By Marc Franklin, AIM ST5
People often ask what a “typical” week looks like in Acute Internal Medicine. The honest answer is that there is not really such a thing but there are recurring themes. These include rapid assessment, early decision-making, teaching, and a fair amount of switching between roles. This is what an average week looks like for me as an AIM registrar.
Monday Morning: Acute Medical Unit Ward Round
The week starts on the Acute Medical Unit with a ward round of all the patients under the care of the acute medicine team. This involves reviewing patients admitted over the previous weekend, refining diagnoses, and setting clear management and discharge plans. A big part of the morning is working with the multidisciplinary team and supporting the resident doctor team as they prioritise tasks and manage a high turnover of patients. It is always rewarding seeing how coordinated care with close communication with nursing and therapy teams can turn around a patient’s trajectory by lunchtime.
Monday Afternoon: Resident doctor teaching
Monday afternoon was time to be an educator, a passion of mine. I was able to facilitate a simulation session for foundation doctors. These sessions focus on common acute medical scenarios and non-technical skills such as communication and leadership.
Tuesday Morning: SDEC
Tuesday morning is spent in Same Day Emergency Care (SDEC). SDEC is designed for patients who require urgent medical assessment but may not need admission. The aim is to provide early senior review, prompt investigations, and a clear plan which then often allows patients to be treated and discharged on the same day. No two days are ever the same on SDEC, and we see a vast array of presentations.
Tuesday Afternoon: Senior Reviews in SDEC
The afternoon continues in SDEC, offering senior input for patients already assessed by junior colleagues. This often involves confirming diagnoses, adjusting treatment plans, and deciding whether admission is required or whether safe discharge is possible with appropriate follow-up.
Wednesday: On Call as Medical Registrar
Wednesday is an on-call day as the medical registrar. This role includes overseeing acute admissions, providing advice to other specialties and primary care, and responding to urgent clinical situations. It is busy, often unpredictable, and requires constant prioritisation but it also provides valuable leadership and clinical experience to learn from.
Thursday Morning: FAMUS
Thursday morning is dedicated to FAMUS (Focused Acute Medicine Ultrasound) training. Developing ultrasound skills is an important part of AIM training, and this time is used to practise scanning and integrate findings into clinical decision-making.
Thursday Afternoon: SDEC
Thursday afternoon returns to SDEC, applying both clinical experience and senior oversight to a new cohort of patients.
Friday: LTFT Day
Friday is my less-than-full-time (LTFT) day. It provides space for quality time with family, recovery, reflection, and non-clinical commitments which is an important part of sustaining a long-term career in a high-intensity specialty like Acute Internal Medicine.
Summary
A week in AIM involves variety, pace, and frequent shifts between clinical care, teaching, and leadership. While the workload can be demanding, the opportunity to influence patient care early in their hospital journey and to support and teach others is a central part of what makes the specialty appealing. I always feel supported and lucky to be a part of an amazing team and I am extremely proud to be an Acute Internal Medicine trainee.