 Here at the R. Adams Cowley Shock Trauma Center at the University of Maryland, we run a month-long transition to residency curriculum for fourth-year medical students going into surgical specialties. Starting five years ago, we included a week of longitudinal simulations, or SIM week, or a week in the life of a surgical intern. This video offers a glimpse into the 20 discreet experiences of the program's 13 fictitious patients our students encounter. From patient consultation to admission to discharge, students spend the week taking turns assuming leading roles and caring for the patients as they learn to work both individually and as part of a team. Each day brings new opportunities to critique each other's work and reflect on their performance. Collectively, these 20 scenarios cover a wide range of topics. Each individual scenario can be broken into multiple subsections and include much other content. Each experience also enables us to introduce ancillary topics allowing us to streamline the learning process without the need for additional scenarios. Both substantive and efficient, the simulation helps to ensure that our students receive the best educational clinical preparation. On Monday morning, the class receives sign-out on patients currently admitted to a multidisciplinary service. Our instructors play the role of night float during patient handoff at the start and conclusion of each day. Two of our fictitious patients, Forest Wallace and Rita Sharma, offer a glimpse of how the program prepares students to handle the real-life decision-making they will face as surgical interns. Our students' ability to handle admission orders comes front and center when they receive a page from Mr. Wallace's nurse, a request for pain medication and notice of hypocholemia from his AM labs. Instructors guide them in recognizing both renal insufficiency and risk of dehydration due to his high ostomy output. Upon learning that their patient cannot swallow pills, the students work through various formulations. Ms. Sharma is 38 weeks pregnant when she presents to the ED with an elevated white count and severe abdominal pain. By the end of day sign-out, test results have confirmed a diagnosis of colisostitis. The patient is admitted to OB and started on antibiotics, while the students discuss how to best manage both pregnancy and surgery for the immediate future. The night float AM sign-out for Mr. Wallace reports that he had a busy night. His ostomy output remains high. He has hypocholemia and his AKI is worsening. I've treated him for a hypocholemia and called the chief. She'd like you to call an aphrology consult this morning in case he needs dialysis. That day, during a central line-themed session, the students realize that in order to start dialysis, Mr. Wallace will need vascular access. Fortunately, he responds to the medical management of the hypocholemia and no HD is started. Ms. Sharma's colisostitis is responding well to antibiotics and the team discusses the pros and cons of surgery versus observation. The decision is made, however, when Ms. Sharma goes into labor. Given that her colisostitis is responding to antibiotics and that she does not show evidence of biliary obstruction, the team decides to offer a lap coli after delivery. Today is tough for Mr. Wallace and his family. Remembering his high ostomy output, the night team did forget his worsening AKI. Mr. Wallace received an order for potassium replacement overnight despite recently recovering from hypocholemia and is now worsening. In addition, radiology has not yet read his post-line chest x-ray. The morning chart review shows a deep sulcus sign, but no obvious pneumothorics. Things are not looking good for our patient and the students are alerted to a code blue, five Weinberg room 10, where the code team has just started working on him after finding him in PEA cardiac arrest. Meanwhile, the students learn that Ms. Sharma delivered a healthy baby. They visit her and her family to ensure her pre-op workup and consent for a lap coli are complete. Today is relatively quiet for Mr. Wallace. During sign-out, the students decide that he needs both cooling for his post-arrest cerebral protection and CRT for renal replacement if those were not included in the plans immediately post-arrest. Throughout the day, they make some minor adjustments to his nutrition plans and ostomy management. Today, Ms. Sharma arrives at the OR for her coli cystectomy. However, when bleeding occurs during laparoscopy, the students are forced to convert to an open operation. The students meet with his son and nephew to deliver a long overdue update on his cardiac arrest as well as his current ICU state and struggle with family questions on prognosis and cause. Fortunately, at the final sign-out, the students learn from the ICU that their patient has started following commands after completing his cooling protocol. While Mr. Wallace's story includes obvious teaching concepts such as line placement, the longitudinal integration of his case connects very diverse topics for the students. During the open operation, the students learn of elaceration on Ms. Sharma's liver, probably caused by one of the laparoscopic instruments. Working with their attending, the team stops the bleeding. Meanwhile, the students take turns meeting with Ms. Sharma's husband and brother in the OR waiting room. The students benefit from longitudinal integration of cases like those of Ms. Sharma and Mr. Wallace. Simulation Week allows students to begin developing a degree of familiarity with level-appropriate patient management. Simulation Week may be easily adapted to the size and scope of your institution. Despite using some models that are not universally available, many of our simulations rely only on faculty, actors, or commonly accessible resources. This method of longitudinal case-based simulation can be applied to any combination of training sessions and activities to provide students with a memorable training experience. Simulation Week goes its continued growth and success to clearly defined educational goals driven by creative storytelling. We would like to take this moment to thank all of our staff whose individual and collective efforts continue to make Sim Week successful year after year.