A Day in the Life

Dr Kailyn Wiersma

A Day in the Life of an Intern

Hello and thank you for considering a residency at the University of Michigan! My name is Kailyn and I recently completed my first year of residency in pediatrics at U of M. For me, one of the most helpful ways I was able to distinguish among programs during the residency application process was to picture what my day-to-day routine would look like if I were to match at each program I visited. The purpose of this page is to help you do just that! Below is a description of what my typical day looked like as an intern on an inpatient service at C.S. Mott Children’s Hospital.

6:00/6:30am to 8:00am – Pre-Rounding:

I arrive at the hospital by 6:30am to receive sign-out from the night team. Our teams are on a rotating admission schedule so that once every four days, each team receives the new gen peds admissions completed overnight – this team arrives by 6:00am for sign-out rather than 6:30am. The night team updates me on any changes which occurred overnight with my patients, and signs out any new admissions our team received overnight. After hearing from the night team, I review vital signs, labs, imaging studies, and notes for each of my patients using MiChart, which is an Epic-based EMR system. Next, I go visit with each of my patients and their families and nurses to find out how they’re feeling and to do a physical exam. Then I form a plan for each of my patients which I typically review with my senior resident in order to make sure I am on the right track and to clarify any questions I have. I also generally use this time to review plans with the medical students on the team, so that they are well-prepared to present their patients on rounds.                                         

8:00am to 9:00am – Morning Report (Monday through Friday):

After pre-rounds, I meet with my fellow residents in our conference room for a light breakfast (provided by the program) and learning. For me, this is often a great chance to take a breath and step away from the busyness of the morning. Our morning reports are typically case-based, resident driven, and participatory. Attendings are present to help guide discussion and emphasize important learning points, but you also learn a lot from all of your co-residents, which is a fun experience. Morning report is also a good opportunity to catch up with friends and take in some scenery – our conference room is surrounded by windows which overlook Ann Arbor, the Huron River, and the beautiful Nichols Arboretum which is located just across the street!

9:00am to 11:30ish am – Rounds:

At 9:00am, I meet back in my team room to begin rounds. At Michigan, we practice multi-disciplinary family-centered rounds. Our rounding team consists of medical students, interns, a senior resident, a fellow (for subspecialty patients only), an attending, nursing, a resident assistant, a clinical pharmacist, and a dietician. We round inside patient rooms, and include patients and their family members as active participants in medical decision-making. With all team members present for and able to give input, our goal is that everyone will be on the same page and that decisions can be tailored to best meet the unique needs of each patient. Attendings often use rounds to do on-the-fly teaching related to our patients and their management as well. Depending on the team census, rounding end-times can vary, but rounds are typically finished by 11:00/11:30am and we are required to be finished by noon.

11:30ish to Noon – Post-Rounds Work:

After rounds, I spend time organizing work flow with the senior resident and deligating tasks to the medical students. I then call consults, place any lingering orders which were not placed during rounds, and work on getting patients discharged. Our program has resident assistants who work closely with each team and are immensely helpful in completing logistical tasks such as arranging for outpatient follow-up, scheduling imaging studies, or obtaining prior authorization for medications. They also frequently play the role of “team moms” and do a great job making sure residents are prioritizing self-care when things get busy. Our resident assistants are one of the largest reasons I decided to stay at the University of Michigan for residency!

Noon to 1:00pm – Noon Conference (Monday through Friday):

At noon, I head back to the conference room for more learning! Noon conferences are typically lecture-based and are always accompanied by a daily catered lunch – pediatric residents at the University of Michigan are well-fed! Noon conference topics range from subspecialty topics, to journal club, to resident wellness, to quality improvement initiatives, and more. Noon conference is another really great opportunity to take a break from the day, decompress after rounds, and see friends.

1:00pm to 6:00pm – Afternoon Work:

After noon conference, I spend the remainder of my day wrapping up loose ends from the morning, following up on test results and consultant recommendations, writing progress notes, and admitting/transferring new patients to our service. I make sure to see each of my patients again at some point in the afternoon to ensure continued understanding of the clinical plan and to address any problems which may have come up. Attendings will often come by to check in and do additional teaching during the afternoons as well. Twice a month, I leave the hospital at lunchtime and spend the afternoon at my general pediatrics continuity clinic. We are sometimes able to wrap up work quickly and sign out early to one of the other day teams or to our senior resident (as early as noon on the weekends or 3:00pm on weekdays!). How often this happens is very dependent on the team census and the busyness of your subspecialty services.

6:00pm – Sign-Out:

The night team arrives at 6:00pm to take sign-out. I provide them with a brief synopsis of who each of my patients is, how they’re doing, and pertinent aspects of their clinical plans which I want the night time to perform and/or follow up. Our program has a night float system for interns rather than call, and you spend about 4 weeks total on general pediatrics nights over the course of the year. Following sign out, I cover my pager and head home to spend time with my family and friends. As with any residency, there are occasional times when I am required to work late in order to address newly evolving clinical problems and/or finish up clinical documentation after sign-out. When this happens, our program provides money (separate from our regular salary) in order to buy dinner from one of the hospital’s cafeterias, which is a nice “consolation prize”!

Days Off:

Making the most of your days off is pretty easy to do here. Ann Arbor has a great college town atmosphere with festivals, performances, and athletic events almost daily. Ann Arbor also has a fantastic parks system, excellent shopping (including a farmers market), and awesome restaurants. Detroit is less than an hour away and has a lot of “bigger city” things to do, such as larger concerts and professional sports. Also within a short drive, you can get to several small towns, farms, and multiple state parks. I’ve been living in Ann Arbor for 7 years now, and haven’t run out of things to do yet! Some of my favorite things to do on my days off include taking my dog to one of the many local parks, hiking, biking, snowshoeing, and canoing or tubing on the Huron River. I’ve also really enjoyed running in multiple local races, going to shows at The Ark (a small concert venue in Ann Arbor), attending Broadway shows in Detroit, attending the Ann Arbor Art Fair, and taking advantage of restaurant week which occurs twice a year in Ann Arbor J. Let’s be honest, I also do a lot of sleeping and Netflix binging, too, but it’s always nice to have so many options when I’m up for doing a little more.