Intern Boot Camp Session 2: Mastering Wards (Part 1)

In this video I discuss:
- how to pre-round and round
- how to present ward patients like a senior on day 1
- how to form a differential diagnosis for common symptoms
- about common ward etiquette
- why professionalism matters and how to be better
- how to be more efficient
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[@maryc5905]

Thanks for making this series!! Super helpful :)
Timestamps for self to keep track:
0:00-4:44 Intro
05:40 Professionalism
1. Do not lie
2. Show up early (5-10 min before your start time)
3. Always be ready
4. Be consistent
5. Take feedback like a boss (just listen instead of responding, take feedbakc and act)
6. Be humble/nice, don't be overconfident
7. Ask for help - at the end of the day, you're there to train
8. Help everyone, including your non-physician staff
9. Own up to your mistakes
10. Don't blame anyone but yourself
11. Never the patient's fault
12. Follow through
13. Prioritize - eliminate non-essentials, focus on things
14. Be ok not knowing! reflect, be curious, ask why - can jot things down you don't know then look up at end of day
19:40 Recs for first day
23:40 Starting on the Wards
26:40 Prerounding
1. Primary Diagnosis
2. Chronic Problems.
3. How am I evaluating if it is getting better or not? (example, for sepsis, look if fevering, WBC, etc)
4. Vitals, labs, micro, images, symptoms)
5. Package this info to present to attending: soap
One liner- Who is this patient?
Subjective: overnight events
Objective (vitals, PE, labs, imaging, micro) ... can write for example 12 (7) to trend labs ... if patient has ESRD can say ESRD labs
6. Don't memorize - have a system down so you can know where the data is
- Ingrain habit (how you do something is how you will do everything else)
7. Don't lie - if you don't have data, be honest
8. If patient looks bad, tell your seniors - don't wait
50:54 Presentations - know how to be systematic with presenting
- if have prior admissions for same reason, can mention in one-liner, now presenting w/ acute/subacute/chronic ... acute would be < 3 weeks, subacute 3-6 weeks, chronic is >6 weeks
- Organize history by talking about how their baseline was, how the pt was doing, then what happened, how fast did it happen, associated symptoms (fevers, cough, SOB, chest pain, n/v/d, headaches, etc - ask what started first, then what other symptoms did they have), how long ago did it happen, did it get better/worse, trend
57:15 example presentation
58:22 thinking about differential
- Form differential before talking to patient so can ask questions to target/try to figure out diagnosis
1:03:10 Review
If new patient: 1-liner, H&P, ED course (how they doing, interventions), overnight events, SOAP
Old patient: 1-liner, presented w/ symptoms, consistent, concerning for ***, or in the setting of *** then SOAP

[@everariasmd6090]

haha, awesome! Thanks

[@joelisakhun]

Thank you for this!

[@MrAlphahustler]

This is great. Thank you

[@besmireille1]

Thank you !

[@Mo-us4bv]

thank you so so much!

[@everariasmd6090]

You're welcome! Check out my patreon for more content ;)

[@nnekaou4490]

Thank you!!

[@everariasmd6090]

You're welcome!

[@ariasadventures3749]

👍🏼👍🏼👍🏼