Internal Medicine Resident Life

One of the first things I noticed about Michigan’s program through my interview (even virtually) was how uplifting, supportive, and welcoming the culture felt. It was clear that both the residents and program leadership were genuinely invested in each other’s success. I was also drawn to the opportunity to learn from such wonderful and accomplished attendings who are not only excellent clinicians, but also wonderful teachers and mentors. One thing that surprised me about Michigan was how strong the multi-disciplinary team dynamic is - we have the opportunity to round with pharmacists, case managers, resident assistants, and so many other incredible members of the care team who help support all aspects of patient care.

I had never even stepped foot in Michigan before Match Day and was nervous to be so far from home - but now, as I enter my second year of residency, I am so incredibly thankful to be here. I have made the most amazing friends and have co-residents who are incredibly supportive and make even the hardest days of residency fun. My experience at Michigan has truly exceeded the wonderful first impression I had on interview day, and I couldn't imagine myself anywhere else! 

What I’ve appreciated most about Michigan is that the support here feels genuine. Residency is hard, and the program doesn’t pretend otherwise. When someone is having a difficult stretch, leadership checks in and actually follows through, whether that means helping with coverage, giving someone the time they need, or just making sure we have lunch and coffee on a busy day. The little things add up.

That same support carries into the people you work with. I’ve never felt like I had to navigate a difficult patient, procedure, or call alone, but there’s also plenty of room to take ownership and build independence. My co-residents genuinely look out for one another, and faculty are approachable and invested in helping you find mentorship that fits your interests.

The breadth of training is another huge strength. Michigan is such a large and specialized health system that there’s very little we can’t offer our patients in-house, and you’re constantly learning from people who are experts in what they do.

And coming from Chicago, I wasn’t sure how I would feel about living in a smaller college town, but Ann Arbor really surprised me. There’s enough going on that I never feel stuck, while still being an easy place to decompress after a long week. Between the training, the people, and the city, it’s ended up being a pretty great place to spend residency.

Medical School: University of Toledo College of Medicine and Life Sciences
Career Plans: Gastroenterology/Hepatology

Rotations on the GI/Liver (GIL) service offer some of the most fascinating clinical learning in internal medicine, blending advanced gastroenterology with high-stakes transplant hepatology.

Here is what a standard call day looks like on GIL:

Morning: Quick Commutes and Double Rounds

• 5:15 AM | Pre-Shift Fuel
  My day starts early. I throw on my scrubs, eat some breakfast, and brew my first iced coffee of the day. One of the best things about living here is the commute—my drive to the hospital is less than 10 minutes, giving me just enough time to listen to some Morgan Wallen and prep mentally for the day.
• 6:15 AM | Sign-Out & Chart Review
  I arrive at the hospital and take sign-out from the night team. Today I am on Early Call, which means I have two overnight admissions to learn about and evaluate. I deep-dive into Epic to review labs, vitals, and imaging before heading out to see my patients.
• 8:00 AM | GI Rounds
  We start by rounding with our gastroenterology attending. Today's bedside teaching focuses on pancreatic duct stones and identifying exactly when intervention is indicated.
• 9:30 AM | Liver Rounds
  Next, we transition to liver rounds with one of our transplant hepatologists. The acuity here is incredible—many of my patients are actively being worked up for expedited liver transplants. The highlight of my morning: learning that one of my patients was just officially approved to be listed for transplant!

Afternoon: Coffee, Conferences, and Advanced Teaching

• 10:45 AM | The Coffee Break
  After rounds, our attending generously takes the entire team to Einstein Bros. Bagels and buys us all coffee (which means iced coffee round two for me!).
• 11:00 AM | Order Entry
  Back in the team room, we hit the computers to put in our orders, coordinate with nursing, and officially log our consults for the day.
• 12:00 PM | Noon Conference
  We head over to noon conference for a delicious, catered lunch from a local restaurant. Today is a case-based learning session on Acute Respiratory Distress Syndrome (ARDS), presented by one of our chief residents with a critical care attending there to weigh in.
• 1:30 PM | Dedicated Hepatology Teaching
  Later in the afternoon, our hepatologist leads a dedicated teaching session. We discuss decompensated cirrhosis and the exact timing for transplant referrals. I am completely fascinated learning about the new perfusion technologies used to keep donor livers viable.

