Genesys FP Residents - Resident Site

Introduction

The Internal medicine service provides the resident with the opportunity to expand his/her knowledge in the area of adult, non-surgical diseases.

A large part of any family physician’s practice is involved with the principles of general internal medicine. A thorough understanding of internal medicine will provide the foundation for the family physician’s practice.

The training in internal medicine must provide the resident with the opportunity to assume an increasing responsibility in the diagnosis and management of the major illnesses that affect the adult population both in the hospital setting as well as the ambulatory setting. The inpatient internal medicine curriculum at Health Park is designed to provide increasing responsibility over the three-year residency.

The first year resident is primarily responsible for his or her individual cases. The second year resident is responsible for his or her individual cases, which may include more acute care (unit) patients and teaching and supervision of the first year residents. The third year resident’s responsibilities include overall running of the medicine service with the attending physician, including knowledge of all patients on the service and appropriate planning of testing and timely discharge of patients, as well as teaching and supervision of the junior residents. The specific responsibilities for each year are listed below.

A core knowledge base is required in the specific areas of allergy and immunology, cardiology, dermatology, endocrinology, gastroenterology, hematology, infectious disease, nephrology, neurology, oncology, pulmonology, rheumatology and geriatrics. A specific listing of topics is included below (learning areas). It should be noted that this list is only a minimum basic outline and residents are expected to learn other topics that may be relevant to the care of their patients.

Rotation Goals

1.       Help the resident recognize and manage medical problems which require inpatient treatment.

2.       Through required monograph readings, the resident will understand the pathophysiology and treatment of common medical problems in the adult population in the inpatient setting and the appropriate outpatient care following hospitalization.

PGY1Goals

1.       To manage with appropriate supervision common medical problems found in hospitalized adult patients.

PGY2 Goals

1.       To manage with appropriate supervision common medical problems found in hospitalized adult patients.

2.       To manage with appropriate supervision potentially life-threatening medical conditions requiring more acute intervention (unit).

 

 

PGY3 Goals

1.       To manage with appropriate supervision all medical problems encountered in hospitalized adult patients.

2.       To assist junior residents in arranging efficient discharge planning and home health services for the team’s patients.

3.       To efficiently run a medical service.

4.       Provide a teaching environment for junior residents.

Rotation Learning Objectives

Core Competency: Patient Care

 

Goal: Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

 

PGY-1 Residents are expected to:

·         Recognize those patients that should be managed in a hospital setting.

·         Demonstrate the ability to diagnose and treat common medical problems encountered in adult hospitalized patients, within the scope of the family physician.

·          Demonstrate the ability to diagnose and manage common debilitating but not life-threatening medical problems encountered in the inpatient setting.

·         Demonstrate the ability to seek appropriate subspecialty consultation in a timely manner.

·         Demonstrate the ability to appropriately manage hospitalized patients including appropriate discharge planning.

·         Demonstrate respect, compassion and empathy for patients and their families.    

·         Obtain a complete patient history including osteopathic structural exam for osteopathic residents, with relevant information from past medical records, and a comprehensive physical exam for newly encountered patients.

·         Correctly delineate normal from abnormal physical exam findings, and understand the diagnostic relevance of abnormal findings.

·         Integrate information obtained from the history and physical exam to develop a pertinent and prioritized problem list and an initial differential diagnosis.

·         Based on the initial differential diagnosis, select initial diagnostic (laboratory, imaging, etc.) studies and therapeutic interventions, with some supervision.

·         Integrate the results of diagnostic studies to refine the differential diagnosis.

·         Select additional diagnostic studies and therapeutic interventions based on the refined differential diagnosis, with some supervision.

·         Counsel patients/families about their medical conditions and educate them about the diagnostic and treatment plan.

·         Work toward completing the requirements for technical and cognitive proficiency for invasive procedures, especially those required by the ABFM and ACOFP.  Perform invasive procedures under supervision until those requirements are met.

