SOM Elective Brochure
 

Electives Type:  Clinical

Elective Title
Acting Internship: Inpatient Internal Medicine at a Community Hospital in Austin
Course Number
MEDU-4036
Duration/Weeks
4
Prerequisites: Successful completion of Year 3 
      Additional Requirements:
n/a
Responsible Faculty Director:
Sherine Salib, MD
Other Faculty:
Location to Report on First Day
Contact Tricia M. McElligott at tmmcelligott@seton.org or 512-324-7860
Periods Offered
1-11
including Period 12 (June), including the holiday vacation Period 13 (Dec)
Maximum Enrollment
3

Goals
 Develop independent thought process in evaluation, diagnosis and management of Internal Medicine patients. To prepare the student to function as house officer.

Objectives
 1. To improve and refine the ability to conduct an interview, perform a physical examination, compile a relevant problem list, develop a thoughtful and thorough assessment, and prepare plans for the management of the patient. 2. To refine skills of the oral presentation of the new patient, and follow up patients, to the housestaff and faculty team. 3. To practice and improve the interpersonal skills needed to address the social and psychological needs of the patient and the family 4. To develop skills in creation and execution of an appropriate management plan for common medical problems. 5. To develop appropriate use of the medical literature as it relates to specific patient problems. 6. To become comfortable with an increased level of responsibility in the management of patients.

Description of course activities
 The student will participate in the diagnosis and care of patients admitted to an acute care medical inpatient teaching service in a busy community hospital. He/she will serve in the capacity of a junior intern on a team consisting of an upper level resident, at least one intern, and an attending physician. Responsibilities will include clinical work from 6:30 a.m. - 5:30 p.m. weekdays, rounds on weekends, and every fifth night call. The team may also admit patients on other days of the call cycle. The student will be attending rounds, noon teaching conferences, and Grand Rounds.

Type of students who would benefit from the course
 Any student who plans on dealing with adult patients with acute or chronic disease. To enroll, UTMB students should submit a C-form to Tricia M. McElligott via e-mail at tmmcelligott@seton.org or fax at 512-324-7988 for approval. Visiting students should submit an application through VSAS: https://services.aamc.org/20/vsas/public/school/instID/174 Select UTMB at Galveston as the host institution and indicate you wish to take MEDU 4036 on the application.

Weekly Schedule
  Clinical Activities (please insert estimated schedule here)
   
  Day of Week AM PM
  Monday Clinical rounds and patient care Clinical rounds and patient care
  Tuesday Clinical rounds and patient care Clinical rounds and patient care
  Wednesday Clinical rounds and patient care Clinical rounds and patient care
  Thursday Clinical rounds and patient care Clinical rounds and patient care
  Friday Clinical rounds and patient care Clinical rounds and patient care
  Saturday Clinical rounds and patient care Clinical rounds and patient care
  Sunday As determined by schedule
       
  Average number of patients seen per week: 20  
  Call Schedule:   every 5th night  

  Research Activities (please insert estimated schedule here)
   
  Activity Hours per Week
  Faculty contact time

  Self-directed study

  Data collection/analysis

  Other


Method of student evaluation
Check all that apply - complete appropriate section(s) only:
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    Daily
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty anbd residents
  B. Frequency / duration of presentation(s)?
    Daily; 2-3/day.
  C. Format - What guidelines are set for the student's presentation?
    Clinical case presentations.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Daily notes/H&Ps
  B. Format - What guidelines are set for the student's written work?
    Clinical case format
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
   
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
   
  F. Audience - Who assesses the student’s written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
  Format
    Oral   Written multiple choice   Written essay / short answer   OSCE
Other

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
   

6.  Other Modes of Evaluation
  Please explain below.
    Students will be evaluated by attending physician and housestaff according to the standard evaluation form developed by the UTMB Department of Internal Medicine. The preceptor and student will meet at the beginning of the rotation to determine the type of problems and patient issues the student would like to emphasize. Mid-rotation feedback will be used to assess the effectiveness of the arrangement.
 
7.  If this course is an Acting Internship, please complete the following:
   
  A. Specify how the student will be given formative feedback on their clinical skills.
    Students will be supervised daily by residents and faculty members on the team. There will be ongoing feedback, as well as verbal feedback at the mid-point and at the end of the rotation.
B. List advanced clinical skills that a student will be assured an opportunity to practice.
    Students will be expected to: • Participate in the clinical decision-making process for their patients, both for diagnostic and management decisions • Participate in the choice and justification of investigational procedures • Participate in multi-disciplinary meetings to discuss their patients’ care • Participate in patient and family members’ counseling and education
C. List other advanced clinical skills that a student may be exposed to depending on clinical case availability.
    " Students will likely/possibly: • Participate in intra- & inter-institutional transitions of care for their patients • Medical emergencies, such as “Code Blue” (cardiac arrests, respiratory arrests, etc.) • Procedures
  D. How will the acting intern student have responsibilities similar to a PGY1 resident? How will their responsibilities differ?
    Similarities in responsibilities to a PGY1 resident: • Students will be involved in formulating a diagnostic & management plan for their patients. • Students will present and discuss those management plan to the team’s attending physician(s). • Students will be involved in multidisciplinary meetings regarding their patients’ care. • Students will participate in patient education & counseling. Differences in responsibilities to a PGY1 resident: • It is anticipated that students will not follow the same total number of patients as a PGY1 resident, although the numbers will be similar at times. • Students will not write and execute final orders on their patients.
  E. How will this course help prepare a student enter an internship in this field or a related field?
    The acting intership experience will help prepare students entering an internship in Internal Medicine since it will simulate in many ways the experience of a PGY1 resident in this field. Students will have an expanded role on the medical teams, and more responsibilities than a third year medical student on the team.
  F. How will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
    Midpoint feedback will be provided by the attending on the team. Areas of deficiencies will be discussed, re-evaluated and revisited prior to the end of the rotation.
  G. Acting Internship students often seek letters of recommendation following their experience. How many different faculty are they likely to encounter during this course? What is the usual number of working days they can expect to encounter the same individual faculty member? Describe the degree of supervision and interaction with faculty vs. residents or other providers.
    It is anticipated that Acting Internship students will consistently work with, on average, two faculty members during a one-month rotation. During a one-month rotation, a student may expect to encounter the same faculty member for more than 14 days each. This may vary, though, depending on scheduling issues. Acting interns will work closely with all team members, and may expect direct & daily supervision by both residents and faculty members on the team.

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