Evening: Late-Call Admissions and Post-Work Trivia

• 2:00 PM – 6:00 PM | Late-Call Window
  My senior resident lets me know a new admission just hit the floor—a patient experiencing an acute Crohn’s flare. Because my co-intern and I are on Late Call, we manage all new admissions coming in during this window (though we sometimes start earlier if the early-call team hits their volume "cap").
• 6:30 PM | Wrapping Up
  I finish writing my admission notes, update our patients' families on the plans for the night, hand off the list, and head out.
• 7:30 PM | Team Trivia Night
  Because it's Thursday, it's trivia night! I meet up with a big group of my fellow interns at a local spot to decompress. After a hard-fought game, our team takes home 3rd place and a gift card!

GIL is an intense, fast-paced rotation, but the balance of cutting-edge medicine, approachable attendings, and a supportive resident community makes it incredibly rewarding.

Medical School: Ohio State
Career Plans: TBD

My alarm goes off sometime around 5 a.m. The first one, of course, because I actually have multiple alarms.

Unfortunately, I am not the resident who wakes up for a run and then peacefully drinks a cup of coffee (although there are actually many residents who do that…they are my idols).

I am always ready to hear what happened overnight, though. I love checking in with the night team. There is always a medically interesting story, a bizarre story, and a touching story that reminds you why you did this in the first place. 

The latter is always my favorite. 

A co-resident tells me at 6:00 in the morning that a lovely daughter brought her mom to the hospital with complications from cancer. They are searching for a last-ditch effort. 

The most fun person I met at a bar during orientation week rattles off a differential during sign-out that I would’ve never even considered. I think, “How lucky am I to work with someone so brilliant?”

Coincidentally, she’s also the person who brought me a cake from Luca Pastry for my birthday a few months ago. 

I get to love people as my best friends and put all of my faith in them as physicians. I get to tell my patients they are being cared for by the people I trust most and really mean it. 

On pre-rounds, the patient’s daughter tells us she feels heard for the first time. My intern and I leave the room and immediately start talking through what else we can do. I shamelessly consult every team in the hospital, and despite TikTok tropes, they are more than happy to explore every option. 

Between consults, pages, and making my way down a couple floors to bring an Einstein’s vanilla latte to my best friend on a very tough rotation, I get a message from my amazing intern wanting to clarify their ideas for a plan. 

Being a senior resident is actually much different from being an intern, and I didn’t expect the transition to be so challenging initially. 

I am still thinking about everyone's potassium level, wondering if we supplemented them correctly or recognized the creatinine bump. More importantly, though, I’m wondering if my intern noticed the anxious shift in the room when we started discussing the plan for discharge. 

Most importantly, I’m wondering if my intern got lunch. 

When I send them downstairs to grab Palm Palace, I think about how it’s a huge cliche, but when someone asks why I love this program, I really do say “the people.” 

It’s impossible not to. 

I think about how my best friend spent extra time in a patient’s room every day after I rotated off-service to ensure my patient made it safely home with hospice. I think about my primary care patient who was admitted overnight by one of my close friends, who made sure to check in with me about the plan. I think about one of the most difficult rapids I have ever encountered, when one of my close friends, Eli, appeared beside me and helped me think, organize the room, and take care of the patient. 

That is what working here feels like. 

Never because anyone is in a hurry to leave, but because our compassion extends without limits. 

They also bring your favorite wine at New Year’s and bring a video camera for you to install to watch your pet on long shifts and learn about everything that you went through in the past with no judgement and infinite praise that you made it through.

And somewhere in all of that, we still manage to learn each other’s hobbies and quirks and go-to orders for doctors’ trays. 

We attempt to comfort each other through impossible experiences. 

And medicine is cruel, honestly. 

But I’ve never felt alone, not a single time.

One of the things I love most about inpatient medicine is that you really never know what is going to happen when you walk in. A patient who looked great yesterday suddenly doesn't. The pager goes off relentlessly. Someone needs an urgent bedside evaluation. An admission arrives at exactly the least convenient moment possible. A family needs a conversation that cannot–and should never be–rushed.