·         Write daily SOAP notes on all patients they are following and discuss the findings and plan of treatment at rounds with the faculty attending.

·         Recognize the role of healthcare providers from other disciplines and services, and work in cooperation with those providers to provide comprehensive, patient-centered care.

 

PGY-2 Residents are also expected to:

·         Demonstrate the ability to diagnose and manage a wide variety of inpatient medical conditions including the management and stabilization of unit patients having potentially life-threatening medical conditions.

·         Demonstrate the ability to elicit subtle findings from the history and physical exam or to augment the physical exam with additional maneuvers as needed to support or refute a diagnostic hypothesis.

·         Integrate all information from history, physical exam and diagnostic studies to develop a diagnostic and therapeutic plan with minimal supervision.

·         Begin to incorporate consideration of risks, benefits, and costs into patient management plans.

·         Effectively communicate the management plan to patients/families and modify that plan based on their values and preferences.

·         Begin to utilize information technology to retrieve and apply current medical evidence (e.g. guidelines, original literature) to refine the patient management plan.

·         Initiate and coordinate the involvement of healthcare providers from other disciplines and services to provide comprehensive, patient-centered care.

·         Write daily SOAP notes on all patients they are following and discuss the findings and plan of treatment at rounds with the faculty attending.

·         Work toward completing the requirements for technical and cognitive proficiency for invasive procedures, especially those required by the ABFM and ACOFP.  Perform invasive procedures under supervision until those requirements are met.

 

PGY-3 Residents are also expected to:

·         Demonstrate the ability to diagnose and manage a wide variety of inpatient medical conditions including the management and stabilization of unit patients having serious and life-threatening medical conditions.

·         Integrate all information from history, physical exam and diagnostic studies to develop a diagnostic and therapeutic plan at the level of a family physician without need for supervision.

·         Consistently incorporate consideration of risks, benefits, and costs into patient management plans.

·         Consistently utilize information technology to retrieve and apply current medical evidence (e.g. guidelines, original literature) to patient management.

·         Supervise all junior resident patients including reviewing the daily SOAP notes.

·         Complete the requirements for technical and cognitive proficiency for invasive procedures, especially those required by the ABFM and ACOFP.

 

Core Competency: Medical Knowledge

Goal: Residents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

 

Progressive Learning Objectives:

PGY-1 Residents are expected to: 

·         Have a basic understanding of the mechanism of diseases commonly encountered in a family medicine ambulatory clinic and on family medicine inpatient services, as demonstrated by:

o        The ability to define an “illness script” for these conditions that includes the risk factors for the condition, the pathophysiologic insult, and the presenting signs and symptoms. 

o        The ability to develop an appropriate initial diagnostic and treatment approach to these conditions, with some supervision.

·         Display an attitude of inquisitiveness and a desire to continuously expand their knowledge base.

·         Utilize reference materials (e.g. textbooks, Up-To-Date®, pocket references) to correct deficits in knowledge related to the diagnosis and treatment of the patients for which they providing care.  

·         Demonstrate appropriate cognitive knowledge of internal medicine learning areas consistent with level of training.

PGY-2 Residents are also expected to:

·         Have more in-depth understanding of diseases commonly encountered in a family medicine ambulatory clinic and on internal medicine inpatient services, as demonstrated by the ability to develop an appropriate initial diagnostic and treatment approach to these conditions, with minimal supervision.

·         Utilize current medical evidence (e.g. guidelines, original literature) to correct deficits in knowledge related to the diagnosis and treatment of the patients for which they providing care.

·         Develop a plan of systematic, independent study to expand their knowledge of internal medicine and its subspecialties.  

·         Demonstrate appropriate cognitive knowledge of internal medicine learning areas consistent with level of training.

PGY-3 Residents are also expected to: 

·         Have an understanding of diseases encountered in a family medicine practice that is appropriate, as demonstrated by the ability to develop a comprehensive diagnostic and treatment approach to these conditions without supervision.

