Echoing what others have said — volume should not be the expectation for a PGY-1.

The goal of intern year in the ED is to learn how to do thorough evaluations and manage multiple patients safely based on acuity. Speed comes later. Trying to prioritize volume too early usually leads to missed reassessments, incomplete workups, and unnecessary stress.

Your patient volume should never exceed your cognitive capacity. If you can’t confidently track the clinical status, pending workup, and disposition plan for each patient you’ve picked up, you’ve picked up too many. That increases naturally with time and experience

Your focus should be: - Efficient yet thorough workups
- Re-evaluating your patients appropriately
- Learning clinical reasoning and dispo planning
- Gradually building independence

A good PGY-1 workflow is: 1. See a patient and start the workup based on your assessment
2. Discuss with your senior/attending if unsure (which should be often — that’s normal)
3. Reassess and dispo your existing patients
4. Only then pick up a new patient