OVERVIEW
The Inpatient General Medicine rotation provides house officers exposure to the diagnosis and treatment of a broad spectrum of medical disease. This rotation is intended to provide the exposure, clinical knowledge, skills, and professional attitudes needed to care for patients. The medical team consists of a supervising attending physician, a resident, one intern, and medical student. PGY-1 residents spend two months on this service.
PATIENT CARE
Interns, under the supervision of a resident and attending, are expected to
MEDICAL KNOWLEDGE
Interns will learn about the diagnosis, evaluation, and treatment of the following major disease categories:
Acute Abdominal Pain, Asthma , Atrial Fibrillation, Chronic Obstructive Pulmonary Disease,Congestive Heart failure, Coma, Diabetes, Diarrhea, Delirium and Dementia, Diverticulitis, Electrolyte Abnormalities: Diagnosis and Management, Endocarditis, Fever of Unknown Origin, Hepatitis, Intestinal Obstruction and Ischemia, Meningitis, Nephrolithiasis, Pancreatitis, Renal Failure, Sickle Cell Disease, Sleep Apnea, Syncope / Falls, Tuberculosis, Pneumonia, Valvular Heart Disease, Venous Thromboembolism
INTERPERSONAL AND COMMUNICATIONS SKILLS
Interns are expected to demonstrate skills to communicate effectively with
PROFESSIONALISM
Interns are expected to demonstrate professional behavior such as timeliness, responsibility in follow-through, compassionate patient care, and to provide professional role modeling to medical students. Interns are expected to attend all teaching activities and to follow a syllabus for self-directed learning that is distributed to house staff at the beginning of their rotation on the Mercy Inpatient General Medicine Service.
General Syllabus
General Medicine Reference Links: http://medicine.uchicago.edu/section_pages/gmed/Intranet/Reference.htm
Program’s Gen Med “Guideline/Landmark Article” Links:
OVERVIEW
The General Medicine Consultation Service at UCM is a clinical rotation that provides house officers exposure to the diagnosis and treatment of a broad spectrum of medical disease. This rotation is intended to provide the exposure, clinical knowledge, skills, and professional attitudes needed to care for these patients. The medical team consists of a supervising attending physician, an intern and a medical student at times; the rotation lasts for two months for those residents who wish to do 4 months of medicine in the PGY-1 year.
PATIENT CARE
The intern will
MEDICAL KNOWLEDGE
Interns will learn about the diagnosis, evaluation, and treatment of a wide range of cardiac, pulmonary, endocrine, hematologic, GI and renal disease presentations, among others.
INTERPERSONAL AND COMMUNICATIONS SKILLS
Interns are expected to demonstrate skills to communicate effectively with
PROFESSIONALISM
Interns are expected to demonstrate professional behavior such as timeliness, responsibility in follow through, compassionate patient care, and to provide professional role modeling to medical students. Interns are expected to attend all teaching activities and to follow a syllabus for self-directed learning that is distributed to housestaff at the beginning of their rotation on the Inpatient General Medicine Service.
EDUCATIONAL MATERIALS
General Syllabus
The PGY-I Neurology rotation is a two-month rotation on the adult neurology consultation service at UCM. Residents may elect to spend one month on the adult neurology service and one month on the pediatric neurology service. The Psychiatry Resident works with the Neurology Resident to evaluate patients as requested by the various inpatient services throughout the medical center. The Resident then rounds with the attending on the consultation service, and all new consults are staffed by an attending neurologist. Patients are followed up as needed.
GOALS AND OBJECTIVES:
Patient Care--The resident will see, examine and evaluate all consults as soon as possible, and will provide feedback to the requesting service as soon as possible.
Medical Knowledge--the resident will evaluate and learn about a broad array of acute and chronic neurological disorders that arise in the hospitalized general medical population. The resident will continue to refine history and physical, differential diagnosis, and management skills acquired in the PGY-1 year.
Interpersonal and Communication Skills--the resident will learn to interact and communicate effectively with colleagues in other medical disciplines.
Professionalism--the resident will aid in educating other house staff and medical students with respect to neurological diseases.
System Based Practice--the resident will learn to function as a consultant rather than the primary caregiver.
