"The Tunnel at the End of the Light": Preparing to Attend on the Inpatient Medical Wards.

Transitionsareawayof life inacademicmedicine.While much has been written about these changes,1,2 less attention has been devoted to amore common shift: the move between academic work and clinical ward time.3 This gap has important consequences. For example, some faculty dread upcoming ward blocks. When on clinical rotations, theystruggle to jugglepatientandacademic activities—often doing neither well. The resulting perceived lack of efficiency and effectiveness leads to weariness, fatigue, frustration, and symptoms of burnout.4 Regardless of clinical effort,most facultywill face this problem. Unfortunately, limited guidance on how best to overcome this common challenge exists. As academic hospitalists, we have made this transition countless times and believe it can be bettermanaged. In this essay,wedraw frommore than30years of combined experience, informal discussions with colleagues, and observations of gifted ward attending physicians5 to provide strategies and tips for assuming clinical duties in the hospital. Our aim is simple: to highlight common-sense management strategies for this neglected yet critical transition (Table).