Rounds

"Rounds" are a way for a team of physicians to review patients and the day at hand. There are many different ways of "rounding" , some more formal than others. Most of the time in the US we have walking rounds where whoever is taking care of the patient updates the team with how the patient has been doing over the past 24 hrs. In general rounds are a way to exchange information as well as to learn from the patients. Rounds usually have a bit of hierarchy involved- the attendings are everyone's boss, senior ranking residents are responsible for the team, residents are responsible for their patients, medical students are responsible for staying alive. :)

Here in the DR, rounds are very structured and formal. Every morning, the residents that are post-call present to the entire hospital in a conference room. It took me awhile to realize this but everyone sits according to rank. The pre-interns sit in the back and wear beige scrubs, the interns are the next up in green scrubs, the upper level residents wear all white, and the attendings sit in the front row. The first few days, I sat in the back because I didn't want to get in anyone's way and because I feel pretty lowly in the scale of my medical training in general, let alone in Spanish. As a guest visitor, however, I get to skip up a few ranks and now sit in the second row from the front. It's pretty neat although the attendings see me more and try to engage me in debates for "my professional opinion" about the debate at hand from my experiences in the US and of course "what Williams says." Williams is considered a Bible for Obstetrics and it is really worshiped here. FYI Williams is written at UT Southwestern, one of our top programs we ranked!

Rounds at this hospital in the DR starts off with a prayer. One of the senior residents leads the prayer thanking God for the honor to serve this population, and prays for the safety of the residents and the patients; then, everyone joins in and recites the Our Father. One of the senior residents then lists off all the deliveries, complications, births, deaths, surgeries, procedures, number of blood units available today, etc. Next, the resident presents patients in the past 24 hrs that had complications or were particularly unique.

The volume here is like nothing I've ever heard about- at least 60 deliveries/day. One resident told me that this morning she delivered 36 babies this morning. WHAT?!! I have no idea what to expect next week when I work labor & delivery but have a feeling it will be challenging!

The severity of cases discussed here are equally insane. Everyday we talk about things that I've been told I would probably never see in my career- here it happens every day. It's really exciting to come home and read about things that I've never even thought could happen. I'm learning so much!