Mastering Your Morning: The Five-Minute VIPMRS Pre-Round Routine

Maya Brooks

Hello everyone, and welcome back to the AI Med Tutor Podcast. I’m your co-host, Maya Brooks, an AI-generated fourth-year medical student and the voice guiding you through the student experience. Today’s episode is one I wish I had at the very beginning of clerkship year.

Dr. Randy Clinch

And I’m Dr. Randy Clinch, a DO family medicine physician and medical educator. I’ve helped many students learn how to pre-round, and almost all of them start out feeling overwhelmed and unsure of the right approach. Today we’re giving you the structure that solves that problem.

Maya Brooks

Pre-rounding often feels chaotic at first. You’re juggling the EMR, the overnight story, your patient’s condition, and then you’re expected to walk into rounds prepared and confident. That can feel like a lot. But once you have a structured system to follow, it becomes manageable.

Dr. Randy Clinch

And that structure is the Five-Minute Pre-Round Routine. It’s simple, repeatable, and built around a mnemonic you’ll never forget: VIPMRS. Once you learn this sequence, everything about your morning gets easier.

Maya Brooks

Before we go step by step through an example, let’s make sure the VIPMRS mnemonic is fresh in your mind. V stands for vitals. I stands for ins and outs. P is for the focused physical exam. M is for medications. R is for results. And S is for the sign-out, including anything that happened overnight.

Dr. Randy Clinch

And the reason this order works is because it moves you from the most objective information to the elements that complete the patient’s overnight story. It keeps your thinking organized. It keeps you from bouncing around the chart. And it helps you gather what matters instead of drowning in data.

Maya Brooks

Once this becomes routine, you’ll move through it quickly and with confidence.

Maya Brooks

Let’s bring this to life with a real example. Imagine you’re pre-rounding on Mr. Hernandez, a sixty-eight-year-old man admitted yesterday with a right lower lobe pneumonia. You sit down at the computer, start your timer, and begin your five-minute routine with the first letter: V for vitals.

Maya Brooks

You look at the past twenty-four hours. Yesterday, his fever reached 102, but this morning it’s 99.1. His heart rate has come down from 110 to 98. His respiratory rate improved slightly. His oxygen saturation is stable on two liters. In less than thirty seconds, you already know whether he’s trending better or worse.

Dr. Randy Clinch

Then you move to I for ins and outs. You check his fluid intake and urine output. Maybe he hasn’t been drinking well. Maybe he received a liter of fluids overnight. You quickly understand his hydration status and whether it might be affecting how he feels this morning.

Maya Brooks

Next comes P for the physical exam, but at this stage you’re still outside the room. This is your moment to prepare for the targeted exam you’ll do once you’re with the patient. For pneumonia, you already know you’ll listen for crackles, check his work of breathing, ask whether his cough is productive, and see whether he looks more comfortable or worse than yesterday.

Dr. Randy Clinch

Then we arrive at M for medications. This gives you insight into the treatment plan. He’s on ceftriaxone and azithromycin. He received Tylenol overnight. Maybe he required oxygen adjustments. This tells you how the team is treating him and whether the treatment seems to be working.

Maya Brooks

After medications, you move to R — results. You check his white blood cell count and see it dropped from 17,000 to 13,000. His BMP is stable. His chest X-ray hasn’t been repeated. These results give you the objective data you’ll later present during rounds.

Dr. Randy Clinch

And finally, we come to S for sign-out. First you scan the nursing notes, the night resident’s documentation, and any updates to the plan. Maybe the nurse charted a coughing episode at two a.m. Maybe the patient finally slept. Maybe his appetite was poor. But sign-out doesn’t stop with the chart.

Maya Brooks

This is where you do something students often skip: you check in with the bedside nurse. Even ten seconds makes a difference. You might say, “Good morning — anything I should know about Mr. Hernandez from overnight?” Nurses often tell you things that haven’t been charted yet. Maybe he was short of breath walking to the bathroom. Maybe he was confused for a few minutes. Maybe he refused a medication. This small interaction gives you real-time information and shows your team that you’re communicating with nursing staff.

Maya Brooks

Now you have your complete VIPMRS picture. And it only took a few minutes.

Maya Brooks

Now it’s time to walk into the room. You introduce yourself, check how he’s feeling, and move through the focused exam you already planned. But this is where something very real happens: sometimes patients are chatty. They may want to share their entire life story or talk about family or tell you about every symptom they’ve ever had.

Dr. Randy Clinch

And while it’s important to make your patient feel heard, this is not the moment for a long conversation. You can set gentle boundaries while still being caring and respectful. For example, you might say, “I definitely want to hear more about that later today. Right now I’m doing my brief morning check so I can update the team on how you’re doing.”

Maya Brooks

Or, “Let me finish checking on your breathing and I’ll make sure the team knows what’s most important to you today.” Simple, kind statements like that keep you on track while still honoring the patient’s voice.

Dr. Randy Clinch

Then you complete your focused exam. You listen to his lungs. You check his oxygen saturation. You ask if he feels better, worse, or the same. It’s efficient because you already know what matters.

Maya Brooks

Once you repeat this routine a few times, you start feeling the difference. You walk into rounds calm instead of scattered. You know the overnight story. You know the trend. You know what the team needs to hear. You’re not drowning in data — you’re interpreting it.

Dr. Randy Clinch

And the consistency of VIPMRS strengthens your clinical reasoning in a way that builds day after day. It’s the repetition that transforms your confidence during third year.

Maya Brooks

Let’s recap. The five-minute pre-round routine uses the VIPMRS framework to help you gather what matters in the right order. You start with vitals, then ins and outs, then your planned physical exam, then medications, then results, and finally the sign-out — which now includes that quick nursing check for anything uncharted. After that, you enter the room, set kind boundaries if the patient is chatty, perform your focused exam, and you’re ready for rounds.

Dr. Randy Clinch

You’re not behind. You’re not doing it wrong. You’re building a skill that becomes intuitive with practice. Trust the structure and let it steady your morning.

Maya Brooks

That's it for this week everyone! Thanks for joining us for this episode of the AI Med Tutor Podcast. We’ll see you next week. In the meantime, stay curious and keep learning!