A Day in the Life of a Duke Anesthesiology Resident

Ifey Ifeanyi, MD, CA-1 Resident

The Categorical Internship

The PGY-1 experience at Duke is basically a transitional year that combines medicine, surgery, pediatrics, emergency medicine, intensive care, and elective rotations. One of the benefits of choosing the categorical, rather than advanced track, is the opportunity to familiarize oneself with the Duke system and getting to work residents in other departments.

The internal medicine rotations include one month of general medicine as well as subspecialty months of cardiology and pulmonary. There are two ICU months built into the year, one surgical ICU month and one pediatric ICU month. Most months are spent at Duke’s Main Hospital, but you also get to do rotations at Durham Regional Hospital (8 min. drive from Duke), and at the Durham VA Hospital (right across the street from Duke).

Here is a breakdown of the core components of the intern year as well as popular electives with brief descriptions to give you an idea of what to expect.

General Medicine: Rotation is at Durham Regional where there are more bread and butter cases (not the zebras so commonly found on the medicine wards at Duke). There are daily morning and noon conferences with great teaching. Call is q4. Team usually consists of a third year medicine resident, you, and medical/PA students. Rotation is typically 6weeks long.
Cardiology: This is a busy service with high turnover. There are several different services that comprise the CAD service (heart failure, heart transplant, consults, to name a few). You work closely with fellows and attendings, but there are several PAs to share the workload. A great rotation, you will learn a lot! Call is essentially q5 with one week of night float, so there are 2 interns on call every night with a hospitalist, fellow, or attending in house as well. This rotation has undergone several changes of late, all for the better. From midnight to 5:00 am you sign your pager over to the senior physician on call so that you can finish up admission notes, or go to sleep if you are all caught up.
Pulmonary: As an intern on pulmonary you will spend two weeks on general and two weeks on transplant. Team consists of you and a fellow. There are PAs on the transplant team and a nurse practitioner on the general team to help share the workload. Call is q4.
General Surgery: Rotation is done at Durham Regional Hospital. A very busy month, but a great opportunity to practice basic surgical skills, manage post-op patients, and get to know your surgical colleagues. The schedule is variable, some months q3, some months you work 12hr shifts alternating weeks of night and day shifts.
Surgical ICU (at the Durham VA): A great month. Patients are lower acuity than ICU patients at Duke, but there is much to learn with a lot of independence. Call is q3-4 with daily lectures.
Emergency Medicine: Great variety of cases and acuity. Some opportunities for minor procedures. Schedule varies, usually 4-5 shifts a week; 8-12hr shifts. Rotation is 4-6 weeks.
General Pediatrics: Interesting patients; lots of teaching. Team consists of an upper level pediatric resident and 2 interns or 1 intern and a nurse practitioner who will round with the team on post-call days to ensure you leave the hospital on time. Each team covers some general peds and usually one to two subspecialty services. Call is q4, rotation is 4weeks long.
Pediatric ICU: With the addition of the cardiac PICU, the general PICU (where you will rotate) has become a much more manageable month. You still have sick kids, lots of learning, great teaching, and many opportunities for procedures. Call is q4 with close fellow supervision. Rotation is 4weeks long.
Anesthesiology: An amazing month. You will get to know attendings, upper level residents, and your way around the OR. No call or weekends. 4 weeks.
Hyperbaric: Definitely a unique experience that few places but Duke can offer. The crew over at “the chamber” are fantastic and easy to work with. Learn all about hyperbaric medicine from experts in the field. A low-key rotation with home pager call on alternating weeks. Rotation is 6 weeks.