About the Medical College of Wisconsin Internal Medicine-Pediatrics Residency Program
Program Mission Statement
About our Program
Intern on Medicine Wards
Keegan Sammons, MD
5:15-6:20 a.m. My first alarm rings! Hit the snooze button at least a couple times (usually more like 4 or 5) and literally risk it all for those sweet 9-minute chunks of interrupted sleep. When I muster up the courage to get out of bed, I start the morning with a sip of cold water and then jump in the shower. I’m typically freezing at this point in the morning regardless if it is cold outside, so I’ll sometimes turn the heat up 1 degree in my apartment, but ALWAYS throw my scrubs in the dryer. This is a big pro tip. While I drink a quick coffee and get a bite to eat, I’m packing lunch before I head out for the day.
6:20-6:45 a.m. I live in Walker’s Point, and I leave around this time to make sure to be on time for sign out at 6:45. It’s roughly 12-15 minutes to get to campus if there’s no traffic, and at this time of day, it’s rarely an issue. There are several options for covered parking, but for Froedtert wards I use the children’s corporate garage, which is right across the street. If it’s nice out, I’ll walk outside, but there’s also an underground tunnel for when it is cold/rainy!
6:45-8 a.m. Obtain sign out from the night team! Apologize for anything they shouldn’t have had to deal with, and then start pre-rounding on my patients! Taking note of any pertinent overnight events, vitals, labs, etc. Try and come up with a tentative plan for each patient before I go see them in person.
8-9 a.m. Go see all my patients! I try to keep these interactions brief and to the point, but sometimes get thrown a curveball and have to investigate a little deeper. Check in with the med students to clarify any questions about the plan and make sure they feel prepared for their presentations. Usually bounce some thoughts off my senior before rounds!
9-10:30 a.m. Now we round with the whole team! Depending on the attending, we usually do either table or hallway rounds. Some do a hybrid of both! On weekdays we almost always have pharmacy with us which is CLUTCH and saves me so much time and future phone calls on my mistakes.
10:30 a.m.-12 p.m. HYDRATE and likely eat a snack as we are running the list after rounds!!! This is where all the action for the day starts: putting in orders, discharging patients, calling consultants! Lots of phone calls regarding logistics, coordinating follow ups and updating families on their loved ones.
12-1 p.m. Unless we are actively admitting or discharging a bunch of patients, I’m usually caught up on tasks and able to make it to noon conference. This is dedicated time each day where either the chiefs or fellow residents will present a case and discuss relevant learning points. This is a great time to see and catch up with friends that are on the opposite I/O schedule from you!
1-4 p.m. Continue with any work (notes, phone calls, etc.) that wasn’t finished prior to noon conference. Follow up on various labs, imaging, and consultant’s recommendations. I try to see all of my patients again in the afternoon if time allows. Towards the end of the afternoon I’m making sure loose ends are tied up, tucking my patients in for the rest of the day, and predicting any issues that might come up overnight. Meanwhile, updating the hand offs for the night team. At Froedtert, the resident team that is on 28-hour call takes sign out.
4-5 p.m. Sign out to the night team! At Froedtert, sign out on non-admitting days is at 4p during the week. Not common, but if I still have any notes or discharge summaries to write I will finish them before leaving because I do not take work home with me.
5-6:30 p.m. Usually some sort of work out! I consistently feel more energized when I have a workout routine, so I really try to prioritize any type of physical activity after work. I have a nearby gym membership that I frequently use for weights. My apartment has a small gym with a Peloton that I’m extremely thankful for. Some days when it’s nice outside I’ll just go for a walk on the lakefront.
6:30-8 p.m. Decide what I want to do for dinner and make it happen! I generally cook something at home, but will occasionally get take-out or meet up with co-residents for a quick bite. When at home, I’ll typically will watch some sort TV while eating or catch up with family on the phone.
8-10 p.m. More lounging around the couch. Sometimes do a little academic reading if my brain can handle it at this point in the day, otherwise I’m usually watching TV, doing some light reading/catching up on emails, or watching cooking videos on YouTube. By 9:30 or 10, I’m getting ready for bed, frantically check that I set all my alarms before lying down, and repeat it all in the AM!
