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Day in the Life of a Pediatrics Resident

Everybody wants to know what to expect in residency. Learn more about our program from those who know.

PG1 Resident's Day in the Life

6:00 am Alarm goes off, wake up ready for another day in the NICU
6:15 Eat breakfast, shower, and head out to work.  On the way in, stop at Star bucks to get my morning coffee (Grande Vanilla Latte).
7:00 Arrive in NICU to get sign out from overnight resident.  One new admission to my team this morning - a full term baby here with hypoglycemia from a mother with gestational diabetes.  I read up on the admission notes in the EMR written by the resident about this new patient.
7:30 Scrub in for the day.  Update all the weights, intakes and outputs for my seven patients in the NICU on my worksheet.  Pre-round, examine and discuss each patient with their nurses about any concerns or problems overnight.  They inform me about orders that need attention and I fix them up on my computer-on-wheels.
8:30 Morning lecture from the NICU attending.  It is about neonates with hypoglycemia.  I think about my new admission and note down the extra signs and complications I now know to look out for.
9:30 Begin rounds with my team, which consists of the senior resident, medical student, nurse practitioner, nutritionist and attending.  I present the updates on each of my patients, outlining my plans for each patient today with a systems approach.  The team gives feedback on my plan.  We decide to continue to wean the medication for a baby suffering from neonatal abstinence syndrome.  A baby with Meconium Aspiration Syndrome is doing really well and is to be weaned from the ventilator to a high flow nasal cannula today.  The attending provides some key teaching points about babies with Meconium Aspiration Syndrome, and gives some hints about possible board questions on this topic.
10:30 Finish rounds.  Before heading off to place the orders for the day, the team discusses interesting radiology images on our patients.  We review the aspiration seen in one of our babies who had a contrast swallow study.  We then discuss the appropriate placement for umbilical lines.
11:00 Enter orders for my patients.  Got some help from the senior resident about how to order the parenteral nutrition properly.
11:30 Head down to the simulation center with all of the NICU residents.  It is my turn to lead the simulation and today's case is a newborn in hypovolemic shock after placental abruption.  We run through the scenario as a team with as simulation robotic baby complete with breath sounds, heart sounds, cyanosis and pulses.  After the scenario, we go through what went well, what could have gone better, and how to improve for our next code.
12:30 Got lunch from the cafeteria with my staff card and catch up the other residents in the NICU and nursery.
1:20 Pager goes off:  Code B in the delivery room for meconium stained anmiotic fluid!  It is my turn to respond.  I head down to the room with the respiratory therapist and the nurse practitioner.  Baby is born and not vigorous in the infant warmer.  I open the baby's mouth and intubate the baby with guidance from the nurse practitioner.  I then suction  meconium from the tracheal through the endotracheal tube and the baby begins to cry.  I perform the rest of the routine warming and drying of the baby with the team and give him some supplemental oxygen.  Once we are satisfied that the baby is now stable, I go over to the new parents to congratulate them on their new baby and update them on what has happened.  We bring the baby upstairs for further care.
2:00 Enter the admission orders at the bedside.  Discuss the baby with the attending.  Finish the admission note.
3:00 Return to the back room.  I receive feedback on the code that just happened with notes on what to improve on for the next time.
3:30 Go through each of my patients to check on the progress of their plans.  Check with the respiratory therapist to ensure the baby with meconium aspiration syndrome is comfortable on the current settings.  Update the parents of the new admission on the baby's progress.  Update the worksheet and the discharge notes for each baby.
4:30 Sign out to the Long Call resident.  Discuss the plan overnight for each of my patients and highlight issues to look out for.
5:00 Leave hospital for the day.  Go for a work out at the gym on the way home.
6:00 Cook dinner and enjoy it with the latest episode of House.        
8:00 Read up on meconium aspiration syndrome with my own copy of the Neonatology textbook provided by the NICU.
9:00 Catch up with a good friend on Skype.  Make plans with my fellow first years for a hike up Mt Tom this coming weekend.
10:30 Off to bed

PG2 Resident Day in the Life On an Elective

1 day in the life of a second year resident on an elective...

9:15 am
My ID attending pages me to run the list over the phone.  We make plans to meet up to round in about 10 minutes.
9:25 I meet my attending in the NICU to see our first consult there.  After we round in the NICU, we head up to Infant's and Children's.  We see two patients on the floor, and then finish our rounds with our patient in the PICU.  After we round, my attending and I meet up with the different care teams to give them our recommendations.  We have a few minutes, so we sit down and discuss different classes of antibiotics and their uses that are pertinent to our patient's at this time.  I start on some of my notes for the day.
11:30 It is time for intake!  I go to the conference room on the floor which is where we have our weekly "intake."  A resident will present a case and ask questions to the different residents and attendings.  The intake today is about retropharyngeal abscesses, an ID case!  My friends and I are able to answer the questions correctly.
12:00 I finish up the rest of my notes and grab a snack in the cafeteria.  It6's now time for me to head to my continuity clinic.
1:00 I see patient's in my continuity schedule.  Several of them are ones I know that are coming to me for follow up, but I also am seeing some new patient visits, too!
5:50 I finish up my clinic notes and head home!  I change quickly into my work-out gear and make it just in time for a zumba class with my fellow second year pedi resident.  It is a lot of fun and a great way to end the day!
6:45 Arrive home, and see that my husband has started preparing dinner.  We eat together, then take our dogs for a long walk through our neighborhood.
8:30 Fold some laundry and start reading one of the articles for Thursday conference.  My husband and I sit on the couch with our dogs and watch some TV.
10:00 Time for bed!  Set my alarm for the next day, and go to sleep.