Sometimes the most important thing I do all afternoon is adjust the bed up two notches. Sometimes I explain a complicated diagnosis. Sometimes I change an antibiotic after getting culture results. Sometimes I debrief with a medical student about the first patient death they’ve experienced. Sometimes I get someone's dad a cup of coffee with 1 cream, ½ a sugar. Sometimes I tell someone they have limited days left on Earth. Not one of these tasks is more important than another.

Eventually, we sign-out. 

On a good day, we walk out of the hospital thinking, “We did some really great medicine today.”

On a hard day, someone sends a message to the group chat. 

“Walk?”

And nobody ever questions it.

We walk through Ann Arbor. We get coffee from Hyperion or ice cream from Blank Slate. We talk about the patient we can’t stop thinking about, the interaction that made us question ourselves, the thing we wish we had done differently. We tell each other that we did great. Or, at least, that we did the best we could. 

And then, eventually, we start talking about dating and families and vacations and whatever ridiculous thing happened last night.

There is not a single person here I wouldn’t trust to take care of someone I love, which may be the most important thing I can say about a residency program. 

Tomorrow morning, my alarm will go off sometime around 5 a.m. 

The first one, of course.

One of us will have been here all night. Someone else will be walking in with coffee. An intern will have a question. A patient will need something none of us anticipated. Someone will make us laugh at an entirely inappropriate time. 

And somewhere around 6 a.m., I’ll sit down for sign-out, with some of the smartest people I know, who have also become some of the people I love most. 

And I’m lucky enough to do that again, 

And again, 

And again. 

Medical School: Case Western Reserve University
Career Plans: Cardiology

Everything is a little funky on night shift, but the ICU night rotation is one of the most exciting opportunities to accelerate your clinical skills, autonomy, and medical decision-making.

Here is what a typical night looks like:

Afternoon: Pre-Shift Routines and the "Beta-Blockers"

• 4:30 PM | The Awakening
  My alarm goes off. Depending on how inspired I’m feeling, I’ll either head to the gym, scroll on my phone for way too long, or head out to my weekly rec league soccer game. Our team, the Beta-Blockers, is made up of residents, fellows, and partners, and we are a force to be reckoned with!
• 6:30 PM | Dinner (or Breakfast?)
  By the time I get home, I have just enough time to down some dinner, catch an episode of a show, brew a fresh pot of coffee, and head to the hospital.

8:00 PM: Handoff and the Night Squad

• 7:45 PM | Cafeteria Run
  I arrive at the hospital and head straight to the cafeteria to snag a late-night meal. We get a steady infusion of program-provided "Blue Bucks" (meal money) throughout the year, which completely covers my laziness. Tonight’s score: a Chicken Banh Mi.
• 8:00 PM | Sign-Out
  I head up to the ICU, link up with my intern, and meet with the day team for handoff. Our ICU night squad consists of two resident teams (each with one senior and one intern), with each team covering two of the daytime lists.

9:30 PM: Hectic Hours & Night Rounds

• 8:15 PM – 9:30 PM | Tying Up Loose Ends
  The first few hours overnight are always fast-paced. My intern and I review our patients and tackle any remaining tasks left over from the day shift.
• 9:30 PM – Midnight | Bedside Rounds
  We mobilize for night rounds by linking up with the other night team and the ICU fellow. We go bedside-to-bedside to discuss major updates from the day, solidify overnight care plans, and address any immediate concerns from the nursing staff.

12:00 AM – 6:00 AM: Procedures, Admissions, and Lulls

• Midnight | Procedure Teaching & Lines
  Tonight turns into a "line night." I spend the first hour after rounds supervising and teaching the other night intern on an arterial line. (Our program requires five supervised attempts before we can perform them independently and teach others). Next, I grab the fellow to supervise me while I place a dialysis central line on one of our patients. Only one more left until I'm officially signed off!
• 2:00 AM – 3:00 AM | The Midnight Blur
  The next few hours fly by as we tuck in two new admissions, manage acute issues on our existing patients, and refuel with snacks (thankfully, I grabbed that Banh Mi earlier).
• 3:00 AM | The Tater Tot Tradition
  We catch a perfect, brief lull in the action at 3:00 AM—just enough time to run down and grab some of the fresh tater tots the cafeteria puts out every night.

