| - Evaluate patients with chest pain/dyspnea and initiate treatement
- Identify adverse drug reactions
- Initiate treatment and diagnostic plans for common cardiac problems (CHF, Arrythmias,HTN, Atrial fibrillation, MI)
- Describe managment of common pulmonary problems (COPD,Asthma, Community Acquired Pneumonia)
- Evaluate patients with common GI problems (Abdominal pain, GI bleed, N/V, Constipation)
- Describe methods of pain control in the inpatient setting.
- Recognize and treat electrolyte Disorders
- Evaluate patients with Renal Failure
- Describe the components of a Sign out, Develop a sign out on patients
- List the components of Discharge Summaries.
- Display effective communication with Consultants.
- Perform thorough but succinct case presentations at the bedside
- Interpret common test results such as CXR, ECG, UA
- Perform and describe protocols for Cross Coverage Hospitalized patients
- Describe basic triage decisions such as indications for telemetry or ICU/CCU monitoring
- Perform appropriate internal medicine procedures under guidance of a experienced physician
- Develop strategies for communication of Bad News
- Enhance physical diagnosis skills of cardiac, lung and abdominal exam
- Review principles of Evidence based Decision-making.
Order Writing:
Students are allowed to enter patient orders only after getting cosignature from an attending, resident or intern from their team.
Orders should only be cosigned by your team. Interns on your team can cosign or your simple orders at any time. These consist of labs, ordering radiology, giving Tylenol for pain. However complex decision-making( ex. tube feeds, PCA pump, antibiotics, starting heparin) can be cosigned by the intern only if confirmation from resident or attending has been obtained. This typically occurs when the resident has his/her day off. These rules will be strictly enforced. Failure to follow these rules may result in a failing grade. AT NO TIME MAY A STUDENT ASK A RESIDENT NOT INVOLVED IN THE PATIENTS' CARE TO COSIGN ORDERS AS THIS IS A PATIENT SAFETY RISK. Cross Coverage:
On weekdays the long call subintern will cross cover on his fellow subI’s patients until 730 PM. They will subsequently transfer care to the night float intern. On the weekend, the long call subI is not responsible for any cross coverage. They will only be responsible for their own patients. Cross-coverage is a time for independent evaluation, however after evaluating the patient, all decision making must be discussed with your resident or attending. If you are asked to see a patient on cross-cover you should always write a note and page an intern or resident from your team to discuss the case. Procedures:
There will be certain procedures that can be done without supervision.
IVs and Blood draws(only arm blood draws)
All other procedures must be supervised by a senior resident or attending.(These include but are not limited t ABG,thoracentesis, paracentesis, NG or dopoff insertion, spinal tap) Day to day responsibilities:
These are similar to the responsibilities of the PGY-1 residents. Independent history taking and physical exam is encouraged. The subintern is then encouraged to think independently about patient care. However, all final decision-making should be in conjuction with a resident or attending. Under no circumstance should a subI evaluate a patient and proceed with decision making without the guidance of a senior resident or attending. Staffing of services:
Northwestern service: 1 attending, 1 resident, 1 or 2 subinterns, 2 junior students: maximum number of patients for sub I is four. Working with a hospitalist:
You may be working with a hospitalist for 2 weeks. During the 2 weeks you will be working one on one with an attending. You will see patients and then make decisions with the assistance of the attending. Hospitalist: 1 attending, 1 senior student. Maximum number of patients is 6. Conferences:
We will meet 2x a week. Tuesday and Thursday at 2PM in the 10SE conference room. The conference will be divided into case conference and didactic lecture. 1st conference: Cross coverage scenarios
2nd conference: Antibiotics
3rd conference: Diabetes/diabetic medications
4th conference: Administering pain medications
5th conference: Acute renal failure/electrolytes
6th conference: EKG readings/CHF medications/post MI medications
7th conference: How to do a good discharge summary?
8th conference: How to do a good case presentation?
9th conference: Mechanical Ventilation
10th conference: How to run a code?
11th conference: Ethics conference
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