Intern on Pediatric Wards
Taylor Orcutt, DO
5 a.m. I wake up and turn off all of my billion alarms. My dogs are crazy and very happy that it’s time to go outside (especially when they can play in the snow). Some mornings I’ll take them for a quick walk around my neighborhood if I wake up in time. I’m a throw on my scrubs and go kind of gal, so mornings are usually pretty quick. Maybe I’ll make breakfast, maybe I’ll grab an energy drink before heading out the door depending on the vibes.
5:30 a.m. (maybe closer to 5:40 a.m. if I’m being honest) Drive to the hospital! Thankfully there are very few other lucky people on the road at that time, so it’s usually a pretty easy drive (not that traffic here is ever super bad). I think to myself how nice it is to have covered parking with a skywalk if needed to not have to walk outside in any bad weather, before heading up to the team room.
6 a.m. Then it’s time to get sign out from the overnight intern about any overnight updates and/or admits before sending them home to get some rest. Pre-rounding can vary depending on the team census, but this is the time to pre-chart. I usually start notes here and write down important info on my list (in my color coded system) to give patients and families a little more time to sleep. Checking in on patients, answering any parent questions, and addressing concerns is next on the agenda. I’ll also either bring a med student with me or touch base after they see their patients independently to discuss their thoughts on assessment and plans to make sure we’re all feeling comfortable for rounds.
7:45 a.m. Intern morning report! This is a time led by a chief resident when all of the wards interns and medical students get together in a conference room to go over a case. It’s also a time to practice presenting a patient to a large group if the patient selected happens to be yours. We get comfortable working through differentials for a wide range of things from bread and butter to zebras. I also love the opportunity to learn from my co-interns and the way they approach things.
8:45 a.m.-ish Time for family-centered rounds, which is something that is really valued on the peds side. We’ll usually go into the patient rooms with the whole team or have the family step out in the hallway to go discuss patient status and plans all together. We have nurses, case managers (who help with discharge planning), pharmacists, dieticians, and sometimes more join us to ensure an interprofessional approach and help us manage all the different aspects of patient care. This is also a time to help fellow team interns out by placing orders in real time as things are decided. The attending and senior resident will try to add in any relevant teaching as the opportunity arises.
11 a.m. The goal is to finish rounding by now to give time finish up post rounds tasks like placing additional orders and talking with any new consultants to give them time to provide recommendations. If I’m lucky, maybe I can sign notes before lunch too. This is also a great time to give med students feedback on rounds and presentations.
12 p.m. Free lunch! A definite benefit on the peds side is the free lunch. It alternates daily between various salads and sandwiches (I’m a salad day person but some may disagree, and sometimes on Fridays there’s pizza). There’s also usually some kind of dessert which is another a plus. We have noon conference daily, which can range from different didactics, case presentations, board prep, etc.; it’s always something new. Friday noon conferences are unbiasedly (probably biasedly) the best because it’s MedPeds conference!
1 p.m. Back to the team room for the afternoon. I’ll usually try to finish notes asap if not already done. We typically get most of our admits in the afternoon, but really they can come at any point during the day so you just kind of go with the flow. Lots of communication with nurses on our Voalte phones happens here too. I’ll also follow up with any consultant specialists, finalize any discharges, and try to get things settled before the night intern comes in.
5 p.m. Time for sign out! There’s one intern on each team assigned to a week of nights. The goal is to efficiently and effectively discuss any pending to-dos and provide contingency plans for any issues you think might arise overnight. This is also the time to staff and tuck in any late afternoon admits. I don’t like to take work home, so I’ll stay to finish any notes or last minute things.
5:30 p.m.-ish After work, my evenings can be super variable. I usually try to be active in some way, whether that’s stopping by the gym on my way home, taking my dogs for a walk, or playing volleyball (fun fact the team I was on with some other peds residents did win our league this fall). If I’m not cooking dinner with my husband, I like to try to hang out with friends either at dinner or maybe a Bucks or Brewers game. Otherwise, maybe I’ll study, maybe I’ll scroll on Instagram or TikTok for a while to unwind.
10 p.m.-ish Get ready for bed and cuddle with my dogs! I’ll also check a million times that all of my alarms are set for the morning. Then it’s back to the grind in the morning.
Senior Resident on Medicine Wards
Chris Wagner, MD
6 a.m.: I usually wake up and get ready for the day. Throw on some scrubs and make sure I have my ID badge, stethoscope, and caffeine.
~6:30-7 a.m.: Leave my house and head to the hospital. I live in one of the suburbs, so it takes me about 20 minutes or so to drive in.
