I’ve started as the senior resident on the general peds inpatient wards, and wow, is it more tiring than I’d ever thought it could be. It’s a blast, though — I have three interns and three third-year med students on my team, and managing a team (rather than a few patients) is a lot of fun.

Of course, it’s also a lot of work, and part of the work that I didn’t anticipate involves dealing with other services that — how can I put this — don’t put the wellness of the patient as their primary priority. One of the surgical subspecialty services had a kid on the floor Wednesday night that spiked a fever to 107.2, and the covering fourth-year resident took over two hours to come to the floor to evaluate the child. (I ended up contacting his departmental chairman the next day and transferring the patient onto my service.) Likewise, the emergency room sent an asthmatic up to the floor last week that had no business being on a semiacute floor — he was as tight as they come, moving little to no air, and it seemed that he was sent up more because it was busy in the ER and less because he was ready for less acute management.

All in all, though, it’s a great experience; I get to teach the interns about day-to-day management, but also spend time working on the bigger picture (long-term management and diagnostic dilemmas).