Daily duties
Engagement in direct patient care is a vital component to the medical student’s education in Internal Medicine. The student is expected to participate in the complete care of assigned patients. Patients should be examined and interviewed daily. All laboratory tests, radiological studies, ECGs and consults should be reviewed daily. The student should carefully consider all patient data, identify and prioritize problems, formulate a differential diagnosis, and attempt to propose a management plan. After initial data gathering by the student, the resident should be contacted to finalize management plans and write any necessary orders. ALL MSIII / MSIV orders MUST be cosigned IMMEDIATELY by a resident. The student should let the team be aware of times he or she will be away from patient care (lectures, exams etc.). It is expected that students are reachable by pager at all times.

Patient census
The student will be responsible for the ongoing care of 2-4 patients. This number may vary based on acuity and complexity of the patients. Additionally, there are many learning opportunities on non-assigned patients – the student should pay close attention during rounds to the progress and care plans of nonassigned patients. Admission history and physical examinations and daily notes should be done on assigned patients.

Daily schedule

 
6 – 8 am

8 – 11:30 am

11:45 am – 1:30 pm

1:30 – 2:30 pm 

2:30 – 4 pm  

4 pm

Evening and weekend call
The General Medicine Teams admit every 4th night, overnight. Students are expected to take call until 8 pm with the team. Students are required to work on the weekends when their assigned intern is scheduled. If the assigned intern is scheduled for a night shift on Saturday, the student is expected to work this shift as well.

Medical student lecture series
Occurs M-F from 1:30 to 2:30pm.  A calendar will be distributed monthly and posted outside the Bross Conference Room. Students are strongly encouraged to attend morning report and noon conference daily. Although, these conferences are geared for residents, they provide a valuable learning experience for the medical student.

Physical exam rounds
As a group, led by our chief resident, students will examine patients, with the goal of refining examination skills. If a student has a patient with an interesting examination finding, the chief resident should be notified so to seek permission from the patient to participate in physical examination rounds.

Preceptor rounds
Each student is assigned to present a complete history and physical examination at least once per month. Preceptor rounds are in a sense “Medical Student Morning Report.” Other third and fourth-year students rotating on Internal Medicine attend these sessions, which are facilitated by an attending. The student is expected to present the patient’s complete history and physical examination, along with pertinent lab and imaging data. The attending will help lead the group through the thought process of creating a differential diagnosis and active working plan.  Although, the student is expected to deliver a formal presentation, the goal of preceptor rounds is purely educational and is not meant to be an intimidating experience.

EKG interpretation
Monthly conference led by cardiology fellow.

EBM
Students are expected to perform a critically appraised topic (CAT) during their rotation. A session with Claire Huntington, medical librarian, is scheduled to assist with literature searches and advanced library skills. CATs will be presented at a lecture session at the end of each month. These sessions are precepted by a staff physician to guide students through the intricacies of critical appraisal.

Overview of inpatient units
There are seven inpatient medicine floor teams, divided into two “firms” of three teams each and a non-teaching service. Each firm is led by an upper-level only triage service. The firms admit every other day. The schedule is available on-line at www.amion.com. Password will be provided upon arrival.