Internal Medicine Clinical Postings hospital ward

Note: The exact timings may vary slightly for different specialties, but generally this what a typical day looks like.

Morning: Ward Rounds

The day begins at 7:30am. For HOs and MOs it’s even earlier (there were times I reached at 7am and they were all already there typing on the computers). They will “pre-round” on selected patients, update patients’ notes etc.

The Consultant comes in later, at around 8:30am. This is also when the morning rounds begin. The HOs/MOs push the COWs (computer on wheels) to the patients’ beds following the team’s patient list.

At any one time, there’s typically four people—the Consultant, one Registrar, and two HOs/MOs (plus two COWs)—gathered at the patient’s bed.

Ward rounds involve the HO/MO giving a verbal update of the patient’s progress (especially overnight events, if any). This is a concise report where the salient points are highlighted. The Consultant will review the notes and charts, and proceed to see the patient. The interaction is usually efficient; only the few questions and physical examination steps pertinent to the case will be performed.

Ward rounds can end anywhere from around 10:30am to past 12pm. It all depends on the patient load and the time taken at each patient’s bedside.

Typically we then leave the wards and head for lunch.

Afternoon: Tutorials or Self-Study

In the afternoons, the doctors will do exit rounds. Instead of walking around the wards, this time they sit in front of their computers and go through all the updates (investigations, management plans, etc.) for each patient.

We don’t join for exit rounds but instead have tutorials with our Core Tutors or self-arranged tutorials. Sometimes we squeeze in shorter 1-hour tutorials before lunch too. These tutorials can be either bedside tutorials or didactic teachings.

We can also go on our own to examine or clerk patients. This is not only for us to see more conditions and signs, but even more so to practise our physical examination and history taking skills.

If there are no tutorials or other activities, we can choose to self-study. (Although it always seems like there’s a lot of things going on. There’s never enough time to study, honestly. Too much content, too little time, and too little sleep.)

The time we end is very variable. The earliest possible would be just after lunch, although we usually end in the late afternoon, around 4-5pm, or even 6pm.

Rotating in the Different Internal Medicine Specialties

To see more of what the different Internal Medicine specialties are like, check out the posts below (more to come!)