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Medical Student Rotations

Internal Medicine

Offering 3rd and 4th year rotations and medicine sub-specialties.

Opportunities

The Department of Internal Medicine offers 3rd and 4th year rotations and medicine sub-specialties for medical students visiting from LCME and AOA accredited M.D. / D.O. schools.

Course Description

The internal medicine clerkship is the core experience for the acquisition of the knowledge, skills, attitudes and behaviors required to care for adult patients in the hospital and outpatient settings. The behaviors acquired during this rotation form the foundation for growth in both the medical and surgical specialties. These are important aspects of the skills of physicians in all disciplines of medicine.

The purpose of the core clerkship in internal medicine is to provide students with the clinical and didactic experiences that will enable them to diagnose and manage patients with the disease processes commonly seen in general internal medicine. It is during this rotation that the information obtained during the basic science years becomes integrated into day-to-day clinical practice. It is the desire of the Department of Medicine to expose the student to the variety of venues in which internal medicine and its subspecialties are practiced, and the range of opportunities available to those who choose careers in internal medicine.

Expectations and Responsibilities
  • Evaluate and follow patients assigned by the supervising resident or attending physician.
  • Function as a member of the team.
  • Seek information and develop in-depth knowledge of the pathophysiology of the clinical disorders seen.
  • Develop complete history and physical examination skills.
  • Integrate history and physical examination data to arrive at a thoughtful and complete differential diagnosis and plan.
  • Present patients in a cohesive and thorough manner.
  • Model the behaviors and values necessary to conduct the evaluation and care of the patient with respect, compassion and integrity.
  • Acquire an understanding of the cost of various studies.
  • Attend and participate in the formal educational programs provided.
Unique Attributes
  • High Value Care Project.
  • Attend medical morning report daily, strongly recommended for 3rd year students).
  • Twice weekly to discuss patients in depth / develop ddx and plan/ bedside rounds. Physical exam rounds incorporated into sessions.
  • Make daily rounds on assigned patients and write a daily progress note in EHR. A new patient should have the history and physical examination entered into the EHR.
  • Participate actively in RRTs (rapid response teams) and codes as requested by your team/resident.
  • Attend Grand Rounds weekly 8–9 a.m. in the John H. Ammon Medical Education Center.
  • Other activities as determined by course preceptors.

Vary.

4 weeks.

3rd year SKMC and PCOM students.

6.

Sidney Kimmel Medical College (SKMC) and Philadelphia college of Osteopathic Medicine (PCOM) Branch Campus students and SKMC assigned.

Inpatient.

Christiana Hospital and Wilmington Hospital.

Day Shift and one weekend note writing 6am-approximatley 12 noon.

Car not required.

  • Professional attire is required in clinical and patient care settings.
  • White coats should be worn, and students must always have their school ID and ChristianaCare ID visible.
  • Scrubs may be required as determined by rotation.
Course Description

The purpose of this rotation is to provide an understanding of the scope of internal medicine as a specialty. The rotation offers an introduction to the knowledge and skills basic to internal medicine as practiced in a hospital-based clinical setting. Management is emphasized as an important goal.

Expectations and Responsibilities
  • Perform and document complete history and physical exams and progress notes and interpret laboratory, radiologic, and other pertinent data and provide a differential diagnosis, assessment and treatment plan.
  • Provide concise and organized patient summaries including previous and upcoming treatment plans at daily rounds.
  • Describe the management of common disorders in the Internal Medicine.
  • Demonstrate sensitivity to the concerns of patients and their families regarding the patient’s illness and treatment (including complications, procedural/operative issues, quality of life and end-of-life issues).
  • Demonstrate appreciation and respect for other professionals by appropriately contacting/responding to consultative and support services.
  • Demonstrate ability to provide high quality sign-out that is concise, accurate, and complete.
  • Attend Medical Morning Report (required), Internal Medicine Grand Rounds (required) resident core lectures (highly recommended).
  • Demonstrate an understanding of the discharge process.
  • Attend weekly rounds with the Sub I director.
  • Complete an abstract of a patient seen during the course of the rotation-suitable for a poster or publication.
Unique Attributes

All 4th yr students must write an abstract on a patient seen while on rotation. This should be suitable fora poster or publication. Weekly rounds /discussions with Sub-I course Director or other attending.