6:00 AM: Handing Back the Reins

• 6:00 AM | The Day Team Arrives
  We are greeted by some familiar faces as the day shift rolls in. We hand the existing patient list back over to them, leaving us an hour to finalize notes and care plans for our new admissions.
• 7:30 AM | Attending Presentations
  We gather with the day team to present the overnight admissions to the attending, wrapping up the shift with some high-yield clinical teaching.
• 8:30 AM – 9:30 AM | Shift End
  I leave the hospital around 8:30 AM and am fast asleep in bed by 9:30 AM.

Nights in the ICU are always hard to predict, but it is an incredibly rewarding rotation packed with procedures, teamwork, and massive growth as a physician!

Medical School: SUNY Downstate 
Career Plans: Cardiology

After wrapping up a demanding six-week stretch of busy inpatient work—two weeks on Barbosa (our Hospitalist Service), two weeks in the medical ICU (the CCMU), and two weeks in the Emergency Room—I was definitely ready for the lighter schedule that comes with an outpatient rotation.

This block, I started a custom elective designed to increase my exposure to Sports Cardiology, cardiomyopathies, and arrhythmias. About a year ago, I reached out to my APD, Dr. Virginia Sheffield, and our Program Director, Dr. Sarah Hartley, about my interest in this niche field. They immediately tapped into contacts across the medical center to help me build a dream rotation. Combined with connections I made during my intern year on our Medicine Coronary Service, we put together an incredible two-week experience.

Here is a look at how my rotation came together:

The Reading Day: Building the Foundation

Outpatient electives here include dedicated reading days set aside for independent education. I used mine to get a head start on the science:

• 9:00 AM | Morning Routine: I woke up, hit the gym, and sat down with sourdough toast and a hot coffee.
• 10:00 AM | Diving into the Data: I opened my laptop to master the International Criteria for the Interpretation of ECGs in Athletes. My current research actually involves the upcoming 2025/2026 updates, but since those won't be published until later this fall, I focused on solidifying my understanding of the current criteria.
• Interactive Practice: I spent a few hours working through an online trainee ECG quiz created by the authors, practicing how to differentiate normal athletic changes from borderline or outright pathological findings.

Thursday: Screening Michigan Athletes

Because I live near the University of Michigan Sports Complex, I got to walk to work—as a former New Yorker, I deeply miss commuting by foot!

• 8:30 AM | Reading with the Team Cardiologist: I spent the day reading athlete ECGs with Dr. Tim Cotts, an adult congenital cardiologist who serves as the team cardiologist for the Michigan Athletics Department.
• Real-Time Triage: Throughout the day, team medical staff popped into our conference room to consult on athletes presenting with concerning symptoms like exertional syncope, murmurs, or a family history of sudden cardiac death.
• Advanced Workups: When we identified pathological findings using the International Criteria, we collaborated with the sports medicine staff to order follow-up testing (echocardiograms, cardiac MRIs, or stress tests) and navigate the high-stakes decision of whether an athlete could safely continue practicing while awaiting results.
• Stepping into the Teaching Role: A medical student joined us midday, and I spent time teaching him our general hospital approach to ECGs versus the highly specialized athlete criteria. I honestly surprised myself with just how much I had internalized through my research and reading earlier in the week!

Friday: Learning from the Guideline Authors

After reviewing hundreds of athlete ECGs, I headed home, worked out, and spent the evening reviewing the 2024 ACC/AHA Hypertrophic Cardiomyopathy (HCM) Guidelines.

The next day, I was in the HCM Clinic with Dr. Sara Saberi—who happens to be a primary author of those exact national guidelines! It is an unbelievable experience to see your attending’s name printed on a major guideline document on Thursday night, and then practice applying those exact algorithms alongside them in clinic on Friday morning.