PG3 Resident Day in the Life On-Call

Day in the life of a third year resident on-call.

6:00 am

Wake up, shower, and pack my overnight bag.


Leave for work.


Arrive to the PICU for sign out.  The unit holds ten patients and there are already 8 on the list so it could be a long day.


Take a look at the overnight flow sheets and examine my patients.


Head down to morning conference where today we are starting a new series on medical errors.  Have my bagel and tea and prepare myself for the day.


Back up to the PICU after conference when I get a page that there is a 10 yo asthmatic on the floor who is quickly worsening.  He came in overnight from an outside hospital and now has increased work of breathing despite continuous nebulizers and now has an oxygen requirement.  Discuss case with Steve, our attending, and bring our asthmatic over to the PICU for futher tx.


Start rounds with Steve. We have a crew of interesting patients today including a 2 mo infant with panhypopituitarism, a 4 wk old ex-premie with apnea, and a 12 yo female with head trauma from a motor vehicle accident.


Finished with rounds and now it's time to make sure all orders are in for the day.


Despite our list of patients, the PICU is calm and Steve gives a lecture on ICP which will turn out to come in handy later this evening.

12:30 pm

Lunch. Always very important to eat whenever the opportunity arises because you never know what a day in the PICU may bring!


My asthmatic is doing much better on IV steroids and an increased dose of albuterol.  I should be able to start to wean his oxygen soon.


Post-op procedure patient arrives.  A 3 mo old infant with Beckwith-Wiedeman syndrome, hypoglycemia and hyperbilirubinemia who went to the OR for a liver biopsy to look for the etiology of her increasing bilirubin.  Infant did very well in surgery, so hopefully she and I will have a quiet night together.


Our 12 yo female with head trauma who is intubated has some vital sign changes after being moved in bed, including an increasing blood pressure, decreasing pulse and respiratory changes, indicative of increasing intracranial pressure.  Steve and I go to the bedside where we hyperventilate the patient and give a dose of mannitol and her vitals begin to normalize again. Based on these new clinical changes, Steve would like to repeat her head CT tonight.


Just as we're getting our 12 yo female settled back down, Endocrine comes by to discuss our 2 mo old with panhypopituitarism. We've been managing his diabetes insipidus with a vasopressin drip and they would like to try to wean his drip tonight so that we can transition him over to oral medications soon.  And while they're here they also would like me to keep an eye on the blood sugars for our Beckwith-Wiedeman baby.  


After working with pharmacy, our new vasopressin drip arrives for our wean and now we're in for a fun night of following sodium levels.


The PICU is quiet, so we decide to take advantage of this opportunity and take our 12 yo head trauma patient down to CT for a repeat scan.  Luckily I have a great group of nurses and staff with me so we make a relatively uneventful trip to CT and back while I stare at her vitals, hoping not to see the changes we observed earlier.


The sodium level on my panhypopituitarism baby is 139 and urine output is good. Excellent!

1:00 am Blood sugar on my infant with Beckwith-Wiedeman is a little elevated at 127, so I adjust her IV fluids and will recheck in a couple of hours.
3:00 Sodium level is starting to creep up to 144 on our panhypopituitarism baby but still within normal range and urine output still good.  While I'm up we check a repeat sugar on my Beckwith-Wiedeman, hypoglycemic infant which is 113. Great!  We're heading in the right direction.
6:00 Brush my teeth and touch base with all the nurses before change of shift and before my fellow collegues come in to relieve me.
7:00 Fellow PICU residents arrive for sign-out.  My call day is now officially over!
7:45 Down to morning conference and intake.  Boy am I ready for breakfast!
9:30 Round with Steve and discuss overnight events.
11:00 Finish up any notes and orders and sign out to the on call resident.
11:45 Call my husband to let him know that I arrived home safely after my night on call and crawl into my bed for a much anticipated afternoon of sleep!

Quality of Life

We recognize that residency can be a time of stress—working in a new, challenging environment, caring for medically and socially complex patients, and balancing work and home life.

Help When You Need It

To make your transition smoother, you will be paired with a faculty advisor who will act as your support person, career counselor and overall advocate. We also have a resident support group facilitator on staff who is available for ad hoc meetings.

Each class also has an academic half-day in the fall and spring to go over issues specific to their group, such as learning to be an effective educator, planning your career, etc.

Reasonable Work Hours

Our residents' workday meets the guidelines for resident work hours—if you are unfamiliar with them, you can review them at ACGME. We have already made additional changes in anticipThere areation of new guidelines in the next two years.

  • Attendings cover the services so residents can be at conferences free from clinical responsibilities.
  • Our residents do very little overnight call when on electives or ambulatory rotations to ensure that there is minimal disruption of their educational experiences..
  • Our residents do not float in from their electives or ambulatory rotations to cover inpatient rotations, except when on jeopardy, if another resident cannot work their assigned shift, or other unusual circumstances.

R & R

It can't be all work and no play.

We have "official" social events during which residents are relieved from any duties, such as our annual resident retreat and graduation bash.

  • Graduation bash
  • Holiday party
  • Talent night

There are several events throughout the year, too—talent night and holiday party to name a couple.

Baystate also has a fitness center and discounts at other fitness centers.