Varies.

4 weeks.

4th year medical students.

5.

Branch Campus (Sidney Kimmel Medical College and Philadelphia College of Osteopathic Medicine) and students from other institutions by application.

Inpatient.

Christiana Hospital and Wilmington Hospital.

Day Shift and one weekend note writing 6am-approximatley 12 noon.

Car not required.

  • Professional attire is required in clinical and patient care settings.
  • White coats should be worn, and students must always have their school ID and ChristianaCare ID visible.
  • Scrubs may be required as determined by rotation.
Course Description

A knowledge of intensive care medicine is important to the practice of Internal Medicine. The recognition of the critically ill patient and then responding to that person’s needs is essential.

The ChristianaCare rotation will provide sub-interns with a thorough experience in the assessment and management of the critically ill medical patient. Students will be assigned patients to manage as part of a team under the direct supervision of attendings, residents, and interns.

Physician assistants, nursing staff and respiratory staff, may be involved in assisting with the educational objectives.

Expectations and Responsibilities

Directly supervised patient care activities—4th years will learn through direct patient care with supervision. New patients will be evaluated, and a thorough differential diagnosis and plan will be derived. Patients will then be cared for in follow-up and differential diagnoses and plan will be adjusted as per the clinical situation. Patients assigned who have been previously worked up and a differential diagnosis and plan derived will be managed as dictated by the changing clinical scenario. Patients will be presented on rounds in the manner determined by the attending and residents. The 4th year will assume direct responsibility for his/her patients.

The 4th year should understand and respect the roles played by ancillary staff—nursing, respiratory, social work, nutrition—these departments will add significantly to one’s understanding of a patient’s course.

Didactic Education

Attendings, interns, and residents will instruct students in various areas during the course of the rotation. Lectures and other educational tools will be discussed by the team.

Patient Care

Obtain a detailed H and P of all patients assigned. This may include speaking with others involved with the patient under consideration as well as old records, EMS/ER reports, etc.

    • Participate in the analysis of labs and other studies.
    • Develop an appropriate differential diagnosis and plan.
    Medical Knowledge

    Demonstrate knowledge and treatment for common critical care problems including shock, sepsis, asthma exacerbation, GI bleeding, DKA/Hyperglycemic hyperosmolar state, acute kidney/liver injury, etc.

    Practice Based Learning
    • Critique your own performance and accept criticism.
    • Educate yourself based on feedback received and your own initiative.
    Interpersonal and Communication Skills
    • Communicate effective to the team, patients and families, ancillary staff.
    • Make sure electronic records efficiently and effectively contain appropriate information regarding patient care and that daily notes are completed in a timely manner.
    • Participate in various team rounds as dictated by the team.
    Professionalism
    • Demonstrate confidentiality, respect and compassion to all.
    Systems-Based Practice
    • Work effectively with all staff members to provide excellent patient care.
    • Understand how medical errors can lead to healthcare improvement.
    Unique Attributes
    • All 4th yr students must write an abstract on a patient seen while on rotation.

    Varies.

    4 weeks.

    4th year medical students.

    2.

    Branch Campus (Sidney Kimmel Medical College and Philadelphia College of Osteopathic Medicine) and students from other institutions by application.

    Inpatient.

    Christiana Hospital and Wilmington Hospital.

    Day Shift and one weekend note writing 6am-approximatley 12 noon.

    Car not required.

    • Professional attire is required in clinical and patient care settings.
    • White coats should be worn, and students must always have their school ID and ChristianaCare ID visible.
    • Scrubs may be required as determined by rotation.
    Electives and Subspecialties
    • Cardiovascular Disease.
    • MICU.
    • Dermatology.
    • Endocrinology, Diabetes, and Metabolism.
    • Geriatric Medicine.
    • Infectious Disease.
    • Nephrology.
    • Medical Hematology/Oncology.
    • Pulmonary Disease.
    • Rheumatology.
    Course Description

    The subspecialty experience may be inpatient, outpatient, or both. The student will see patients with a broad mix of diseases and illness severity. It is an expectation that consultations/progress notes will be entered into the EHR. This will be at the discretion of the supervising attending physician.

