straight internship orientation 2011
TRANSCRIPT
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Welcome to the Department of Medicine!SI 270.2 Straight Internship in Medicine
Dr. Iris Thiele Isip TanDr. Adrian Paul Rabe
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A little history ...
Straight internship program in the 1980s before the INTARMED program was established
Straight Interns were the JAPODs - term survived even if straight internship program was discontinued
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A program in evolution...
Lesser students
More duties
More electives
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SI 270.2 Straight Internship in MedicineCourse Description
Rotation in medicine and its subspecialties with opportunities for self-directed learning and direct patient care as junior admitting physicians
Refinement of knowledge and skills learned in LU 5 and LU 6 as health practitioner, leader/manager, researcher, health educator and social mobilizer
Education in medical informatics will be integrated in the rotation
Instill the knowledge, skills and attitudes of information management
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SI 270.2 Straight Internship in MedicineTerminal Competencies
Recognize and diagnose common and some uncommon medical problems/ diseases/ emergencies
Manage common and some uncommon medical problems/ diseases/ emergencies using sound clinical judgment, logical decision-making strategies and evidence-based medicine
Completely document patientsʼ cases including the medical history, physical examination, course of illness and management plan
Submit a completed research work
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SI 270.2 Straight Internship in MedicineTerminal Competencies
Formulate a plan for patient education based on perceived need
Demonstrate the proper attitudes and values of a humane and community-oriented physician
Effectively communicate with patients, their caregivers and colleagues
Demonstrate harmonious working and professional relationships with other members of the health team (superiors, peers, subordinates and paramedical personnel)
Acquire essential informatics skills
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44 weeks in Medicine8 weeks in community rotation
OPD: General medicine, Hypertension, Geriatrics, Subspecialty clinics (not covered by subspecialty rotation)
Mandatory subspecialties: IDS, Endocrinology, Cardiology, Pulmonology, Gastroenterology, Nephrology
ER (4 weeks)MICU (4 weeks)
Wards (12 weeks)
OPD (8 weeks)
Elective subspecialty (4 weeks)
Mandatory subspecialty (12 weeks)
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ER Rotation
PM
Pre-duty
(7 am- 7 pm)
Post-duty(Day off)
24-h DUTY
Pre-duty
(7 am- 7 pm)
Post-duty(Day off)
24-h DUTY
Pre-duty
(7 am- 7 pm)
AM
SunSatFriThursWedTuesMon
On pre-duty day, decked 2 old patients to manageOn duty day, decked 2-3 new patients (1 patient every shift) and 1-2 old patients to manageMaximum patients allowed: 5No continuity clinic; only one duty intern per day
4 weeks
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Ward work
D U T Y
PREDUTY Blood bank
screening
Ward work
Ward work
Blood bank screening
Straight Intern’s hourWard work
Blood bank screening
PREDUTY
D U T Y
MICU Subspec rounds
MICU Team Captain rounds
MICU Subspec rounds
MICU Subspec rounds
Ward workAudit/ Grand
RoundsWard workWard
work Ward work
Ward work
Endorse ment
rounds
Endorsement
rounds
Endorse ment rounds
Endorse ment
rounds
Endorse ment
rounds
TIME OFF
TIME OFF
Ward work
Ward work
PM
PREDUTY
Endorsement
rounds
Endorse ment
rounds
Endorsement
rounds
Endorse ment rounds
Endorse ment
rounds
Endorse ment
rounds
AM
SunSatFriThursWedTues Mon
MICULast 2 weeks: one Straight Internʼs hour (case management conference) per week
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Ward rotation
1st week of 1st 4-week block: JAPOD
Decked 2 old service patients to manage under direct supervision by senior medical resident (countersigns all orders) and service consultant
APOD duty: decked 2 new patients to manage
During duty, will manage decked patients at ER while awaiting admission under direct supervision by ER medical resident
WAPOD duty: answer all ward referrals under direct supervision by ward resident
12 weeks divided into 4-week blocks
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Continuity clinic
Service rounds
Ward workService rounds
Ward work
Endorse ment
rounds
TIME OFF
Endorse ment conf
Sat
Endorse ment
rounds
Consultant rounds
Ward work
Audit conference/
Grand Rounds
Endorsement rounds
Ward work
Endorsement rounds
Service rounds
Ward work
Ward work
24h
WAPOD
DUTY
Endorse ment rounds
Consultant rounds
Endorsement rounds
TIME OFF
Ward WorkWard WorkWard Work
Ward WorkWard Work
PM
Ward work
Endorsement conf
24h APOD
DUTY
Endorsement confEndorsement
conf
Endorse ment confEndorsement
conference
AM
SunFriThursWedTuesMon
Attend continuity clinic
Submit two case write-ups per block of rotation (comprehensive discussion with appended literature review)
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OPD rotation
Mainly general medicine clinicMay substitute 10 half-days with consultantsʼ private clinics
4 half-days eachGeriatrics
Hypertension
Subspecialty clinics (not covered by mandatory/elective rotations)
8 weeks divided into 4-week blocks
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OPD rotation
Attend continuity clinic
Go on duty: ER, SCU-POD, SAPOD
ECG readingWeek 1-2 of first 4-week block: ECG reading homework
Remaining weeks: Decked 5 ECGs to read after every OPD day, counter-signed by medical resident
8 weeks divided into 4-week blocks
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Night DutiesOPD/Subspecialty rotations (24 weeks)
7 pm to 7 am
4 weeks: ER duty
4 weeks: Pay duty
8 weeks: SAPOD duty
8 weeks: SCU-POD duty
Post-duty status: May go home after 12 nn
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Subspecialty rotation
12 weeks mandatory rotationIDS, Nephrology, Cardiology, Endocrinology, Gastroenterology, Pulmonology
4 weeks elective rotation4 one-week blocks, 2 two-week blocks, one 2-week block and 2 1-week blocksAllergy, Adult Medicine, Medical Oncology, Rheumatology, Hematology, Neurology
16 weeks
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Subspecialty rotation
Consultant buddySigns learning contract, gives end-of-rotation grades, goes on pay rounds
Learning contract for each rotationSectionʼs blueprint PLUS what youʼd like to do
Continuity clinic Night duties: ER, Pay, SCU-POD, SAPOD
16 weeks
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Google Group
Feel free to post - letʼs document the journey
Main mode of submissions for requirements - I hate paper!
Research
Patient log
Venue for announcements
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Logbook
Document attendance
Document all patient encountersCannot upload patient log with identifiers
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Research
Research adviser
MilestonesWeek 11: completed research proposal
Week 22: progress report
Week 33: preliminary report
Week 44: final research paper
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Informatics sessions
Baseline computer literacy surveyMonthly brown bag/lunch sessions (lecture/demo)
Discuss results of computer literacy survey
Introductory lecture on health informatics
Literature search using PubMed (mobile access to PubMed)
BIBUS (open source bibliographic software)
PDA use in medicine
Evaluating medical information on the Internet
Patient resources on the Internet
Decision support tools
Continuing medical education on the internet
Basic database operations
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The program is what YOU make it!
Just ask and you can ...
Have more patients
Do procedures
Attend subspecialty conferences/conventions
Go to consultantsʼ private clinics (near PGH)
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A little about myself ...
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A little about myself ...
Anything you’d like to tell me?
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Thank You
http://www.endocrine-witch.info