7-9 a.m.: Pre-rounding time. I get sign out from the team that was covering overnight or touch base with the intern on the team if they already got sign out. Then I usually review other overnight events, morning labs, and vital signs before I go and see our team’s patients. I prioritize seeing the sickest patients on our list and potential discharges for the day. I usually try to run plans with medical students or interns if they have questions.
9 a.m.: Typical round starting time. The attending will often have preferences about either table rounding or walk rounding. I am a firm believer in table rounds and seeing the sickest patients as a team if need be, so I generally advocate for them from an efficiency stand point. In either case, we discuss the updates with our attending and decide on a final plan for each patient on the list. The senior resident ideally runs rounds and keeps the team focused on meeting patient’s goals and working towards discharge.
On call days (every 4th day at the VA or every 5th day at Froedtert) we start taking patients as early as 8 a.m., so during rounds there are usually 1-2 patients that come our way. Taking the accepting all and placing basic orders is often a job I can do as my interns present our established patients.
11 a.m.-12 p.m.: Post-Round work time. We will get back to the team room and start ensuring that we have all of our orders in and consults called. (Part of the beauty of table rounds is we can make sure we enter orders as we work.) I often use the whiteboard in the team room to make a shared “to do” list which we divvy up tasks from and are all able to see what has been done already. I find this is a good organizational tool which makes it easy to split up tasks between the team.
12-1 p.m.: During the weekdays, this is protected educational time so we can go to noon conference. Attendings and nursing staff are supposed to know that this is our protected time and so usually do their best to give us the hour to eat and get some education in.
1-4 p.m.: This is more time to finish up items on our to do list, such as following up with consultants or getting labs or imaging back. If we are on call, usually we will get a few more admissions during this time which we will go see and talk about as a team. I try to do some teaching about pertinent things for our team’s patients during this time and often attendings will stop back to teach as well.
4 p.m.: Sign Out! If we aren’t on call, we sign out to the on call team. If we are on call, the intern who is spending the night and I will get sign out from our colleagues on the other medicine teams.
4:30 p.m.-1:30 a.m.: Overnight, our team is a senior resident and an intern (sometimes with a Sub-I). We finish taking admissions while we do cross cover for the other teams who are home sleeping.
1:30-5:45 a.m.: At 1:30 we stop taking admissions if we haven’t already capped. The rest of the night we wrap up stuff for our admissions and we try to get some sleep in between cross cover pages.
5:45-6:45 a.m.: I usually am up and pre-rounding on our list, making sure things still look good and being around to answer questions for the interns and medical students.
6:45-7 a.m.: We sign out our cross-cover patients back to their respective teams.
7-10 a.m.: Post-call rounds start at 7, so we can prioritize getting the post-call senior and intern out safely before duty hours. The intern who was not on overnight (the “sweeper”) pays close attention to the plans for all the patients. When rounds are finished, the post-call team will try to get things set up for the sweeper before signing out. Early in the year an additional senior comes in off of an elective to help the sweeping intern get through everything and to answer any questions.
Then, drive home safely and get some sleep. Our program has a sweet deal where if you don’t think you can drive safely we can get an Uber (or other method) home and get reimbursed both for the ride home, but also for the ride to get us back to our car later.
Senior Resident on Cardiology Elective
Rebecca Rings-Miller, MD
5:45 a.m.: Alarm goes off, I shamelessly hit “snooze” a couple of times and probably actually get up at 6:00. I throw on my scrubs and make sure I’m downstairs in time to sit in the swivel chairs by our living room window to sip coffee slowly and watch neighbors walk their dogs. I’m a little spoiled since my home-barista husband usually makes the coffee, and we have two cats who have “morning chair time” built into their internal clocks. They sit on our laps and watch the birds, which usually threatens to make me late because it’s hard to move them.
6:35 a.m.: Out the door! From my house in Bay View it will take me 15 minutes to the hospital, my favorite part of the commute is driving over the yellow Hoan Bridge on 794. You get a beautiful view of the sunrise on the lake, which projects pretty colors on the glass Northwestern Mutual building downtown. My radio is set to 88.9 Radio Milwaukee, which highlights a lot of local Milwaukee artists and keeps me updated on local events, concerts, etc. I get to Children's Wisconsin in time to stash my things in the resident lounge, say hi to some of the senior residents on inpatient wards who are pre-rounding in the lounge.
