Anatomy of a Wards Team

The medicine wards team is the bread and butter of the teaching hospital. To understand the type of care you’re getting at a hospital, it’s important to know the roles of the various members whether you’re a patient or practitioner.

Medical Student

• Number per team: ~2
• Experience: 2-4 years of medical school, plus various incredibly fake Standardized Patient* experiences.
• Specialized role: dodging as much work as possible so that they can study for their shelf exams and actually learn something.
• Underrated abilities: taking incredible social histories, copy-pasting resident assessment and plans, asking how the page operating system works, asking attendings questions (to ‘show their interest’) that prolong rounds by ~20 minutes per question.
• Dies inside when: asked to obtain outside hospital records.
• Common line: agreeing with anyone on the team about anything.

*an actor is paid to memorize a spreadsheet of symptoms and repeat them when prompted. It’s not very realistic. I wish the simulated schistosomiasis was more Shakespearean. “Ahhh! Hark! Doctor! Woooee is me! Ere I sat, with naught but a care in the world, when perforce did a foul ache spring forth from my innards and rest in my side. Methinks mine humours have been wrent asunder!”

Intern

• Number per team: 1-2
• Experience: 1-12 months of actual responsibility.
• Specialized Role: discharging patients as soon as humanly possible.
• Underrated abilities: constipation management, Tylenol dosing, instinctively resisting nursing staff requests to give patients “something to sleep,” ability to cry very discretely when looking at social media and seeing people actually enjoying their lives.
• Dies inside when: a friend utters the phrase “what are you doing tomorrow?”
• Common line: introducing themselves to other residents as ‘doctor’ so-and-so, before realizing how douchy that sounds.

Resident

• Number per team: 1
• Experience: intern year, plus between 1-6 years of additional training.
• Specialized Role: actually knowing anything about how to help the patients.
• Underrated abilities: showing up to the hospital the latest and leaving the earliest, conjuring a morning report out of a straightforward admission, worrying at all times that your interns are killing your patients, retaining sanity during 28 hour calls.
• Dies inside when: discharges get delayed.
• Common Line: [to intern, morning of surgery, anesthesia calls and asks for the resident] “YOU MADE HIM NPO, RIGHT???”

Fellow

• Number per team: 0-1
• Experience: Brittany Spears said it best: I’m not a girl resident….. not yet a(n) woman attending / All I need is time / A moment that is mine / While I’m in between.
  
• Specialized Role: making you feel guilty for consulting their service.
• Underrated abilities: competently managing patients within their specialty, forgetting all medical knowledge not related to their field, being grossly underpaid.
• Dies inside when: consulted at 4:58 PM.
• Common Line: [to resident] Tell me about the one you just saw. In 4 seconds.

Attending

• Number per team: 1
• Experience: years and years. Team leader. Most senior member.
• Specialized Role: knowing how not to get sued.
• Underrated abilities: adjusting the entire team’s rounding schedule based on little Billy’s soccer practice, warping space-time to somehow know what to do with a patient before they are presented, boosting team morale with food (re: buying loyalty), elegantly dissing the other team’s management decisions.
• Dies inside when: they hear this before the one liner: “Ugh, this guy. Super complicated, he basically has everything. 6 admissions in the past 9 months….”
• Common Line: “Strong work, team.”