A Day in the Life of IR Residents

January 18, 2019 by daf4a@virginia.edu   |   Leave a Comment

A Day in the Life of IR Residents

Yasser El-Abd (fourth year) and Sara McCann (third year), UVA Interventional Radiology Residents, say they have both gained many valuable experiences from their time in this residency program. The program is collaborative and flexible in nature, designed so that residents learn as much as they can in the time they spend with attending physicians, fellows, and other residents. Sara and Yasser gave us some inside details on what their days “on service” look like.

6:30 – 7 AM: PREPARATION IS KEY

Still shaking off sleep, Sara and Yasser arrive at the hospital bright and early and make their way to the Radiology Department. They both grab a pair of grey scrubs from the scrub machine and head back to the IR Reading Room. This is time for residents to clear their heads, get focused, and prepare for the day.

Both residents sit down at their stations and start looking up labs. The schedule for today is up on a large screen on the wall and the residents chat with one another about which rooms they think they’ll cover today.

The IR department has seven procedure rooms, which allows each fellow and resident on service to have their own assigned room. This means that residents have plenty of cases to experience and learn from- a huge perk of the program!

They pick their rooms and start looking up information about their patients and procedures. Soon the residents will be presenting their patients to the on-call attending physician. Preparation is key to ensure that they are aware of any potential patient issues and can discuss any anticipated challenges with the attending prior to the procedure.

The two residents munch on their breakfasts and listen to some music as they work. Soon it is just before 7, and both residents head upstairs to briefly visit their patients from the prior day before lecture to make sure their recovery is going well.

 

7 – 7:45 AM: LECTURE

The morning schedule includes time for a lecture where the residents review interesting cases and solidify key concepts. Dr. Fritz Angle, the attending on call today, walks in and the residents pull up chairs around the projector screen in the IR reading room. Dr. Angle pulls up a complex case from the other day and calls on Sara to scroll through the images and describe the findings. Yasser takes over next and is asked to give the diagnosis and possible treatment options. A fellow then goes through the steps of the procedure and answers questions about potential challenges.

Sara and Yasser both love this collaborative method of dissecting cases. Because the discussion is geared to each resident’s level of knowledge, it allows everyone to learn from each other and receive educational benefit, whether a first year resident or IR fellow.


7:45 – 8 AM: RUNNING THE BOARD

Once the attendings and residents wrap up the lecture, they move on to “running the board.” Nurse practitioners and techs join them in the reading room to discuss all the patients scheduled for IR procedures that day. As the attending “runs the board” patient by patient, each resident quickly briefs the group on all the particulars surrounding their case.

Sara and Yasser both pull up notes for their patients and anxiously wait for their turn to present. For each case, they rattle off the patient’s medical history, the reason for their procedure, prior imaging findings or procedures, and the plan for the patient today.  They will also discuss any potential patient or procedural issues. “And ALL of this occurs before 8 am,” says Yasser with a laugh.

8 AM – 5 PM: SCHEDULED CASES

Just like that, it’s time to get today’s cases started. As patient’s arrive, they are directed to the pre-procedure area. Yasser and Sara look to the board to find where their first patient’s are located and head off to meet them. They head into the room and give a friendly introduction to the patient and any accompanying friends and family. They then go over the patient’s medical history, perform a focused physical, answer any questions, and review the  consent form for the procedure.

Next, they let the nursing and tech staff know the patient is ready, and the nurse brings the patient back to the procedure suite. Sara and Yasser assist the techs in prepping and draping the patient. Finally, the attending enters, and the entire team does a final “time out,” which is one last safety check with the patient before the procedure. The nurse administers medications to keep the patient comfortable during the procedure and the resident and attending work together to complete the case.

Yasser eagerly explains that he enjoys training at UVA  because of the level of resident involvement and collaboration during cases. As a resident, he is able to take part in a wide variety of cases and is given the autonomy to perform a large portion of procedures on his ownall under the attending physician’s supervision.

At the end of the procedure, the patient is brought back to the post-procedure area for recovery. The residents accompany the patient back to the post procedure area and then head back to the IR reading room to dictate the case. Shortly after, they head off to the pre-procedure area to meet their next patient and to check in on their first patient.

As Sara and Yasser go from case to case, they take a break and grab lunch or a snack when they can. They explain that while their schedule is fast-paced, it also can be flexible. If time allows, they try to join in the daily lunch lecture in the department auditorium and catch up with some of their diagnostic colleagues.

5 PM – 6 PM: TEAM ROUNDS

When the IR cases are done for the day, Sara and Yasser join the fellows and the attending on call for team rounds.  The crew of residents and fellows present their patients from the day and any consult patients they are currently managing to the IR fellow and attending on call to ensure any follow-up plans or concerns for overnight are communicated. Next, they head out as a team to see any of the IR patients who will by staying overnight.

During this time, they also see any old or new consult patients that were referred to them from other doctors in the hospital. This is another opportunity for the attending physician to offer teaching points to the residents regarding the patients they are visiting. Yasser mentions that  many of the doctors at UVA highly value the opinion of the interventional radiologists, so it’s always a great experience for residents to follow along.

 Sometimes, this portion of the day can go longer, but Yasser and Sara confidently say that it is worth it. They love ending the day with this team effort as well as interacting with other departments within the hospital. It has been a long day, but one full of challenges and growth. Sara and Yasser look forward to many more days on IR service during the remainder of their residencies.

 

 

 

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