7 a.m.: I meet the cards fellow at the morning fellow lecture. We spend an interesting hour sipping coffee and learning about exercise physiology and how to interpret numbers from an exercise stress test. The lecture is given by one of the attendings and it’s a small and casual enough setting that it quickly becomes more of a question/answer discussion format instead of a lecture.
8 a.m.: I follow all the fellows to echo rounds, where we go through recent echocardiograms with one of the other attendings. I’ve never seen a congenital heart echo before this week! But I’ve seen enough images on adult cardiology wards that following along isn’t too hard.
9 a.m.: The fellow and I have some time to chart-review some of the consults and cardiology inpatients on service. We meet up with the attending to run the list and talk about some tentative plans for patients that day.
10 a.m.: The fellow, attending and I meet up with Blue Team, the inpatient wards team that covers inpatient cardiology, nephrology, hepatology, and rheumatology. They’ve already rounded with the nephrology and hepatology attendings, so now it’s our turn! We go room to room with the interns and medical students presenting. Children's practices “family centered rounds,” so parents/caregivers are usually involved in the discussion. I listen to some tiny murmurs and palpate tiny pulses. We have a wide variety of pathologies on Blue Team this week, so as we walk between patient rooms we talk through some of the specific physiologies for some of the patients.
12 p.m.: Time for noon conference! But more importantly, lunch! Children's provides lunch for housestaff, so I swing upstairs to grab something. It alternates sandwich day/salad day. Today is a sandwich day, it’s usually a boxed lunch with the sandwich and a few sides. I pick a box which has my favorite type of Sun Chips as a side, and make my way down to noon conference. On Mondays conference is often split for the PGY-1s, 2’s, and 3’s/4’s. Today the PGY-3’s/4’s have a board prep session called “Serious Senior Surfing,” we go through practice questions based on Peds in Review articles and debrief them afterwards. It’s nice to have dedicated time to talk through not only content, but some test taking strategies as well.
1-4 p.m.: The rest of the day I’m hanging out with the cards fellow, seeing new consults and touching base with Blue Team as needed. We see anything from arrhythmias in the ED to congenital heart lesions in the nursery or NICU to acquired lesions like viral myocarditis or Kawasaki’s! Depending on the attending’s schedule, we’ll all go see patients together or the fellow and I will staff later in the day. On an elective day I’m usually heading out by 4pm to go enjoy the evening!
5 p.m.: After getting home my husband and I usually do some combination of making dinner, walking to one of the neighborhood restaurants in Bay View, doing something physically active, and/or working on one of my sewing projects at home (I got really into sewing during pandemic downtime). We both play on an ultimate frisbee team in the summer/fall, so lately we’ve been going to South Shore Park overlooking Lake Michigan to get some throws in to prep for the season! When the weather’s bad we’ll go to the local rock-climbing gym where we often run into some of our categorical medicine and pediatric resident friends. I’m usually in bed around 10pm, ready for the next day!
The COVID-19 Pandemic has changed some of the Global Health Opportunities the past few years and we are excited to announce that some opportunities are now opening again!
Milwaukee’s population is culturally diverse, and within the confines of Children’s Wisconsin we serve a global community. Given the current U.S. national government’s dedication to improving healthcare in this country, as well as local efforts by the Board of Directors of the Children’s Health System of Wisconsin to have the healthiest children in the nation, it is imperative that we train future physicians to confidently treat all patients, regardless of ethnic background. Sixty percent of the residents who receive training at Children’s remain in Wisconsin to care for children in our community—a community that continues to see a large influx of immigrants, international adoptees, growing healthcare disparities and increasing demand for medical pre and post-travel counseling. To best serve our community, and to equip our pediatric trainees to become competent pediatricians globally, the Department of Pediatrics offers a Global Health Training Track.
