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Interns' Guide to Rotations at VA

Structure Overview

Teaching Service Structure Patient Cap
Morgan 1-6 1 resident, 1 intern 10
Geriatrics 1 resident, 1 intern 10
Rogers (Hep, ID, Pulm, Renal) 1 resident, 1 intern 10
Heart Failure (CHF 1 & 2 ) (one team) 1 resident, 2 interns 8 per intern (16 total)
Cardiology (Harrison 1 & 2) (two teams) 1 resident, 1 intern 10
Hematology (Brittingham A & B) (one team) 1 resident, 2 interns 8 per intern (16 total)
Oncology (Onc A & B) (two teams) 1 resident, 1 intern 10
VU MICU 1 & 2 (two teams) 3 residents, 3 interns no cap (typically 10-12)
VU CCU 3 residents no cap (typically 10-12)
VU Night: Admitting Morgan/Rogers 1 resident, 2 interns 10
VU Night: Admitting Harrison/Heme/Onc 1 resident, 1 intern 10
VU Night: Crosscover 1 resident, 1 intern N/A
VA Wards 1-5 1 resident, 2 interns 8 per intern (16 total)
VA Wards 6 2 residents 8 per resident (16 total)
VA MICU 3 residents, 3 interns no cap (typically 10-12)
VA Night: Admitting 1 resident, 2 interns 10
VA Night: Crosscover 1 resident N/A

VA: Veterans Affairs Rotations

VA General Wards (1A – 6B)

  • Always make sure that your VA login works a few days before you are scheduled to start!
  • Team: 1 Res, 2 Interns with soft patient cap of 8 each (16 total)
  • Pagers: See VA Phone/Pager Directory Section for pager numbers
  • Pick up list by 6:30 AM In the pulm/ID fellows workroom on the 2nd floor (between team 4 workroom and the MICU), sign-out at 6 PM
  • Admitting: Teams 1-3-5 & 2-4-6 alternate admitting days and admit until 5:30 PM
  • Non-admitting teams can sign out once their work Is complete as early as 2PM on weekdays and 12PM on weekends
  • Rounds alternate at 7 AM on admitting days, 8 AM on non-admitting days, meet at workrooms; night admitting team presents to attendings at 7 AM (depending on team)
  • Work rooms:
    • Team 1 on 2N hallway, past RN station
    • Team 2 on 2N hallway, past RN station
    • Team 3 on 2N hallway, between main elevators and RN station
    • Team 4 at 2nd floor adjacent to main elevators
    • Team 5 on 3N hallway
    • Team 6 in pulm & ID fellow workroom outside MICU on 2G
  • Tips: Admission days can be very busy and anything you can get done on the non-admitting days will make your life easier (ex: DIPNs). Ensure that you tag PCP on EVERY H&P so they know patient is admitted (right click signed H&P -> dropdown menu -> "identify additional co-signer"), make documents in OneDrive (it's HIPAA-compliant!) to use as your pre-rounding sheet and sign-out sheet and share these with your team (for days off); roll your pagers via Vanderbilt operator (same as at VU); ensure all orders on patients still in the ED are “delayed” or they will disappear once on the floor (ask your resident); all consults must be accompanied by page to the covering fellow (use Synergy for medicine subspecialties consult schedule, TVHS website for surgery/other), beware that medications disappear after 1 month of admission (your pharmacist can help!), beware that diets disappear when converting obs to inpatient, enjoy a complimentary VA square!

VA MICU

  • Team: 3 Res, 3 Interns, no specific patient cap
  • Combined CCU and MICU; 7AM CCU rounds followed by 8AM MICU rounds
  • Day Intern: 7 AM - 9 PM; Night Intern 8 PM - 10 AM; MICU between 2N and 2G (2nd floor)
  • Tips: Night intern presents all of the old patients in the morning and signs the notes. The day intern owns the A&P of the notes by keeping them updated. Never hesitate to relay information to your resident overnight if you are concerned (wake him/her up!)

VA Nights

  • Team: 1 Res, 2 Interns, total of 10 admissions overnight
  • Pager: NIGHT ADMIT RESIDENT must roll the night admitting pager 317-0227
  • Start at 7 PM, Admit until 5 AM, present new patients to teams at 7 AM, leave by 8 AM
  • Start Sunday night for interns, Wednesday night for residents; off day is Saturday night for interns/cross-cover resident (covered by clinic resident), Friday night for admitting resident (covered by BMT resident)
  • Tips: Admissions typically bolus at the start of shift and slow later in the night, so worry about seeing pts, formulating plans with resident and putting in orders first as notes can be finished once it slows down, cafeteria at VU closes at 2 AM, communicate everything you do with your resident who is supervising a second intern as well, ensure all orders on pts still in the ED are “delayed” or they will disappear once on the floor (ask your resident), enjoy a complimentary VA square for breakfast!