Daily routine of a houseman

To those who aren't housemans, have you ever wondered what's the daily routine of a houseman like? Well, let me give you an insight into a typical day of a houseman. Medical students pay attention! Cos this will be the shit that you're going to have to put up through every single day for 2 friggin' years once you graduate.

5.30am: Wake up, get ready for work. If you wanna have breakfast, wake up earlier.

6.15am: Leave the house. Reach hospital usually in 15-20mins.

6.30am: Find a parking space, punch in around 6.45am, then go to your respective ward.

6.50am: Check the whiteboard to see the list patients you have been assigned to. Pray hard that you dont get a complicated case.

7.00am: On average, there are about 5 HO and 5 nurses in a ward, but there are only 5 computers. If you're lucky, you can straight away use the computer to see what's the history of the patient. If not, wait for your turn. Print out the history, jot down the trend of the vital signs, laboratory investigations, imaging results, current medications, patient's progress overnight, and latest plan of management. Find patient's medication chart to confirm the list of drugs and current doses, and if there are any procedures planned, make sure the consent form is filled up and signed by the patient. Go to the bedside to check up on your patients, get relevant information and history as required, and do a quick clincical examination. Bear in mind that you don't always get co-operative patients.

7.30am: MO will start their rounds around this time. If you havent finished reviewing your patients by this time, then be prepared for some scolding. Even if you finished reviewing your patients, you're gonna get scolded one way or another, either because you missed some minor details, or forgot to carry out some orders. etc. If the current plan of management is wrong, despite the plan being ordered by another MO, and clearly it's not your fault, you're gonna get scolded anyway.

8.00am: Carry out orders after the MO rounds. Blood taking, insert branula, update patient's bedside folder, order medications, request for imaging procedures, refer cases to other department, etc.

8.45am: Specialist rounds. Present the history, findings on admission, current findings, current issues, latest medication and investigation, vital signs and their trend, and latest plan of management. Get scolded again, and this time by both the specialist and MO.

11.00am: Finished specialist rounds. Carry out new orders. If there are new cases, you need to clerk them.

12.00pm: Finished carrying out the orders. Enter the notes for the morning rounds. Wait for your turn to use the computer again.

12.45pm: Done entering notes. Grab something from cafeteria and have a quick lunch. Sometimes you might finish carrying out the orders and entering notes as late as 2.00pm. By 'sometimes', I mean about 3 to 4 days per week. If you finish lste, then you wont have the time for lunch.

1.45pm: Review patients again and prepare for the afternoon rounds with MO.

2.30pm: Afternoon rounds with MO.

3.30pm: Carry out orders for afternoon rounds. Enter notes for afternoon rounds.

4.00pm: Occasionally specialist will do afternoon rounds as well, usually around this time.

4.30pm: Carry out orders. Enter notes.

5.00pm: Clerk new cases, help others take blood, do procedures, whatever. You can't be seen sitting around doing nothing. If you're a junior, simple procedures might take up to 1 hour. If you're a senior, please guide your juniors.

6.00pm: Pass over case to the evening shift HOs. I usually finish around 6.30pm.

6.30pm: Punch out. Drive back home.

7.00pm onwards: Do whatever you want. Sometimes you need to prepare for seminars and other presentations, sometimes you need to study for your assessment. Some department are using the BD shift system, which means some of you can't go back and have to stay at the hospital until 12 midnight, or come back to work at 11pm and work until 2pm the next day.

So there you go, a brief outline of a houseman's daily routine. There are days you need to work evening or night shifts, so the routine is a bit different. And the shift system will mess up your body's circadian rhythm, so you hardly get any sleep prior to your night shifts.