·         Have a basic understanding of unusual or complex diseases commonly encountered in the subspecialties of internal medicine, as demonstrated by the ability to:

o        Develop an appropriate initial diagnostic and treatment approach to these conditions.

o        Refer to a consultant, when appropriate.

·         Demonstrate appropriate cognitive knowledge of internal medicine learning areas consistent with level of training.

Core Competency: Practice-Based Learning and Improvement

Goals: Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. 

Progressive Learning Objectives:

PGY-1 Residents are expected to: 

·         Be able to teach medical students.  Seek and accept feedback from students and use that feedback to improve their teaching and supervisory skills.

·         Seek and accept feedback from attendings and supervising residents, and utilize that feedback to improve their clinical performance.

·         Set short-term learning goals for this rotation based on cases encountered on the service.

·         Set long-term learning goals (learning plan) for the academic year and residency with their advisor.

·         Be able to formulate clinically relevant questions related to the diagnosis and treatment of their patients’ medical conditions.

·         Be familiar with common databases of medical literature (e.g. Medline) and common search engines (e.g. OVID, PubMed, etc.).

 PGY-2 Residents are also expected to:

·         Be able to supervise and teach medical students and interns. Seek and accept feedback from students and interns, and use that feedback to improve their teaching and supervisory skills.

·         Seek and accept feedback from attendings, and utilize that feedback to improve their clinical performance.

·         Set longer-range learning goals for their residency training.  Develop learning plans with their advisor to help achieve those goals and a method of evaluation to determine their success in meeting them.

·         Know basic methods for searching the medical literature, and be able to find original medical literature related to the diagnosis and treatment of their patients’ conditions.

·         Be able to critically appraise literature related to diagnosis and treatment, and appropriately apply the results of that literature to their clinical practice.    

PGY-3 Residents are also expected to:

·         Be able to present effective teaching conferences, including Morning Report and a Clinical Pathological Conference.

 

Core Competency: Interpersonal and Communication Skills  

Goals: Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients families, and professional associates.

Progressive Learning Objectives:  

PGY-1 Residents are expected to:

·         Provide verbal presentations that are thorough, yet succinct and pertinent, and that reflect understanding of the patients’ condition and/or support a differential diagnosis.

·         Provide dictated and written notes that meet the same criteria.  In addition, written notes should be legible.

·         Provide written/electronic and verbal sign-out of patients that is efficient, pertinent, and explicit.

·         Be open and receptive to questions and recommendations from members of the nursing staff and ancillary healthcare services.

·         Develop a therapeutic relationship with patients and their families, regardless of their background.

·         Be able to explain a patient’s condition and plan of care to the patient and family in terms that are understandable and appropriate.

·         Be able to discuss the risks and benefits of procedures or interventions with patients and families, and obtain informed consent.

·         Be able to discuss resuscitation status with patients and families, answer their questions regarding this issue, and elicit the patient’s wishes in regard to cardiopulmonary resuscitation.

·         Communicate expectations to students and provide them with feedback.

·         Dictate discharge summaries that succinctly summarize and convey the pertinent details of the patient’s hospitalization and post-hospitalization follow-up needs. 

PGY-2 Residents are also expected to:

·         Provide written senior admission notes that succinctly summarize the patient’s condition, reason for admission and management plan.

·         Dictate discharge summaries that succinctly summarize and convey the pertinent details of the patient’s hospitalization and post-hospitalization follow-up needs.

·         Effectively communicate verbally with consulting physicians.  Be able to succinctly summarize the patient’s condition and the explicit reason(s) why consultation is being requested.

·         Effectively communicate and coordinate the plan of care with nursing staff and members of ancillary healthcare services.

·         Engage patients and their families in shared decision-making, especially in situations whether there is clinical uncertainty and /or ambiguity.