The Inpatient pediatric experience has been designed to develop the needed competencies for an intern to manage patients with a wide array of conditions requiring hospitalization, from the perspective of a general pediatrician. As an intern, the general pediatrics inpatient experience comprises 1-2 months of service at Comer Children’s Hospital at the University of Chicago. This monthly rotation is organized with a team consisting of two day senior residents and 4 interns. The four interns are responsible for Q4 in-house 16-hour overnight call on their service and are supervised overnight by two alternating night senior residents to maintain continuity of care. Residents are required to attend all scheduled meetings and conferences except when detained by a medical emergency on the wards.
While on this rotation the intern is expected to act as a primary physician for the designated patients. The intern is expected to perform a complete history and physical exam, formulate a differential diagnosis and working diagnosis, and develop a treatment plan appropriate to the suspected diagnosis or condition, all under the supervision of a senior resident with whom all aspects of care are discussed. Interns are then expected to follow their patients throughout the length of the rotation, being responsible for the day to day management, follow up, procedures, consultations and discharge planning under the close supervision of the supervising resident and attending physician.
The attending physician has ultimate responsibility for the patients admitted under his/her care. The attending carries out daily rounds with the team and discusses each patient, verifying history and physical findings, and guiding the residents through the discussion of the appropriate management from the perspective of a general pediatrician. Rounds and attending-resident interaction provide the opportunity for the discussion of differential diagnoses, criteria for hospitalization, evidence-based treatment plans, and cost-effective medical care. Attending physicians are Board Certified in General Pediatrics and act as role models in the intervention and communication with patients. They actively participate in family conferences, the process of delivering difficult information for patients and families, the interpretation of diagnosis and management plans to patients, in obtaining DNR authorizations, and in discussions with consultants, among others. The attending physician is readily available for consultation 24 hours a day, 7 days a week.
The rotation seeks to emphasize several principles essential to the practice of general pediatrics:
COMPETENCY 1. Patient Care – Interns are expected to provide patient care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, and treatment of disease. To that end, interns will:
COMPETENCY 2. Medical Knowledge – Interns are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care and the education of others. Interns are expected to apply an open-minded, analytical approach to acquiring new knowledge, access and critically evaluate current medical information and scientific evidence, and apply this knowledge to clinical problem solving clinical decision making, and critical thinking. Specifically, interns will:
COMPETENCY 3. Practice-Based Learning and Improvement – Interns are expected to be able to use scientific evidence and methods to investigate, evaluate, and improve patient care practices. To that end, interns will:
COMPETENCY 4. Interpersonal and Communication Skills – Interns are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams. To that end, interns will:
COMPETENCY 5. Professionalism – Interns are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession and society. To that end, interns will:
COMPETENCY 6. System-Based Practice – Interns are expected to demonstrate both an understanding of the contexts and systems in which health care is provided and the ability to apply this knowledge to improve and optimize health care. To that end, interns will:
PGY-1 Residents spend one month electively in the Emergency Department at Comer Children’s Hospital
COMPETENCY 1. Patient Care – Residents are expected to provide patient care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, and the treatment of disease. To that end, the resident will:
COMPETENCY 2. Medical Knowledge – Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical, and social sciences, and the application of their knowledge to patient care and the education of others, and apply an open-minded, analytical approach to acquiring new knowledge. The resident will access and critically evaluate current medical information and scientific evidence, and apply this knowledge to clinical problem-solving, clinical decision-making, and critical thinking.
