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Surviving your Inpatient Rotation

Surviving your Inpatient Rotation

1. Patient load

Inpatient rotations are usually structured quite differently than any other rotation. Usually your day will start with rounding on established patients, and you could have new consults come in throughout the day. The patient load is usually a lot lower than an outpatient rotation. You likely can expect around 5 or less patients a day as a student. This is normal as the patients are much more complex than in the outpatient setting.

2. Complex patients

As mentioned, the patients can be very complex. I’m talking about multisystem organ failure, electrolyte imbalances, and a history of big medical events. This can be very intimidating at first as a student. Try to break it down and approach each issue, and also ask your preceptor about their methodology of treatment. I promise, at first it’s overwhelming, but it will get easier after you get the hang of it.

3. Zebras

Usually the inpatient setting will have patients that have “zebras” more so than other rotations. This is due to the fact that they are a sicker population given that they are having to stay at a hospital. You may get to see conditions that you were told “would just be a classic board question”. Take the time to embrace the learning experience of any new conditions you are seeing. Research it, take notes, and ask questions.

4. Continuity

In family medicine there is continuity, in that, the same patients come in for follow up. In inpatient medicine, this is enhanced where you could potentially see the same patient for weeks in a row. There are some patients that are in long term stay units and may stay for the duration of your rotation, and others may leave after a couple of days. Regardless, you will be seeing many patients more than once. Utilize this opportunity to really dive into the health of your patient in a more detailed way than you would typically have time for.

5. Down time

Some inpatient rotations may have a lot of downtime due to the lower number of patients. This time will be used to deep dive into your patients, chart, and prep for the next day. Sometimes you may even have some downtime to study up on those conditions. If possible, you can also inquire about spending time in other areas of the hospital, such as an inpatient consulting team (ex. neurology, nephrology, cardiology) or another area such as the ICU. Use this time wisely to enable you to get the most out of this rotation. 

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