·         Lead family/team meetings, with some support from the attending physician, including discussions of end-of-life care.

·         Be able to resolve conflicts with patients/families, staff, or within the team, with some involvement of the attending physician.

·         Communicate expectations to interns and students and provide them with feedback.  

PGY-3 Residents are also expected to:

·         Effectively communicate with junior resident physicians as a consultant, and be able to provide succinct, explicit recommendations both verbally and in writing.

·         Lead family/team meetings, with minimal or no support from the attending physician, including discussions of end-of-life care.

·         Be able to resolve conflicts with patients/families, staff, or within the team, with minimal or no involvement of the attending physician. 

Core Competency: Systems Based Practice

Goal: Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.  

Progressive Learning Objectives:  

PGY-1 Residents are expected to:

·         Complete all charting/documentation/dictations in a timely manner.

·         Learn the role of other members of the healthcare team, including case managers, social workers, physical/occupational/speech/respiratory therapists, dieticians, clinical pharmacists, and others.

·         Recognize when their patients may benefit from the involvement of other healthcare providers, and invoke their assistance when appropriate.

·         Learn what evidence-based guidelines and standardized order sets are available in our institution.  Know how to find these resources, and utilize them when appropriate for patient care.

·         Prescribe medications and diagnostics in accordance with the patient's health plan or obtain prior authorization/patient assistance when necessary.

 PGY-2 Residents are also expected to:

·         Effectively coordinate the involvement of healthcare providers from other disciplines and physicians from other specialties to provide comprehensive, patient-centered care.

·         Learn to anticipate patients’ discharge needs (e.g. transportation and medication assistance; need for placement, home health care, and durable medical equipment; etc.), and begin discharge planning early in their hospitalization, with some prompting by the attending physician.

PGY-3 Residents are also expected to:

·         Consistently anticipate patients’ discharge needs and begin discharge planning early in the hospitalization, with minimal or no prompting by the attending physician.

·         Describe the basic systems of payment for health care, and the principal types of payers for health care.

·         Demonstrate understanding of commonly used coding systems and describe the relationship between supporting documentation, accurate coding and reimbursement.

·         Demonstrate understanding of basic principles of healthcare management systems.

 

Core Competency: Professionalism  

Goal: Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

 Progressive Learning Objectives:  

PGY-1, PGY-2, and PGY-3 Residents are expected to:

·         Treat all patients, regardless of background, with respect, compassion and empathy.

·         Treat everyone else – nursing staff, ancillary healthcare providers, program personnel, students, residents from our own and other programs, attending physicians in all specialties, others – with respect and courtesy, and in a way that reflects positively on them as individuals and the medical profession as a whole.

·         Respect patients’ autonomy and their right to make informed decisions about their own health care.

·         Commit to advocating for their patients’ needs in the healthcare system, and be willing to place the patients’ needs above their own.

·         Commit to provide the highest quality, most effective and most efficient care that their experience and level of training permit.

·         Understand and safeguard patient confidentiality and protected health information.

·         Be honest in all aspects of their professional life, including documentation of patient information, disclosure of medical errors, and acknowledgement of deficiencies in medical knowledge and clinical skills.

·         Be committed to self-directed learning, self-evaluation, and self-improvement.

·         Comply with the policies and expectations of the residency program, and complete administrative tasks (e.g. evaluation forms, medical records, logs) on time.

·         Be willing to assist their colleagues and the program with patient care and service coverage when needed.

·         Prompt completion of duties such as, but not limited to, timely reporting for clinical duties and educational activities, completion of portfolio requirements, completion of medication and other flow sheets used in the ambulatory setting, timely response to patient messages.

·         The PGY-2resident will have demonstrated the ability to act in a supervisory capacity to the junior residents when the senior resident is unavailable.

·         The PGY-3 resident will have demonstrated the ability to appropriately manage and organize a medicine service with the attending staff physician.