    Unique interviewing skills, hypothesis driven physical exams, and specialized procedures as well as common diagnostic differentials and treatment plans are components of most rotations.

    Students encounter patients in both the inpatient and/or outpatient clinic settings. Faculty supervise histories, physical exams, and management. Patients are seen both under direct supervision and in concurrent (exception model) care with attending involvement. Evidence-based management is stressed, as well as an emphasis on cost-effective care and health-systems’ impact on the treatment plan. Communication skills are stressed as an essential component of all students.

    Students are encouraged to attend the ongoing core didactic series of lectures while on most of these rotations. This includes Medical Grand Rounds and the Noon Conference Series. Further direction will be given by each subspecialty preceptor.

    Expectations and Responsibilities
    • To gain knowledge and skill in the diagnosis and management of a broad range of disorders of various organ systems.
    • Develop the clinical skills of data collection including history taking, physical examination, and the appropriate request of laboratory and imaging studies.
    • The interpretation of diagnostic tests and therapeutic procedures common in the practice of a variety of subspecialties.
    • Review the typical radiographic, endoscopic, and laboratory features of common diseases in various specialties.
    History Taking

    Students will collect a thorough history by soliciting patient information and by consulting other sources of primary data in a logical and organized fashion.

    Physical Exam

    Students will conduct a hypothesis driven physical exam.

    Medical Decision Making, Clinical Judgment, and Management Plans

    Students will progressively be able to generate a rational differential diagnosis for the most common conditions seen on each rotation, and they will correctly identify and interpret abnormal findings. They will understand their limitation of knowledge and seek the advice of more advanced clinicians.

    Medical Knowledge

    Students will consistently apply current concepts in the basic sciences to clinical problem solving. They will use information from the literature and other sources including electronic databases.

    Interpersonal and Communication Skills

    Students will develop and refine their individual style when communicating with patients. They will create effective written communications through accurate, complete, and legible notes. They will exhibit listening skills appropriate to patient-centered interviewing and communication. Students will respond to feedback in an appropriate manner.

    Professionalism

    Students will demonstrate integrity, accountability, respect, compassion, patient advocacy, and dedication to patient care.. They will be punctual and prepared for teaching sessions. Students are expected to show sensitivity and responsiveness to patients’ culture, age, gender and disabilities.

    Practice Based Learning and Improvement

    Students will utilized evidence based materials to augment their understanding of various diseases and apply this to develop an appropriate differential diagnosis and plan.

    Systems Based Practice

    Students will be sensitive to health care costs while striving to provide quality care. They will effectively coordinate care with other health care professionals as required for patient needs. Clinical practice guidelines will be used whenever applicable students will be expected to seek out and understand current clinical guidelines of various disorders and recognized their limitations.

    Unique Attributes

    All 4th yr students must write an abstract on a patient seen while on rotation. Suitable for poster or publication.

    Varies.

    4 weeks.

    4th Yearr SKMC and PCOM Branch Campus Medical Students; 3rd yr PCOM Branch Campus only.

    Varies.

    Branch Campus and then other schools.

    Inpatient and/or Outpatient.

    Christiana Hospital, Wilmington Hospital, and outpatient faciltities.

    Day Shift.

    Car required.

    • Professional attire is required in clinical and patient care settings.
    • White coats should be worn, and students must always have their school ID and ChristianaCare ID visible.
    • Scrubs will be provided, if needed.

    Clerkship Directors

    Matthew J. Burday, DO and David M. Cohen, MD
    Email: mburday@christianacare.org

    Clerkship Coordinator

    Paula L. Barnes
    Email: pbarnes@christianacare.org or call 302-733-6059.

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