Daily routine at Denver Health

My daily routine while working on the Medicine service at Denver Health was surprisingly predictable.

I woke up between 5:00-5:30 am to get to the hospital between 6:00-6:30 am, which gave me enough time to pre-round on my patients before rounds at 8:30 am. Rounds usually lasted until 10:00-11:00 am, depending on how efficient we were and how many patients we were carrying.

From the end of rounds until 12 noon, I took care of my patients. This included things like consulting various specialists (infectious disease, renal, etc...), following up on labs and studies, and ordering new labs or medications. At Denver Health, medical students can place orders, but they must be signed by a licensed physician, usually the intern or sometimes the resident.

Then we had Noon Conference until 1:00 pm, lunch catered.

Afternoons were also generally reserved for patient care. If I finished earlier in the afternoon, I would go back around and visit with my patients, then study until around 5:00 pm, then check in with my patients one more time, then ask my intern and resident if there was anything else I could do to help out before going home. On late days, I would stay until 7:00 pm or so.

Overall, I would guess that my average day was 11 hours long. I worked a couple 9-hour days and several 14-hour days, but the rest were between 10-13 hours. Of course, that's not counting the time spent at home studying or reading up on my patients.

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I attribute the regularity of my schedule at Denver Health to its rolling admissions structure. At Presbyterian St. Luke's and many other hospitals, doctors take call (i.e. admit new patients) every fourth day; that's not the case at Denver Health. Instead, the medicine team with the lightest census (carrying the fewest patients) takes the next admit. This makes good sense to me: whoever has the least amount of work admits the next patient.

However, this isn't the traditional model. Some interns and residents don't like rolling admissions because it eliminates post-call days, which are essentially an extra day off. From my perspective as a third-year medical student, though, I love this set-up because it secures for me a steady flow of patients. On any given day, if I wanted a new patient I could generally get one. That meant a lot to me in terms of my educational experience.