-> Through clinical experience, attending physician education, and independent reading, resident knowledge should include, but not be limited to, the following disorders, and should emphasize the pathophysiologic correlates of the clinical situations:
-> The resident is expected to review clinical guidelines for the above disorders found on the Chief Resident website as well as review other pertinent literature related to the above conditions
COMPETENCY 3. Practice-Based Learning and Improvement – Residents are expected to be able to use scientific evidence and methods to investigate, evaluate, and improve patient care practices, and
COMPETENCY 4. Interpersonal and Communication Skills – Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams, and
COMPETENCY 5. Professionalism – Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession and society, and
COMPETENCY 6. Systems-Based Practice – Residents are expected to demonstrate both an understanding of the contexts and systems in which health care is provided and the ability to apply this knowledge to improve and optimize health care. The resident should:
OVERALL PROGRAM GOALS & EDUCATIONAL OBJECTIVES
GOALS
EDUCATIONAL OBJECTIVES:
PEDIATRIC NEUROLOGY RESIDENT RESPONSIBILITIES:
PATIENT CARE:
The PGY-1 resident will be able to:
MEDICAL KNOWLEDGE
The PGY-1 resident will be able to:
SYSTEMS BASED PRACTICE
The PGY-1 resident will be able to:
INTERPERSONAL AND COMMUNICATION SKILLS
The PGY-1 resident will be able to:
PROFESSIONALISM
The PGY-1 and PGY-2 resident will be able to:
PATIENT CARE
The PGY-1 resident will be able to:
INTERPERSONAL AND COMMUNICATION SKILLS
The PGY-1 resident will be able to:
MEDICAL KNOWLEDGE
The PGY-1 resident will be able to:
PROFESSIONALISM
The PGY-1 resident will:
PATIENT CARE:
The resident will be able to:
MEDICAL KNOWLEDGE
The resident will be able to:
SYSTEMS BASED PRACTICE
The resident will be able to:
INTERPERSONAL AND COMMUNICATION SKILLS
The resident will be able to:
PROFESSIONALISM
The PGY-2 resident will be able to:
PATIENT CARE
The resident will be able to:
INTERPERSONAL AND COMMUNICATION SKILLS
The resident will be able to:
MEDICAL KNOWLEDGE
The resident will be able to:
PROFESSIONALISM
The resident will:
SYSTEMS BASED PRACTICE
The resident will:
PATIENT CARE:
The resident will learn how to conduct emergency psychiatric evaluations through the examination, evaluation, and provision of emergency care to patients presenting to the UCMC Emergency Room with emergent psychiatric and substance-related problems, and/or with psychiatric symptoms of medical problems.
MEDICAL KNOWLEDGE:
The resident will develop a basic knowledge of
The resident will learn to differentiate psychiatric emergencies from medical/surgical emergencies with psychiatric symptoms.
INTERPERSONAL AND COMMUNICATION SKILLS:
The resident will learn to interact with the ER doctors and staff to provide optimum care for psychiatric patients in the ER.
SYSTEMS BASED PRACTICE:
The resident will learn about the State of Illinois Mental Health System including hospitals and community mental health centers, Substance Abuse treatment programs and other community resources for referral purposes.
PATIENT CARE:
PGY-II psychiatric residents will treat substance abuse inpatients for acute detoxification from a large variety of substances, and follow substance abuse rehabilitation patients in inpatient, partial hospital, and outpatient programs at UChicago Medicine Ingalls Memorial. Residents will conduct a "medical aspects of addiction" group for inpatients.
MEDICAL KNOWLEDGE:
Residents will:
PROFESSIONALISM:
Residents will develop an attitude of helpfulness, compassion, and empathy toward patients with substance abuse problems, and will develop a realistic understanding of what psychiatry can provide for such patients. Residents will consider the complex issue of physician impairment.
SYSTEMS BASED PRACTICE:
Residents will develop an understanding of the community resources for people with substance abuse problems.
LOCATION- UChicago Medicine Ingalls Memorial
HOURS
Five mornings per week halftime, plus one evening per rotation (AA Meeting). Rounds will be arranged by Dr. Joe Beck
SUPERVISION
Dr. Joe Beck
PATIENT CARE:
PGY-2 residents spend two months in Community Psychiatry, where they perform psychiatric diagnostic evaluations in the community and at a community clinic. They care for patients with chronic psychiatric illness in several community settings:
MEDICAL KNOWLEDGE:
Residents will learn about the special problems of homelessness in the chronically mentally ill, and about mentally ill offenders. They will become familiar with the "recovery model" of mental health care.
INTERPERSONAL AND COMMUNICATION SKILLS
Residents will observe caseworkers interacting with patients in homes, on the streets, and in other public settings. They will learn and utilize engagement techniques for reaching difficult-to-treat and reluctant patients.
SYSTEMS BASED PRACTICE:
Residents will:
PATIENT CARE:
This is an optional rotation at UChicago Medicine Ingalls Memorial provides a rich and diverse clinical experience in child and adolescent psychiatry. The population ranges in age from 6 to 18 years of age and represents a diverse ethnic and cultural mix. Residents work with patients from 6 to 18 years of age, becoming familiar with evaluation, diagnosis, and treatment issues in child psychiatry as well as the family and systemic issues that contribute to a child's hospitalization.
MEDICAL KNOWLEDGE:
Residents will become familiar with the presentation of psychiatric illness in children, including the evaluation and treatment of attentional disorders, affective disorders, anxiety disorders, psychoses, and developmental disorders. Residents will understand the modifications necessary to use the psychotropic medication in child patients, and the particular vulnerabilities and risks in using medications in children.
