A Day in the Life Pulmonary Consult, Niruja Sathiyadevan, CB-Y (PGY-1) I usually try to get up around 6:30 AM…although after hitting snooze several times, it’s closer to 7:00 AM. After getting ready and drinking my coffee, I’m out of the door by 7:30 AM and at the hospital by 7:50 AM. Most mornings, there’s something going on from 8-9:00 AM (medicine grand rounds, TB conference, chest conference, etc). After that, I start pre-rounding on my patients (about 4-5 patients for me, but depends on the census), and see any new consults (usually 1 consult daily). After lunch, around 1 pm, the pulmonary team (for me, it consisted of the attending, pulmonary & critical care fellow, third year medicine resident, medical student and me) would meet in the conference room and go over X-Rays and CT Scans from that day and then round on our patients. Depending on the day, rounds would last between 1-3 hours. Some days, there are afternoon teaching sessions, and most of the days, I would be done by 5:00 PM. I was planning on taking my USMLE Step 3 a few weeks after my rotation, so I used most of my free time to study…although, I did make sure to take some breaks to enjoy the beautiful Rochester summer! General Anesthesia, Derek Mitchell, CA-1 I set my alarm to go off sometime around 5:43 AM on a typical weekday morning. I shower, then head out the door by 5:53 AM. I have a very quick commute to campus and most mornings I see some form of wildlife (raccoon, squirrels, rabbits, skunk, deer, wild turkey, etc.) that provides a glimpse of entertainment before starting the workday. I park in the farthest lot from the hospital that demands a brisk power-walk to get to the entrance, but the walk in gives me time to review the day’s cases in my head and get “dialed in”. I change into scrubs, grab the biggest flower cap I can find, and head to my scheduled OR. I perform the anesthesia machine check and get all the equipment and drugs ready for the day. Depending on the complexity of the cause, it takes anywhere from 20-40 mins to set up the room. Once my room is ready, and after morning lecture from 6:30-7:00 AM, I meet my patient in the pre-anesthesia area where I review their history, medications, and allergies, and discuss the anesthetic plan. When the patient gets the ready-to-go green sign, I go all Mad-Max through the hallways to get the patient in the OR by 7:30 AM sharp. On most days, my attending will get me out for a 15 min morning break and a lunch in the afternoon. Cases usually end between 3:30-5:00 PM, however, many days an on-call resident will relieve me from before 5:00 PM. When my room finishes, I check the next day’s schedule and pre-op those patients and complete their chart. This generally takes 30-45 minutes, again depending on the complexity of the patient and how frequently they eat an infamous Rochester garbage plate. When I have reviewed their chart, I call my attending and discuss the patient and anesthetic plan. Often, some great teaching occurs during the pre-op session with the attending. All-in-all, most days I’m walking out the hospital doors around 4:00 PM. I power-walk back to the furthest parking lot and use my remote key thingy to set off my car alarm so I can find my car. I drive back home in time to make dinner with my wife and kid. I do feel very fortunate to have enough free time in the evening that I can spend quality time with my family, study for an hour(ish) and usually get enough sleep for the next day. Neuroanesthesia (on call), Jennifer Chiem, CA-2 My alarm clock starts to beep at 4:30 AM, and after 2-3 snooze buttons, I get dressed and make myself a smoothie and coffee for the car ride to work, which lasts 7-8 minutes. The walk from the parking lot to the locker room probably takes longer than my actual commute from my apartment to the hospital. I change into scrubs and go to my assigned OR for the day; since I’m on a neuro rotation, I could expect to do a neuro-interventional case in our IR suite, an ortho-spine case, or even the occasional craniotomy (both asleep and awake). I start my machine check, draw up my drugs, and make a pit stop to the Anesthesia stock room to "shop" for extra materials I may need for the day. Once everything is set up to my liking (since Anesthesia allows me to utilize my obsessive-compulsive habits to its fullest potential), I head over to morning lecture and then to the Pre-An area to meet my first patient. I usually try to call my patients the night before to discuss their medical history and thetentative plan for anesthesia; this way, in the morning, I’m able to complete my preop by asking just a few additional questions and performing a physical exam. After all the paperwork is done, I'll wheel the patient to the OR for a 7:30 AM on-time start. Depending on how stable the patient is and how many cases there are that day (usually 2-3 neuro cases), I try to draw up drugs and prepare my airway materials for the next case. I also try to study, utilizing the question bank application on my phone. During the day, I'll get a 30 minute lunch break and a 10-15 minute morning or afternoon break. Since I’m on call, when I finish my assigned cases I’ll check-in with the clinical coordinator as to which cases I'll be taking over. Being on call typically means I'll be in the ORs until approximately 7:00 PM, when the Night Float team arrives. At the end of the day, I'll pre-op my patients for the next day and call my attending to discuss my anesthetic plan. When I get home (roughly 8:00 PM when on call), I may complete the evening with a dinner outing; since I moved to Rochester, I have organize weekly dinners with my co-residents to try a new restaurant each week. I also take Aerial Silk classes once a week (think of Cirque De Soleil and the performers doing tricks on silk sheets hanging from the ceiling). If there isn't a dinner or class to attend, I'll end my evening being nerdy, watching episodes of Big Bang Theory or New Girl with my boyfriend (after studying, of course!). My life in residency has been an amazing learning experience, and I couldn't be happier that I can balance family and friends, work and fun times over these past couple of years. Regional Anesthesia at Sawgrass, Joseph Poli, CA-3 I typically get up around 5-5:30 AM to the sound of my alarm clock. I enjoy my early morning routine at home consisting of my first cup of coffee and a light breakfast. After a short commute to Sawgrass (door-to-door in less than 6 minutes) and a quick change in the locker room I’m ready to see my first patient by 6:30 AM for a 7:30 AM case start. The morning is very hectic with often multiple first case starts requiring some form of regional intervention. Many of the patients at SG are relatively healthy and most of the procedures are orthopedic in nature, affording an ample opportunity for a multitude of peripheral nerve blocks, including brachial plexus blocks (interscalene, supraclavicular, axillary) and sciatic nerve blocks via the popliteal approach. I try to grab a quick lunch on the fly and then finish up the last few blocks as the day winds down. It is not uncommon for me to personally perform between 8-14 blocks/day. Throughout my residency, I’ve done close to 150 blocks (not including neuraxial blocks), and I still have a couple weeks of regional anesthesia scheduled before I graduate. Once done, I will log my cases, make follow up phone calls for the patients seen the day prior and print out and go over the next day’s cases with my attending. I’m out the door and home well before 4-4:30 PM most days with plenty of time to read and relax. I usually grab dinner around 6-7:00 PM, digest and hit the gym around 8:00 PM, shower and read until bed around 11:00 PM.