Day in the Life of a Surgery Resident

An Intern's Perspective

4:00 am	My alarm clock goes off. I roll around in bed once or twice before I head straight to the shower. In total it takes me about 20 minutes to get ready. I pour a cup of coffee (that I programmed the night before) and take a few minutes to feed and walk my dog. I open the Praxify application on my phone and take a mental note of the number of my new patients on my list. I am on the Emergency General Surgery (EGS) Service, which depending on the number of new consultations overnight, can significantly increase the number of patients I will be taking care of. Luckily, I live 10 minutes away from the hospital. Baring there is no snow or frost on my car, I can be on the road in a minute or two. I throw on the Behind the Knife podcast and away I go.
5:00 am	I arrive in the resident room to meet my night float co-intern and get sign-out for events occurring overnight, and new patients. This takes approximately 10-15 minutes. Since the trauma service also gets morning sign-out from the same resident, I always coordinate the night prior who will be getting there first and at what time. After signing out, I take over the service pager and walk over to a computer. I typically have 10-15 minutes before rounding to quickly jot down drain outputs, follow up on specific morning labs, and quickly glance at imaging for patients undergoing the small bowel protocol. I make copies of our list and head over to the EGS work room to meet the rest of my team.
5:30 am	We meet as a team, including the chief resident, a PGY3 resident, an anesthesia PGY1 resident, two PAs, and medical and PA students, in the Wesson building work room. I go over overnight events and present new patients to the team. We all sit at computers and work together following up studies or labs ordered from the day prior, or figuring out what is pending for new patients overnight. Our chief residents develops preliminary plans and splits the team in two for rounding. I grab the consult phone from the overnight PGY3 resident, fill my pockets with dressing supplies, and go with my assigned rounding team.
7:00 am	We meet back in the Wesson work room shortly before 7:00 am to join morning report via Zoom with all the attendings in the department. In this call the chief resident or PGY3 will go over pressing developments for existing patients, present new patients, and go over our operative cases for the day. Shortly after the call, we meet together as a team in our service attending’s office to run the list. With plans in our hands, interns and PAs split tasks including note writing, repleting labs, calling consultants, or other floor work, such as pulling drains.
7:30 am	Our first patient is in the operating room. Our case may be a routine tracheostomy and PEG or an emergent pneumoperitoneum from a perforated viscus, there is no way to predict what the night may bring. Our PGY3 heads down to get the patient settled and ready while our chief resident either starts rounding with the attending or is facilitating other patient care. Depending on the case and any pending consultations, I may sometimes join the operating room. If a case is appropriate for my level of training, my chief or PGY3 may stay out of the operating room to cover consults while I scrub.
8:00 am	On the Emergency General Surgery service every day is different. Some days there are no consults and no cases, and we have time to prepare for education, catch up on case logs, and even order lunch as a team. On other days we have a full OR board and new consultations coming in every hour. Either way, the work for our current patients needs to be done and thus a great portion of the morning is spent on notes and floorwork. New consultations are triaged appropriately and seen and staffed shortly thereafter. On busy days, lunch is on the go. Every day is challenging in its own way because you don’t know what the day will bring. A positive attitude and willingness to work hard to get the job done goes a long way. We stop taking non-emergent consults at 4:30pm. If there are no pending consults from earlier in the day or pressing floor work, at this time we make sure things are wrapped up for the day, including updating “stickies” (our handoff tool) and making sure our night team is prepared for success by re-ordering expiring medications and providing anticipatory guidance to nursing.
5:00 pm	I head down to the resident workroom to meet my night float co-intern yet again. Generally, the Blue Surgery service signs out first because they have a shorter list of patients. Trauma and EGS alternate who signs out first depending on who got there first in the morning. After I hand off the pager, I double check to see what is pending. Generally, if everything has been taken care of, I can go home. However, if things are still pending from earlier in the day, it is my responsibility to stay and make sure it gets done. On occasions I stay late, but it is part of the job.
6:00 pm	Finally, I’m home after a long day. I am tired but there are still plenty of things to do. I am greeted by a wagging tail. We go potty and either go for a quick walk around the block or a run around the backyard. I heat up some left-over food in the microwave and check to see if I have been assigned to any cases for the next day. If so, I will prepare for my cases. Otherwise, I will take some time to go over the general surgery education topics for the week. And if it is ABSITE season, well... Studying.
10:00 pm	Down time or bedtime. Depending on my level of energy I will work on my hobbies, otherwise if it is a sports night, I'll throw on the last few minutes of the game. I am tired, but so is everyone else. I chose this career path. I fall asleep ready to do it all over again.