“I had the wonderful opportunity to spend February 2020 in Punta Gorda, Belize with Hillside Healthcare International. It was a welcome change of pace from typical rotations that challenged me to think in new ways about patients, available resources, and other social determinants of health. My med-peds training was valuable in treating both adults and children in clinics both on-site and at mobile sites. We primarily managed chronic diseases, but in a new light using our available treatments and limited testing. I worked beside US medical students and attendings, but also with Belizean pharmacists, nurses, and medical assistants. It was also an awesome opportunity for self-reflection and the chance to fully immerse myself in a culture and community with the added bonus of weekend travel adventures and new friendships!” – Krista Tuomela, MD (PGY 4)
“During my 3rd year of residency I had the opportunity to participate in a global health rotation in Nepal. I have always had a passion for global and undeserved care and this seemed like a perfect opportunity to further investigate that passion. My healthcare experience took place at an academic hospital in Patan, near the capital city of Kathmandu. The medical exposure that I received was incredible. Cases ranged from primary tuberculosis arthritis to salmonella meningitis; two things that I certainly have never seen in the US. While the cases were interesting the way that the Nepali physicians cared for their patients was also a great learning experiences. They demonstrated the value of a good physical exam, the importance of a thorough history and the skill of working in a resource limited environment. They were kind to their patients and educated families. While the medicine exposure was certainly valuable the culture exposure was also eye-opening and formative for me. The people of Nepal are incredibly generous, warm and welcoming. They are quick to invite you to lunch and learn about who you are as a person. Despite a large portion of the population living on very little you always sensed cooperation, and a desire to care for one another. Overall my rotation in Nepal provided me with an opportunity to learn about medicine, learn about people and culture and learn about myself. I feel very fortunate that I was able to participate in such an experience and I know that I will be a better physician because of it.” –Andrew C. Rose, MD (2020 Med-Peds Grad)
The COVID-19 Pandemic has altered some of the social events for our program, but we are excited to announce that some opportunities are now opening again!
One of the most important aspects of our program is the camaraderie that exists between the residents. There is no shortage of fun in the Med-Peds Program. We work hard, but we always make time for relaxation and fun. Below is a sample of the social opportunities our Med-Peds Residents get to experience throughout their residency. Also, our residents are invited to the social events and activities of both categorical programs.
Med-Peds Monthly Residency Dinners
3rd Tuesday of every month, the Med-Peds monthly residency dinner is hosted at rotating Med-Peds resident and faculty homes and includes residents' families.
Med-Peds Biennial Residency Retreat
A time for residents, staff and their families to get away for some bonding time. Held off-site, this 2-day retreat gives residents the time to reflect on their residency while bonding with their colleagues.
Med-Peds Annual Brewer’s Tailgate and Game
As part of our orientation for our incoming interns, we meet and get to know one another at our annual Brewer’s Tailgate and game.
Virtual Trivia
Our APD, Dr. Malcom, put together a monthly virtual trivia event for residents during the pandemic. We will continue to do this if we have in-person precautions during our Med-Peds monthly dinners.
Graduation Celebrations
Dinners and more dinners during the month of June. A great time to celebrate the achievement of our graduating seniors.
Yes, Milwaukee!
Milwaukee is a wonderful community that has the advantage of an urban, metropolitan city without the stress or cost. Milwaukee offers a variety of career opportunities, excellent universities, low commute times, diverse neighborhoods, affordable housing and abundant recreational choices. Milwaukee also boasts professional sports teams, museums and activities, outstanding restaurants and performing arts comparable to cities more than twice its size. The Milwaukee Region’s size, accessibility and friendliness are among its greatest attributes. It’s easy to meet people and maintain acquaintances. Not to mention, Milwaukee is less than 80 miles away from Chicago – a good perk if you are looking for a quick weekend getaway.
There is no shortage of recreational activities in Wisconsin. In Milwaukee County alone, there are more than 15,000 acres of parks, the greatest acreage per person in the country. In 2009, the Milwaukee County Parks System was awarded the National Gold Medal for Excellence by the American Academy for Park and Recreation Administration and the National Recreation and Park Association. We have an abundance of biking trails, golf courses and a strong running community.
Whether you are here for a day, a weekend or your residency, you can have a variety of experiences, making it a perfect place to explore. Find your perfect itinerary at Visit Milwaukee!
The Big City of Little Neighborhoods
Milwaukee is not so much a city as a large collection of neighborhoods situated on the shores of Lake Michigan, often referred to as the Big City of Little Neighborhoods. With eleven distinct neighborhoods, Milwaukee has a huge variety of affordable housing options not to mention the beautiful suburbs just to the south, west and north of the Medical Complex. Current and past MCW residents have lived everywhere from revitalized warehouse buildings overlooking Lake Michigan in the Historic Third Ward neighborhood to farmhouses with lots of extra land and everywhere in-between, all within a short commute to the Milwaukee Regional Medical Complex.
As a starting point, please feel free to visit the following sites for a look into what neighborhood or suburb might be right for you:
Visit Milwaukee
Real Estate Search