The residents typically come in at 5:30 a.m. to pre-round on the ICU patients as a team. The residents and senior staff then meet in the NICU at 7a.m. for patient radiology rounds followed immediately by patient rounds in the ICUs and on the IPD units. The operating room begins at 8 a.m. with four to five rooms running daily except Wednesday when the neurosurgery operating rooms begin at 11 a.m. after the academic sessions. The operating days is usually done by 6 p.m. when the chief residents will paper round with the junior residents. The chief resident on-call comes in for any emergency cases that arise during the night.
The junior residents who are not on-call that day have no floor responsibilities. The on-call junior resident (assisted by four Physician's assistants) is responsible for evaluating ER and IPD consults, admitting patients from clinic, assisting the ICU teams with ICU management and overseeing the IPD floor work, the bulk of which is done by the four PAs.
The junior residents have no out-patient clinic responsibilities. The chief resident on the HFH Oncology/Spine/Epilepsy service spends one day a week in the out-patient clinic with Drs. Kalkanis and Rock and the chief resident on the Vascular/Spine service does not go to the clinic and is free to cover the operating rooms five days/week. When rotating to the West Bloomfield Hospital neurosurgery service, the PGY 6 senior residents cover the Vascular, Spine, Tumor and Functional services.
Wednesdays are the designated academic days and all but emergent surgical cases start at 11 a.m. after the conferences are done.