·         The PGY-3 resident will have demonstrated the ability to foster a teaching environment for junior residents by being available for consultation, teaching and assistance in a timely manner.

Core Competency: Osteopathic Principles and Practice / Osteopathic Manipulative Medicine 

Goal: Osteopathic resident demonstrates a commitment to osteopathic principles and practice by including and documenting osteopathic diagnosis and treatment in their patient encounters.

PGY1 Residents are also expected to:

·         Be able to complete and document an osteopathic exam for inpatients.

·         Perform and review osteopathic examination with osteopathic preceptor.  

·         Integrate osteopathic principles and philosophy into patient care in the hospital setting.

·         Document osteopathic manipulative diagnosis and treatment in patient’s charts.

·         Understand the indications and contraindications for osteopathic manipulative techniques.

 PGY-2 Residents are also expected to:

·         Identify when to utilize osteopathic manipulative techniques in the care of their hospitalized patients..

·         Teach PGY 1 residents and students osteopathic examination techniques.

PGY-3 Residents are also expected to:

·         Teach more advanced techniques of osteopathic manipulative medicine to junior residents and students under supervision of osteopathic attending.

·         Clearly articulate the indications and contraindications for utilizing osteopathic manipulative techniques.

·         Actively promote osteopathic principles and philosophy in patient care through promoting them on a daily basis.

Learning Areas

1. Allergy and Immunology

• Understand the biology of the immune response, immunological tolerance, mechanisms of allergic reaction, anaphylaxis, active and passive immunization, immuno-suppression and potentiation, environmental control.
• Understand the diagnosis and management of primary and acquired immunodeficiency
• Understand how to perform an allergic history and initiate treatment programs for allergic patients.

2. Cardiovascular Disease

• Know the diagnosis, evaluation and treatment of heart murmurs, hypertension, peripheral vascular disease, heart failure, coronary artery disease, infective endocarditis, cardiac arrhythmias, pulmonary heart disease, congenital heart disease, and valvular heart disease.
• Know the signs and symptoms of cardiac manifestations of systemic diseases.
• Know how to perform a cardiac history and exam, pre-op evaluation, CPR protocols, EKG interpretation and CAD prevention (risk factors and modification).
• Know indications for bypass surgery.

3. Dermatology

• Know the diagnosis and treatment of common skin disorders: papulosquamous, vesiculobullous and eczematous diseases, macular and urticarial eruptions, pruritic conditions, pyoderma, acne and skin injuries (burns, shock and chemical).
• Know how to perform biopsy, culture and skin scrapings

4. Endocrinology

• Know the diagnosis and management of thyroid disease, diabetes mellitus (including DKA) and secondary hypertension.

5. Gastroenterology

• Know the diagnosis and management of non-ulcerative gastritis, constipation and diarrhea, anal fissure and fistula, perineal and perianal abscess, proctitis, rectal pain, hemorrhoids, peptic ulcer disease, gallbladder disease, hepatitis and hepatic coma, pancreatitis, inflammatory bowel disease, GI bleeding (varices, gastritis, ulcer), GI malignancy and acute abdomen.
• Know indications for endoscopic studies and abdominal imaging studies.
• Know TPN indications and methods.

6. Hematology

• Know the diagnosis, evaluation and treatment for anemia, coagulation defects.
• Know the diagnosis and evaluation for white blood cell and platelet abnormalities.
• Know the indications for transfusion (blood and blood products) and management of transfusion reactions.
• Know how to interpret CBC and differential, peripheral blood smears and coagulation studies.

7. Infectious Disease

• Know the diagnosis and management of bacterial sepsis, urinary tract infection, meningitis, STDs, abscesses (furuncle, carbuncle, anorectal, pelvic), respiratory infections (URI, laryngitis, tracheitis, bronchitis, bronchiolitis, pneumonia, pleurisy), parasitic infections (pinworm, scabies, pediculosis, ascariasis, helminthiasis), viral exanthemas and intrauterine infection.
• Know the appropriate and proper specimen collection.
• Perform lumbar puncture, wet prep, KOH prep, Tzanck smear, gram stain, stool evaluation for parasites.
• Know appropriate antibiotic selection and sensitivity testing.
• Know appropriate epidemiology and control of infection diseases, isolation techniques and immunization programs.