INTERPERSONAL AND COMMUNICATION SKILLS
Residents will work collaboratively with staff in a multidisciplinary team format and will learn to present evaluations in teaching rounds. Residents will learn to interview children of different ages and will learn techniques to establish rapport, obtain data and gain cooperation from children who may be difficult to treat or reluctant patients.
SYSTEMS BASED PRACTICE:
Residents will:
Each PGY-4 resident spends all or part of the year as a Chief Resident. There are one or two Administrative Chiefs, as well as Chief Residencies on the UChicago Medicine Ingalls Memorial Inpatient Unit, the Evanston/Northshore Inpatient Unit, the UCMC Consultation Service, the UCMC Emergency Service, and the Outpatient Department. Chief Residents meet regularly with the head of the service on which they rotate, and/or with the Program Director.
PATIENT CARE
Chief Residents provide supervision for junior residents and medical students in conducting interviews, evaluating and delivering care to patients.
MEDICAL KNOWLEDGE
The Chief Resident identifies, learns and teaches about areas important to delivering excellent patient care such as diagnosis, evaluation, and treatment of major mental illnesses, personality disorders, substance abuse, delirium and dementia, and process issues in the management of mental health care teams.
PRACTICE-BASED LEARNING AND IMPROVEMENT
The Chief Resident identifies benchmarks for performance in at least one area related to the focus of the Chief Residency, measures it, creates an intervention, and assesses the effect of that intervention in a QA project during the PGY-4 year. The Chief Resident identifies problems in communication, performance, or outcome in the day-to-day work of the unit he/she supervises, assesses the contributing factors, and intervenes to ameliorate the problems on a regular basis, working with staff, residents, medical students and attending physicians.
INTERPERSONAL AND COMMUNICATIONS SKILLS
The Chief Resident
PROFESSIONALISM
The Chief Resident develops a sense of leadership and clinical competence promotes excellence in teaching and models professional behavior for junior residents and medical students. The Chief learns to deal with interpersonal differences among subordinates and to resolve problems that arise on any busy clinical service
SYSTEMS BASED PRACTICE
The Chief Resident learns how his/her service interfaces with other services in the hospital or the system of mental health care and addresses problems that arise at those interfaces.
Each PGY-4 resident identifies an area of interest in which to pursue a Quality Improvement project. Residents address a clinical problem, either already identified by the Department's Quality Assurance Committee or one that emerges in their work as Chief Residents on clinical services. Under the supervision of the Director of Clinical Services or other faculty, they collect data to establish the nature of the problem, define an intervention, and follow up with a further assessment. To direct their focus, residents write Goals and Objectives under the supervision of the Program Director. Residents write up their projects at the end of the year; some have been presented at hospital-wide QA meetings or national meetings.
PRACTICE BASED LEARNING AND IMPROVEMENT
The Chief Resident identifies problems in communication, performance or outcome in the day-to-day work of the unit he/she supervises, assesses the contributing factors, develops benchmarks for performance in at least one area, measures baseline performance, creates an intervention, and assesses the effect of that intervention in a QA project during the PGY-4 year.
INTERPERSONAL AND COMMUNICATIONS SKILLS
The Chief Resident educates staff, attendings, junior residents and medical students about the identified problems, the process of QA, the intervention proposed and its rationale, and the outcome.
PROFESSIONALISM
The Chief Resident develops his/her own self-critical abilities to identify areas of improvement and models a stance of self-improvement for junior residents and medical students.
SYSTEMS BASED PRACTICE
The Chief Resident addresses issues that arise at the interface of systems of care, usually between institutions, between Departments or between teams.
PGY-4 residents work directly with individual research mentors to carry out and complete a research project. Following the PGY-2 research course which fosters an increased understanding of issues related to research study design, methods, and statistics, residents identify a research laboratory with which they intend to work. Supervised by Dr. Kristen Jacobson, residents gain familiarity with the data and research methodologies of the laboratory with which they are working in the PGY-3 year. In PGY-4, residents meet regularly with research mentors in individual and laboratory meetings to work on the formulation of research questions, organization, and analysis of data, and a review of the literature. Residents present their research project to the Department in the Spring of the PGY-4 year. Many presentations result in publication. Residents spend 4-25 hours per week on research.
MEDICAL KNOWLEDGE
The resident will:
The resident will learn to apply statistical tools, evaluate and select appropriate methodologies, critically evaluate the literature, and draw conclusions supported by the data.
The resident will learn to apply statistical tools, evaluate and select appropriate methodologies, critically evaluate the literature, and draw conclusions supported by the data.