PREREQUISITES AND PLACEMENT IN THE CURRICULUM: Year Four; Completion of all Core Clerkships.
GOALS AND OBJECTIVES:
1. The general goal of the Medicine Sub-Internship is to provide an educational experience for clinical clerks by offering graduated supervised responsibility for patient care in the area of general internal medicine. The student will assume the role of a sub-intern which are essentially the same responsibilities as the intern.
2. The senior experience in internal medicine represents, in part, a continuation of the basic core clerkship. During this clerkship, each student will gain an awareness of the knowledge, skills, values and attitudes that internists strive to acquire and maintain throughout their professional lives and will understand the patient-centered learning process that permits the gradual acquisition of these attributes over longer periods of time.
3. The student will gain experience in the development of professional relationships with patients, peers, and other health care professionals, learn good communication skills when dealing with patients, as well as learn the various functions of an acute care hospital. The student will also develop the facility to maximally utilize time, recognize his/her limitations, and develop the ability to perform adequately under stressful and fatiguing conditions.
4. Duties include writing initial orders, work-up, physical examination, problem lists and write-ups for approximately six new patients per week:
a. Write-ups will include a comprehensive assessment of the patient's progress and be presented to the faculty in an approved format.
b. He/she will perform and record a thorough history and physical examination, and review all data with the faculty.
c. Students will utilize clinical reasoning skills and form hypotheses to study presenting problems in general internal medicine. He/she will obtain an accurate, pertinent history from all appropriate available sources, and record them in a complete, concise and literate manner.
d. He/she will develop an understanding of and appreciation for the psychosocial, educational, economic, and religious backgrounds of patients that underlie their diverse belief systems sensitivity to and an understanding of the ethical dimensions of patient care. This understanding will be demonstrated in the student's approach to the management of individual patients.
e. The student will also strive to heighten his/her sensitivity regarding the patient's anxieties and concerns.
f. Clinical laboratory, x-ray, and other testing procedures will be utilized in an appropriate and cost-effective manner to diagnose patients. The student will develop the necessary skills to perform these essential technical tasks in internal medicine and demonstrate mastery of such skills.
g. Follow-up for patients is expected using the problem list as a framework for daily progress notes and the student will order further work-up as the case develops. Continual discussions with the faculty regarding diagnostic options are expected.
5. Students are also strongly encouraged to read appropriate major texts and current literature to complement the discussions concerning those items on a patient's problem list. Students will be given the opportunity to demonstrate critical reading skills in selected journal articles, and learn to identify characteristics of effective medical articles.
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