Two teams, each comprising of one resident and 2-3 interns, provide care to hospitalized internal medicine patients on general medical wards. For the first 2 blocks of the academic year, the teams have 3 interns each, for the remaining 11 blocks the teams have 2 interns each. All resident care of patients is supervised by academic hospitalist attending physicians.
During the rotation, residents will learn through participation in:
- Experiences include:
- Procedures including abdominal paracentesis, ABG, NG tube placement, thoracentesis, central line placement, EKG analysis
- Review of radiologic studies with a radiologist and daily as needed
- Formal teaching sessions lunch and learn and morning report
- Morning and afternoon patient management rounds with the hospitalist attending physician.
6:45 a.m. – 7:30 a.m.: Day interns get sign-out on old patients, usually in the midst of pre-rounding on old patients, read new patient H&Ps.
8:00-8:30 Team Communication- Senior Resident meets with interns to discuss plan for the day
8:30-9:00 a.m. Daily Progress Notes are put into final structure
9:00 -11:30 a.m. Morning Work Rounds
The interns and resident join attending to round on patients and finalize management plan for the day. Interns are expected to present preliminary plan for their patients in rounds, residents are expected to determine sequence of patients and identify learning opportunities, attending physicians are expected to support the team and resident in their learning and patient care decisions. Use of a rounding template is encouraged. Efficient day begins with efficient and effective work rounds.
11:30 -12:15 p.m. Multidisciplinary Rounds
Team resident reviews/contacts allied health providers including case managers, nutritionists, physical and respiratory therapists, social workers and nurses to coordinate care and make discharge plans. MDR rounds are facilitated by the resident.
3 p.m. Short-call team takes its last admission
4 p.m. Afternoon Rounds
Each ward team convenes with their attending to review the patients’ progress, discuss new patients. Thereafter, team members share their answers to previously identified clinical questions. This time also serves as a venue to discuss team dynamics and identify strategies for improvement.
6:45 p.m. Handoff to the night team