My Key Milestones & Takeaways

By the end of this two-week elective, I gained far more education, experience, and inspiration than I ever expected. I was challenged to:

• Evaluate dozens of patients with complex HCM, arrhythmias, and rare cardiomyopathies.
• Consider first-line management choices for LQT1.
• Discuss the nuances of genetic testing for a patient presenting with hypertrophic findings in their seventh decade of life.
• Calculate risk scores to determine exactly when an ICD is indicated for primary prevention of sudden cardiac arrest.
• Apply the International Criteria directly to active U-M athletes, fulfilling the exact goal I set for myself a year ago.

I had an absolute blast on this rotation and honestly wasn't ready for it to end. It completely reignited my passion for Sports Cardiology while sparking a brand new interest in the management of HCM. I am incredibly grateful to our program leadership for helping me cultivate my specific career goals and providing opportunities that wouldn't be possible anywhere else!

Medical school: Medical College of Wisconsin
Career Plans: Hematology/Oncology

Coming into residency with almost no prior inpatient hematology/oncology experience, I wasn't sure what to expect—but I have absolutely loved my time on this service! This rotation exposes you to a broad spectrum of medicine and state-of-the-art treatments, from inpatient chemotherapy for leukemias to managing complex internal medicine complications like infections or bowel obstructions.

Here is what a typical day looks like on the hematology/oncology service:

Morning: Prep and Scenic Commutes

• 4:45 AM – 5:00 AM | Wake Up & Scope the List
  My alarm goes off, and I check the Haiku app (the mobile version of Epic) to see if any new patients were admitted to our team overnight. Admissions split between two dedicated Hem/Onc teams, taking call every other day.
• 5:15 AM | The Drive to Work
  I throw on some scrubs and enjoy the drive. One of the best things about Ann Arbor is the beautiful, scenic nature—even in the early morning. I listen to music or put on a medical podcast if I'm feeling extra ambitious.
• 5:40 AM | Fueling Up
  After a quick five-minute indoor walk from the parking lot, I use my program-provided "Blue Bucks" to grab an Einstein bagel from the cafeteria and a hot chocolate from the House Officers lounge.

Mid-Morning: Sign-Out and Interdisciplinary Rounds

• 5:45 AM – 8:00 AM | Pre-Charting
  I head to the team room to take sign-out from the night resident. Admissions on call days are split between two interns: Early Call handles overnight admits up until 2:00 PM, and Late Call covers 2:00 PM to 6:00 PM. Our senior resident is always there to supervise, teach us management steps, and help us navigate patient care logistics. I then "pre-chart" by checking labs, vitals, and medications to prepare my notes.
• 8:00 AM – 10:30 AM | Dual-Attending Rounds
  Heme/Onc is unique because we round with two separate attendings: a hematologist and an oncologist. Rounding alongside pharmacy colleagues, medical students, fellows, social workers, and resident assistants brings incredible on-the-spot teaching. We discuss plans, walk the floors to examine patients as a team, and wrap up around 10:30 AM to place orders and call consults.

Afternoon: Mid-Day Learning and Task Management

• 12:00 PM | Noon Conference
  We head to our noon conference to work through board practice questions, learn about specific conditions, or discuss unique program initiatives. It’s always catered (free food!), and it’s the perfect midday opportunity to catch up with co-residents on other services.
• 1:00 PM – 4:00 PM | Patient Care & Wrap-Up
  Afternoons are spent finishing up tasks, checking in on patients, and taking new admissions with the senior resident. Program leadership—who are genuinely the nicest people—frequently pop by the team room to drop off snacks and check in on us.

Evening: Handover and Work-Life Balance

• 3:00 PM – 5:00 PM | Sign-Out
  If you are on Early Call or Non-Call, you sign out to the Late Call intern between 3:00 PM and 5:00 PM, passing along overnight "to-dos" and things to watch out for. This opens up plenty of evening time to explore Ann Arbor, work out, cook, or spend time with family.
• 6:00 PM – 7:00 PM | Late Call Cross-Cover
  The Late Call intern takes admissions until 6:00 PM and provides cross-cover for the service until 7:00 PM.

Weekend Workflow & Time Off

Weekends look a little different! Rounds usually wrap up around noon, giving us a lot more time to decompress. Plus, we get one full day off per week during these rotations to completely recharge.

Overall, this service has been an incredibly fun, exciting, and educational rotation. It gives you the perfect balance of clinical independence, strong senior support, and the chance to work alongside amazing people!