Meet Evan Edwards, a third-year MD student at Feinberg School of Medicine. Join him for "a day in the life" on the surgery clerkship.
4:00 a.m.
My alarm goes off. Oof, that’s early. Don’t worry, once you get into the routine, it’s not so bad.
4:30 a.m.
I head to the kitchen and pour some coffee that I made the night before. I’ve been told I consume a LARGE volume. Then I pop a waffle in the toaster and make my signature waffle-peanut-butter-banana taco, which I eat while the electronic health record boots up on my computer. I’m currently on the otolaryngology (ENT) service as part of my surgery clerkship which is a required clerkship you take during your third year at Feinberg. Before heading to the hospital, I like to get a sneak peek at our patient list to see if there are any new patients or if anything acute happened overnight. And now I need to get going to the hospital to pre-round on my patients.
4:45 a.m.
My wife and I live in River North, an adjacent neighborhood to Streeterville where Feinberg School of Medicine and Northwestern’s main hospitals are located. From pressing the down arrow on the elevator in my apartment building to arriving at the hospital, it takes me about 12 minutes to walk there. I cross over Chicago’s Magnificent Mile, which is usually bustling with tourists, but not at this hour!
5:00 a.m.
I arrive at Northwestern Memorial Hospital, change into jade green scrubs from the scrub machine, and head up to the ENT workroom to finish off preparing the team’s list of patients. Looks like all our patients are doing well, so I update the list with fresh labs, follow up on tests we ordered, and update any other outstanding to-dos for the patients.
5:30 a.m.
After I’m happy with my updates, I go see the patients to check in on a few I’m following (i.e., taking a bigger role in their care). This gives me a lot of helpful information to reflect on so I can practice my clinical reasoning and oral presentation skills on rounds.
6:00 a.m.
Time for rounds! On surgery, it’s speedy—just the way I like it. The chief resident (PGY-5) leads the team (me, intern, PGY-4) down the list, checking in on our post-op and consult patients. After rounds, the chief will discuss the plan with the attending and send out any updates to the rest of the team.
7:00 a.m.
Now that rounds are over, it’s time to head to the pre-op area to meet the patient for the first case of the day. After introducing ourselves, the surgical team goes through the consent process with the patient by explaining the risks, benefits and alternatives to the surgery they’re about to have. Usually, this has already been discussed earlier at their clinic visit, but going over it again gives the patient an opportunity to ask any questions they have. It’s also a great learning opportunity for me.
7:30 a.m.
Now it’s time to roll back with the first case for the day! Today, I’ll be with Andrew Stein, MD, assistant professor of otolaryngology. We’re doing a rigid esophagoscopy and balloon dilation of the cricopharyngeus muscle today. Basically, the muscle at the top of the patient’s esophagus is too tight, causing him to have trouble swallowing—or dysphagia. After getting the patient off to sleep and intubated, the first part of the surgery involves visualizing the entire esophagus with a long metal tube (esophagoscope) to make sure there aren’t any structural abnormalities further down. Then we pass a deflated balloon through the mouth to the opening of the esophagus, inflate it and allow it to dilate the opening. Hopefully, the patient is able to swallow a little better after this!
9:30 a.m.
After we wake the patient up, we get the patient to the PACU (post-anesthesia care unit) for recovery. Typically, at this point, I’d go and pre-op the next patient, but today’s a little special. I have to get changed out of these scrubs for my next commitment.
10:00 a.m.
Today, I’m presenting a research poster at the Institute for Public Health and Medicine’s Population Health Forum and Poster Session. The poster contents are derived from a project I worked on during my second year at Feinberg with the other members of my Education Centered Medical Home (ECMH). The ECMH program provides students with early and comprehensive educational exposure to team-based medicine in an authentic outpatient environment. During M2 year, as part of our Health and Society curriculum, we develop and implement with our ECMH a Community and Health Advocacy Initiative (CHAI) as a team. Our project was on promoting safe gun storage practices of patients in our clinic. We partnered with the Chicago Police Department to obtain firearm locks and have been distributing them to patients who screen positive for unsafe storage practices. During the poster session, it was great to chat with faculty, other presenters, and visiting public health experts about the difference we were making for our primary care patients!
12:00 p.m.
After the presentation, I grab a quick lunch from my locker and check back in with my team. The residents are phenomenal here at Northwestern. Despite being extraordinarily busy, they also really enjoy passing their knowledge, tips and tricks down to the medical students. They frequently do short informal teachings that, after an entire year of clerkships, really add up to some valuable lessons!
This afternoon, all M3 students across the different clerkships are getting together for classes called Integrated Curriculum of Phase 2 (or IC2). These sessions happen once a month during M3 year and are a great way to reconnect with my class. Today we’re having some career development sessions and a lecture about implementing data-driven improvements to help us work on our Quality Improvement (QI) project. The QI project is an M3 initiative that focuses on developing an intervention to improve the quality of patient care within our ECMHs. My ECMH has chosen to increase the proportion of our patients we screen for social determinants of health. This lecture helped us refine our approach by teaching us how to accurately measure our impact.
4:00 p.m.
One of the last parts of IC2 is a college meeting. Fletcher college is made up of 20 classmates who I’ve spent the most time with over the last three years. I really look forward to this, specifically, at IC2 because it feels like coming home. Today, Dr. Michelle Fletcher (our college faculty mentor) organized an activity called "Heart Seat" where college members take turns delivering compliments to a chosen individual for that day. And wouldn’t you know... today was my turn.
I try to prioritize a little bit of every evening to relax, play with our pet ferret (Draig), and watch some TV with my wife. It’s a busy day, so my wife often has to nudge me to stay awake at this point. We watch a lot of "Critical Role," a show where professional voice actors get together and play Dungeons & Dragons (D&D). It’s a shared interest between us and the rest of our weekend D&D group—so we try to keep up to date! D&D is a regular weekend activity for us, along with making waffles for the week every Sunday morning.
9:00 p.m.
Today was such a great day. I appreciate you reading along to join me on it. Before turning in, I set my alarm for 4 a.m. They keep me busy, so I’ve never had trouble falling asleep since starting the surgery clerkship. Zzzzzz...