morning and I’m just heading out the door to a rheumatology clinic today, so rheumatology is basically the study of inflammation in the body and sometimes that inflammation is about arthritis and other times it’s inflammatory conditions throughout the body. So stuff you might have heard on like House M.D. like lupus. Some of those rare conditions we actually see in these clinics, so it’ll be an interesting day. And I was just reviewing some of the medications that they give, because they’re a bit more rare, expensive, really, really cool drugs like rituximab, hydrochloroquine. And one of the ones I always struggle with saying is adalimumab, adalimumab. Whenever I’m trying to say it to patients, I feel like it gets balled up in my mouth, adalimumab, adalimumab. Try to say that a whole bunch of times. So here is the clinic that I’m working at today. I like it because it’s really new and fresh colors. So you know, got the typical things. We can look in eyes and ears with this, you’ve got a regular table. Gowns are kept below here, this is to put sharps in, so needles. Got some good hand hygiene, so you can either wash your hands with soap and water or with Purell over here. Typical workstation right here, I can access all of the notes online. And then I usually get my patients to come sit over here, and of course we can draw the curtains, if anyone is coming in. So standard office, but I happen to really like this one, because it’s so new and fresh and it feels good in here. All right, so it’s about 5 p.m. now, just finished the day. This morning was in the rheumatology clinic and basically saw a lot of patients with rheumatoid arthritis and that means people have a lot of inflammation in their joints. And so I feel way more comfortable looking at their joints, figure out which ones need more medications. And then this afternoon all the internal medicine residents get together for our academic half-day. And basically we have a series of lectures, this time we had something called M&M. And I always think of like M&Ms, like little candies, but it’s actually morbidity and mortality rounds. so we look at a case that we can learn from and where things didn’t go well that we as doctors and healthcare professionals can do better. So in this case we were looking at cases where medication errors happened. So when someone comes into hospital and they don’t get the right medications or they don’t get the right dose and that’s considered a medical error. So we’re talking about ways to do better in our own hospitals and solutions for that, so super super useful topic. Anyway, now heading to a coffee shop just to study for a bit. I know if I go home that I’m doomed and I’ll probably sit on the couch and get no work done. So do a little bit of work first and then I’m meeting up with my internal medicine lady friends. And we’re having sort of a girls night, so it’ll be nice, so we’ll see… it will be a good night. Good morning guys, 8 o’clock now. Sorry it’s so loud, I’m on the street here. Normally I usually walk to work, especially when it’s a close by hospital. But today it’s raining, it’s so gross and I probably woke up a little bit too late, so I’m going to get myself an Uber, get to work. And I’ve got a hematology clinic starting at 8:30 in the morning. So that’s a specialty of all the issues that can happen in your blood. So do you clot too quickly? You bleed too much? Could it be a cancer? That kind of thing, so it’ll be a different type of clinic. So it’s now 12:30, I just finished up with my hematology clinic. So here’s the room today. As you can see, it’s all pretty similar. This is just a little bit smaller, same deal though. You know everything to stay clean and safe. So now I’m heading upstairs, I’m gonna eat on the way. And I’ve got a nephrology clinic, so basically looking at patients with kidney problems. So it’s about 4:15 now. I finished the nephrology clinic, but honestly I’m so tired and a lot of you guys send really nice comments talking about how you don’t know how I keep up with so much energy. But it’s times like this that I want to tell you I do not have a lot of energy all the time and I do get exhausted. And this is one of those days that I really just want to go home and I don’t really want to be on call. But that’s not the reality of life, so ehm… I have about 40 minutes or so to get over to a different hospital. I figured I would walk and that’ll perk me up, hopefully get a little bit of outdoors some nice fresh air. So basically right now I’m gonna be considered a fly-in resident and the whole idea behind that is I don’t know the teams, I’m not actually on an inpatient rotation right now, but they still need people to be there overnight on calls. So I’m covering for call, so the important part is that I’m gonna show up at around 5 p.m. and I’m gonna have to get to know all of these patients, and that’s when handover becomes incredibly important. I’m gonna sit down with the residents, they are gonna show me a long list of patients that I’m covering. They’re gonna give me all their issues that are pertinent, so that I know what’s going on with this patient. What are their issues? What’s important? And what kind of issues will I probably get called about overnight? So I’ll have some context when I get called, which definitely is important for safety. So that’s, that’s about it. Just gonna go for a walk, Get some food and then mentally gear up for the night, because there’s definitely a big mental component to knowing that you’re on call. Alright it’s 4:45, just came to the hospital. You can hear all the sirens, so you know I’m in the right place. So now for me the call is gonna be from 5 p.m. until 8 or probably 10 a.m. next morning. It’s still early in the night, but for whatever reason it’s actually kind of quiet. It’s eerie, but actually you’re never supposed to say the word quiet, otherwise you’re gonna jinx everything, so hopefully I didn’t jinx everything. So I’m gonna take a nap, it’s sort of between nap or food and I think right now sleeping is gonna be more beneficial to me and I don’t you know… I can eat between patients later on tonight, so nap time. I’m just in my call room right now, so basically it’s just like an actual patient’s bed. Yeah, I don’t know… It’s actually comfortable, I can’t complain at all. One eternity later. It’s 10:10 in the morning now. Just left the hospital, literally the birds are chirping. It was a really good thing that I took that nap when I had the chance, because in the end it ended up being a super sort of back-loaded night, where at about midnight we just got slammed with consults. So I went down to the emergency department and I didn’t get back to my call room after about 11:30 at night. So it’s just kind of one consult after the other. And some of them were complicated, so that means they were interesting and they’re good for my learning and they were great people to meet. But all I really wanted to do was go lie down at a certain point, so now I’ve earned that sleep. And even though it’s such a beautiful day, I can barely see. I’m gonna go draw my curtains and go fast asleep. So we made it through the week, it’s about 7:00 p.m. on Friday now. I’ve slept for like six, seven hours after I got home, then had a shower. I’ve now gotten dressed up and even have a little makeup on, because I’m heading out with some friends tonight. So the grand total for this week was 49 hours of work. And I think you know if I didn’t have that call shift last night, it would have been closer to 40 hours of actually work in the clinic, which is pretty standard, much more of a normal work week. And it just goes to show you that there’s a lot of flexibility in terms of what you can do in medicine and what you choose to do as a doctor, so this is just a week in my residency program on my particular schedule. It’s definitely not representative of all doctors or everyone working in clinics. You can work more or less and when you’re an independent practicing physician, you have a lot more say in the type of work and number of hours you want to do, that’s what I’ve been told anyways. So thanks for joining me this week, don’t forget to subscribe if you haven’t already and comment below with any questions, comments, thoughts that you have. I’d love to hear from you guys. So bye for now and I’ll chat with you guys later.