A Week in the Life (PGY1, Med-Psych)

A Typical Week for Elana Horwitz, MD

Monday 

  • Elana Horwitz (on right) and partner at a baseball game

    Morning: I prepare my mug of coffee and grab a protein bar and my helmet on my way out the door. I bike 10 minutes to arrive right at the entrance of Duke Hospital. On Duke Gen Med, I’m getting there around 7am and head straight to the workroom in time for sign out. I review charts and take notes on my patients while I sip my coffee. Rounding normally starts around 8am. While my co-resident (or sub-I, depending on the season) is presenting a patient, I grab a hallway computer and put in orders/call consults/check new labs. I’m usually back in the workroom by 11:30 so I can get a few more urgent orders in before noon conference.

  • Afternoon: Noon conference is in an auditorium where I can check in with fellow interns while the senior holds the pager. We stop by the lunch table on the way back to the conference room and sometimes take time to go eat lunch outside. I’m vegetarian and there is always a good vegetarian option, which is much appreciated. The rest of the afternoon is spent talking to consultants, putting out fires, admitting new patients and writing notes. Sign out to the second-year residents who cover Gen Med nights is anywhere from 6:30-7:00pm, and I normally stop by the cafeteria on the way out to cash in on our $10 per day to grab some more protein bars or hot food for dinner.

  • Evening: First thing I do when I get home is change into comfy clothes. I like to spend my evenings cooking a yummy meal and either Facetiming with friends and family or watching Netflix.

Tuesday

  • Morning: On ambulatory block days, you have more of the morning to yourself. I like to try to get up early to work out before Morning Report at 7:15am. Morning Report is a 45-minute Zoom session where we learn about high-yield topics in primary care such as diabetes, sinusitis or trauma-informed care. I like to be showered and drinking my coffee in time to tune in and rev up for the morning. I drive 10 minutes to my continuity clinic location and usually see up to four patients in one half day.

  • Afternoon: While on ambulatory, we get Tuesday afternoons to join our psych colleagues for Academic Half-Day. This is a good time to brush up on psych basics and interact with my class. During this time, we have Process Group, where we can share openly about difficult patient interactions or anything else on our mind.

  • Evening: Even on weekdays you’ll find people out and about, especially at the breweries. I like Ponysaurus for a weekday beer and place to see friends and be outside.

Wednesday 

  • Med-Psych Campfire in Duke Forest

    Morning: On Cardiac ICU (CICU), sign out is also at 7am. We round using the mobile computers, which makes it easier to have all the patient information. Seniors and fellows are super helpful on this rotation. We often find time during rounds to do teaching, likely reading an echo or cath together.

  • Afternoon: CICU is a great place to get your reps on procedures. I placed a-lines and central lines under the excellent guidance of my senior.

  • Evening: The med-psych team occasionally gets together in the evenings. This week we did a campfire in Duke Forest and ate burritos and s’mores. It’s always nice to get a chance to pick the brains of the upper-level residents on their experiences during intern year.

Thursday 

  • Morning: Back to gen med inpatient. Coffee, bike, chart review, rounds.

  • Afternoon: Afternoon: Noon conference again. Recently we were in a point-of-care ultrasonography (POCUS) series, where we learned about different ways to use and utilize ultrasound. Twice a week, we have intern report in the afternoon where we get together for less than an hour and talk through interesting cases together. It breaks up the day nicely and allows for some extra learning.

  • Evening: A favorite spot of mine in Durham is Motorco. They have lots of beers on tap and an extensive and can’t-go-wrong small plates food menu. Next door, there’s a venue where they get DJs, live music and, my personal favorite, The Monti storytelling event—where any attendee can put their name in a hat to be called to tell a short story.

Friday

  • GM6 Elana Horwitz, John Barber, 2 med students making "6s" with their hands/fingers
    Dr. John Barber (left), two medical students and Elana (lower right) showing their Gen Med 6 spirit

    Morning: Coffee, bike, chart review. Medicine Grand Rounds are at 8am on Fridays and are an interesting time to see what the research experts are doing both within Duke and outside.

  • Afternoon: No noon conference on Grand Rounds days gives extra time to get everything wrapped up and patients tucked away in time for sign out to enjoy as much of the Friday night as possible!

  • Evening: Both medicine and psychiatry group chats are usually lively on the weekends, with people looking to do fun things. Boxcar is a fun bar and has something for everyone with arcade games inside and big Jenga and cornhole outside.

Saturday

  • Morning: Weekends are all about Durham food. Saturday mornings are best spent stopping by the Farmers’ Market for seasonal produce and other interesting homemade goodness.
     
  • Afternoon: Durham coffee shops are plentiful and are great places to catch up with friends or casually study for yet another Step exam. I like Coco Cinnamon, which is Latina/women-owned and has unique flavors and great vibes. Durham also has beautiful hiking trails all over the place. I like to do trail running or take a walk with a buddy and set up hammocks to relax.
     
  • Evening: Dinner possibilities are endless—from pizza to authentic French or Italian to Ethiopian and Asian fusion. If I’m feeling particularly energetic, it’s always fun to check out Chapel Hill or Raleigh for a different type of night out. If not, someone in the residency class is usually organizing a low-key barbeque or game night.

Sunday

  • Morning: I like to sleep in at least once a week if I can get the opportunity.
     
  • Afternoon: The rest of the day is spent doing life stuff: groceries, laundry and Target runs.
     
  • Evening: If I have clinic the next day, I start prepping charts for the morning or looking through the patient list for subspecialty clinics. Otherwise, I like to spend time with my partner before the next busy week begins.


Estimated average number of work hours per week: 40 (ambulatory), 72 (inpatient)

I chose Duke because ...

… being here for medical school made me see how dedicated, kind and sociable the residents are and how smart and engaged the faculty are. I wanted to be a part of a learning environment like that.

My favorite thing about Durham is ...

… the culture. There’s always some kind of event, whether that’s the Durham Bulls games, storytelling, pop-up food truck rallies, art walks, you name it!

My favorite thing about Duke is ...

… the opportunities. You can always find someone to support your passion. 

My advice to prospective residents is ...

… to think about all the things outside the hospital that keep you happy, and whether you can find those things in the cities you’re considering. If unsure at all, talk to a resident! 

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