Perioperative Medicine

General Information

  • Consult service for the department of medicine

  • Hours: 8am to 4pm, M-F (weekends off!)

  • Generally there are 3 types of consults you’ll see:

    • Pre-operative evaluation

    • Medical management of a surgical patient with medical comorbidities

    • Request for transfer of a patient to the medicine service

  • Arrive at 8am to the medicine control room, get sign out from the DACR

  • Pre-round on your patients, rounds with the attending are around 9:30-10am.

  • Continue to field new consults until 4pm.

  • Sign out to DACR at 4pm and go home!

Intern Periop Survival Guide

Welcome to Perioperative Medicine! This rotation falls under the department of medicine and functions as a medicine consult service. During this block you will learn how to co-manage surgical patients with medical comorbidities, gauge the appropriateness of transfer requests to the medicine service, and evaluate patients prior to surgery. Comparatively, this rotation is pretty laid back, and runs from 8am to 4pm, Monday to Friday. Depending on the day, you should have some free time to catch up on studying/reading/your favorite show. Feel free to hang out either in the medicine control room or anesthesia resident lounge.


Pre-op Evals:

These patients are planned for surgery. They could range from neurosurgical to ortho to urological to anything in between. Our job during this rotation is to read up on their medical history and evaluate the current status of their medical comorbidities. We may then recommend additional testing or management prior to surgery. Remember, we don’t “clear” anyone for surgery, we simply risk stratify and medically optimize :)


Medical Management:

Other teams may ask us for assistance in managing a patient’s active medical issues. This could be as simple as diabetes or HTN but can sometimes get more complicated. Evaluate the patient as you normally would and provide recommendations on how to best manage their active medical issues. As a consult service, it is not our responsibility to place orders. However, out of courtesy it is always a good idea to reach out to the primary team directly via Epic Chat and provide any updates to the plan/recommendations instead of just hoping they read your note.


Transfer to Medicine:

If a patient no longer has surgical needs however still has active medical issues that require continued hospital admission, the primary team may reach out to transfer them to a general medicine service. Evaluate the patient to see if these active medical issues deem the patient appropriate for transfer of services, and let the admissions coordinators know. This skill will come with time and reps; always confirm the plan with the attending before communicating with the primary team and admissions coordinators.


Below is a link to a set of resources created by the Department of Medicine to help you throughout the month:


Peri-Operative Medicine Rotation