8. Nephrology

• Know the diagnosis and management of electrolyte abnormalities, acid-base disturbances, proteinuria, hematuria, acute and chronic renal failure, urinary calculi and obstruction, renal hypertension, diabetic glomerulosclerosis, SIADH, diabetes insipidus, eclampsia, glomerulonephritis, nephrotic syndrome.
• Know how to perform and interpret microscopic urinary evaluation, renal function tests.
• Know the signs and symptoms of renal disease from system illness (endocarditis, chronic infections, collagen vascular disease, sickle cell anemia, and multiple myeloma).
• Know the signs and symptoms of hereditary renal disease.
• Know the signs and symptoms and evaluation for renal cancer.
• Know indications and management of renal dialysis and transplant.
• Know indications for renal imaging studies.

9. Neurology

• Know the diagnosis and management of alterations of consciousness, dementia (Alzheimer, pseudo-dementia, acute confusion), dizziness and vertigo, seizure disorders, headaches and migraines, memory loss, Parkinson’s (movement disorders), neuropathies, TIA, CVA, meningitis and encephalitis, MS, Myasthenia Gravis, Temporal Arteritis and Trigeminal Neuralgia.
• Know the diagnosis and treatment of coma, increased intracranial pressure and acute visual loss.
• Know the definitions of acute brain death and vegetative state.
• Know indications for neurologic testing (EMG, EEG, MRI, CT and ENG).

10. Oncology

• Know the common malignancies and their presentations for GI, respiratory (trachea, larynx, lung), skin, breast, genital tract, urinary tract, Hodgkin’s disease and lymphoma, leukemia and bone and soft tissues.
• Know the presentations of common benign lesions (lipoma, skin tags, warts, fibrocystic and fibroadenoma breast, uterine fibroids).
• Know the appropriate screening procedures for common cancers (stool guiac, pap, pelvic exam, rectal exam, breast exam, oral exam).
• Understand the proper use of analgesic, narcotic and psychotropic drugs.

11. Pulmonary

• Know the diagnosis and management of COPD, chronic bronchitis, asthma, pneumonia, pulmonary embolism, sleep apnea, pleural effusions, TB and respiratory malignancies.
• Know the indications and interpretation of ABGs and pulmonary function tests.
• Know the indications and interpretation of pulmonary imaging studies.
• Know the indications and interpretation of diagnostic studies (thoracentesis, bronchoscopy).

12. Rheumatology

• Understand the diagnosis and management of the common rheumatic diseases.
• Understand the indications and interpretation of the common serological studies.
• Understand the indications and interpretation of arthrocentesis.

13. Geriatrics

• Understand the specific issues and medical problems associated with the geriatric population.
• Know the specific community and hospital resources available specifically for the geriatric population.
• Additional Geriatric training will occur on the Inpatient Medicine Service with Dr. Amy Daros. Dr. Daros will meet with the PGY-1 residents during the week to review their geriatric patients and make recommendations.

Monographs- See Monograph Grid

Independent reading – Suggested sources for medical topics

·         AAFP Journal

·         AAFP Monograph Series

·         AAFP Video CME Series

·         AAFP Online: http://www.aafp.org/

·         JFP Online: http://www.phypc.med.wayne.edu/jfp/jfp.htm

·         National Guideline Clearinghouse: http://www.guidelines.gov/index.asp

·         General Internal Medicine/Comprehensive Textbooks

·         Textbook of Primary Care Medicine J. Noble; H. Greene; W. Levinson; G. Modest; M. Young. Mosby-Year Book

·         Cecil Textbook of Medicine J. Bennett and F. Plum. W.B. Saunders Company

·         Current Medical Diagnosis and Treatment L. Tierney; S. McPhee; M. Papadakis. Appleton & Lange Publishers, Stamford

·         Current Practice of Medicine R. Bone. Current Science, Inc.

