A Day in the Life of a Senior Neurology Resident

Yu-Ting Chen, M.D., in a casual outdoor setting

Yu-Ting Chen, M.D.

Today is Thursday. You wake up at 6:00 a.m. You quickly brush your teeth, fix a sandwich, and get ready for a new day. 6:40 a.m., you park your car at parking 2. You always park at the same spot so you can easily find your car when you go home. You walk into the hospital and pass by the cafeteria towards the new hospital elevator. You run into a MICU nurse in the hall way whom you worked with on your night float last year. The elevator is slow, and you finally arrive at H8.

You enter the resident work room, it’s 6:45 a.m. and there are four residents working in front of computers. One of them is the night float resident who is sending a checkout email to everyone. The other three residents are updating their general team, stroke/Neurocritical care team, and consult team lists. After the night float resident sent the email, she gives oral checkout to other residents. It was a good night as only three new patients were admitted. After the checkout, the residents print out their patient lists and start seeing patients. You briefly review the lists and decide to go to ICU to make sure one of the stroke patients is stable.

It is 7:30 a.m., you start walking towards the spine building. You go to Lucy Library and download the PowerPoint file you made last night for the upcoming chairman round. It is 8:00 a.m., Dr. Archer, the department chair, is sitting in the first row. The room is full of residents and medical students, and you start the presentation. The case is about foot drop, and you have a very interesting discussion with the residents and students.

It is 9:30 a.m., you already came back to H8. You decide to round with general inpatient team today because they have more patients and some of them have interesting symptoms and neurological exam findings. When a student is presenting a patient who likely has Guillain-Barre syndrome, a nurse rushes into the room and tells you that a patient in the epilepsy monitoring unit just had a seizure. The patient is admitted for ictal-SPECT test, and the nuclear medicine student successfully injected the isotope in the beginning of the seizure. You assess the patient, who is post-ictal but stable. You call the on-call epileptologist, order the anti-epilepsy medication, and send the patient for the SPECT scan.

It is 10:45 a.m., when you are about to go back to join the round with general team, the stroke pager beeps. The stroke patient is at the Emergency Department room 2. You immediately go down to the emergency room and the consult resident is already there evaluating the patient. It is not a straight forward case, but finally you decide that the patient is a candidate for tPA. You order the tPA and report to the stroke attending.

Now it is around noon, and you are back to Lucy Library for the noon lecture. You don’t need to waste your time because the department provides lunch. Today’s topic is movement disorder phenomenology given by your program director, Dr. Lotia. The lecture ends at 1:00 p.m. You feel you learned a lot and enjoyed a delicious meal.

You have resident continuity clinic in the afternoon, so you take the elevator to the second floor of the Spine Institute and walk to the neurology clinic. On the television screen, it shows your first patient is in the exam room. You quickly review the chart and go see your patient. The patient presents with a first unprovoked seizure one month ago. You get a detailed history, perform thorough neurological exam on the patient, and leave the room to discuss the case with your attending. You and your attending go back to the exam room to discuss the management plan with the patient. You have six patients scheduled today, and five of them show up.

It is 4:30 p.m., and you just saw your last patient. You walk back to H8 work room. Residents have checked out to the short call resident at 4:00 p.m., but they are still in the room working on notes. You make sure everything has been taken care of, and then go home.

Yu-Ting Chen, M.D.No, the day is not over yet. Tonight, you will finish writing your clinic notes, read on some diseases you saw today, and start preparing for your lecture next week.  You will wake up tomorrow and may find yourself rounding with a stroke team followed by a quick session for the medical students and then reading up a review article on a newly approved MS drug. While there is some structure to the day, it’s the unpredictability that keeps things exciting.

Yu-Ting Chen, M.D., is from Kaohsiung, Taiwan and was a Co-Chief Resident in the Department of Neurology. He graduated from the program in 2018.