·         Harrison's Principles of Internal Medicine K. Isselbacher; J. Martin; A. Fauci; J. Wilson; D. Kasper; S. Hauser; D. Longo. The McGraw-Hill Companies

·         Internal Medicine J. Stein. Mosby-Year Book

Resident Duties

PGY-1:

1.       Round on all your patients prior to attending rounds. Know all relevant labs and tests. If you have questions or concerns check with your senior residents.

2.       Daily progress notes.

3.       H & P on new medicine admissions during the day.

4.       Present your patients during attending rounds.

5.       Discharge summaries on all your assigned patients.

6.       Read on your assigned patients and present this information when possible (morning report or rounds).

7.       Perform procedures with appropriate supervision.

8.       Attend morning reports and Wednesday afternoon conferences.

9.       Round on weekends per schedule (schedule done by senior residents).

10.   Respond to floor calls.

PGY2:

1.       Assume senior role when senior is not available (supervise junior residents and review admissions and orders).

2.       Be available for instruction and evaluation of junior residents.

3.       Round on all your patients prior to attending rounds. Know all relevant labs and tests. If you have questions or concerns check with your senior residents.

4.       Daily progress notes.

5.       Present your patients during attending rounds.

6.       Assigned patients will be of higher acuity than junior residents (unit patients) will.

7.       Read on your assigned patients and present this information when possible (morning report or rounds).

8.       Perform procedures with appropriate supervision.

9.       Attend morning reports and Wednesday afternoon conferences. (CPC Conference)

10.   Round on weekends per schedule (schedule done by senior residents).

PGY3:

1.       Round on all your patients prior to attending rounds. Know all relevant labs and tests. If you have questions or concerns check with your attending.

2.       Maintain the service morale and foster a teaching atmosphere for the junior residents.

3.       Maintain an efficient service by ensuring prompt and appropriate ordering of tests and discharge planning.

4.       Maintain a working knowledge of all patients on the service. Pull patient census every morning and make sure all patients are assigned.

5.       Assign patients to junior residents. Give clear expectations as to their responsibilities.

6.       Be available to junior residents – answer questions, see patients and review their treatment plans and H & Ps.

7.       Write an admit note on all new patients.

8.       Make weekend rounding schedule. (A senior resident must make rounds every weekend).

9.       Meet with attending and schedule attending rounds.

10.   Attend weekend sign out rounds.

11.   Carry medicine code beeper.

12.   Cover FHC answering service.

13.   Read on interesting patients and present this information (articles) when possible (morning report or rounds). Provide medicine team with relevant articles on interesting teaching cases and rounds.

14.   Perform procedures with appropriate supervision.

15.   Attend morning reports and Wednesday afternoon conferences.

16.   Complete billing sheets for attending signature

 

A family practice core faculty physician will round with the staff medicine service on a daily basis.

1.       The staff physician will attend daily rounds with the medicine team supervising the management of all patients on the service.

2.       The staff physician will provide instruction and feedback to the residents on the management and care of all patients on the service.

3.       The staff physician will take part in evaluations of the residents during the medicine block and provide feedback to the Program Director and the CDE committee on issues relating to residents and the Medicine rotation.

Morning Report & Noon Conference

All medicine residents are expected to attend all morning reports and Wednesday afternoon conferences. Family Practice Faculty as assigned by the Program Director will monitor conference attendance.

Evaluation

All residents will take the assigned rotation quiz following completion of the rotation.

Residents will be evaluated by the staff attending physicians assigned during the rotation

Residents following completion of the rotation will evaluate staff attending physicians and faculty.

Schedule: See individual rotation grids.