PREREQUISITES AND PLACEMENT IN THE CURRICULUM:
Year Four; Completion of all Core Clerkships.
M3/M4 Internal Medicine Clerkship Director:
Asra Khan, MD
M3/M4 Associate Internal Medicine Clerkship Director:
M4 Assistant Internal Medicine Clerkship Director:
Email: [email protected]
The four-week senior experience in internal medicine will provide an educational experience for M4 clinical clerks that offers graduates supervised responsibility for patient care in the area of general internal medicine.
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. You will not have time to acquire all of these attributes yourself during the rotation, but you will understand the professional responsibilities and student-centered learning process that permits the gradual acquisition of these attributes over longer periods of time.
GOALS AND OBJECTIVES:
The four-week senior experience in internal medicine represents, in part, a continuation of the basic M3 IM clerkship. The M4 IM Sub-Internship will provide an educational experience for M4 clinical clerks that offers graduated supervised responsibility for patient care in the area of general internal medicine.
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. You will not have time to acquire all of these attributes yourself during the clerkship, but you will understand the professional responsibilities and student-centered learning process that permits the gradual acquisition of these attributes over longer periods of time.
The fourth year experience is to be four continuous weeks spent on an inpatient general medicine service.
- Fourth year students will act in the role of an intern, reporting directly to supervising residents and taking cases in rotation with PGY-1s on the service. No intern is to be assigned to the cases to which a sub-intern is assigned.
- MOD experience, i.e. taking first call for de novo problems arising on their own hospitalized patients, is expected
- Fourth year students are guaranteed, on average, one day off per week, to be decided by the supervising resident and these are typically weekend days, unless the team is on or post call. Days off for special circumstances or interviews must be requested in advance with the site Director and Coordinator. Approved days off may be required to be made up at the discretion of the Clerkship and Site Director. The supervising resident, attending and team must also be notified in advance.
- The student should sign-out all of his or her patients to the covering intern or covering Sub-I.
Clinical Objectives and Tasks
To utilize medical knowledge and clinical reasoning to form hypotheses related to patient problems in general internal medicine.
- Evaluate, discuss, observe the progress of and be responsible (with supervision) for the care of approximately 3-5 new patients per week.
- Attend and participate in mandatory student didactic sessions and house staff and departmental conferences.
To acquire a basic knowledge of internal medicine and a greater knowledge of the medical conditions of assigned patients.
1) Attend and participate in in mandatory student didactic sessions and house staff and departmental conferences.
2) Read in detail from major texts and the current literature about the medical problems of assigned patients and of other patients of interest on the service.
3) Demonstrate the ability to research a clinical problem in the primary medical literature.
To obtain an accurate and pertinent medical history from all appropriate available sources and to record it in a complete, concise and literate manner.
- Work-up approximately 3-5 new patients per week.
- Write up each new or transferred patient, presenting patient data in the approved format and including an assessment (differential diagnosis and the reasoning that dictates the diagnostic and management approach) and plan for each problem.
- Turn in write-ups for review and correction by a faculty member (ward service attending or clerkship site director).
- Receive feedback on write-ups from the supervising resident and ward service attending or clerkship site director.
To perform and record a thorough physical examination and review the physical findings with the faculty.
- Perform examinations on approximately 3-5 new patients per week and record the findings in the approved
- Review abnormal or uncertain findings with the appropriate housestaff and faculty.
To use the clinical laboratory, x-ray, and other testing procedures in an appropriate and cost-effective manner.
- Write the initial orders for the work-up of approximately 3-5 new patients per week, discussing these orders with the supervising resident and faculty.
- Follow the results of this work-up and order further studies as indicated.
- Understand the methods and limitations of commonly performed diagnostic tests.
- Discuss diagnostic options with the supervising resident and faculty member. Complement this discussion with appropriate reading in major texts and the current literature.
- In the event of the death of a patient, subinterns are strongly encouraged to attend and review the findings of the autopsy.
To utilize medical knowledge and clinical reasoning skills to develop a complete and accurate problem list for approximately 3-5 new patients per week.
- Develop an initial problem list in the expected institutional format.
- Discuss this list and the assessment of each problem with the supervising resident and faculty member.
- Use this problem list as a framework for daily progress notes.
- Revise and update problem lists as appropriate.
To effectively utilize the library and electronic resources to research the problem list and to demonstrate proficiency with critical reading skills.
- Search and read about the clinical problems of each assigned patient in major texts and the current literature.
- Do literature searches of clinical problems of assigned or other interesting patients.
- Identify quality articles that address the problems presented by such patients.
- Critically analyze the methods and conclusions of relevant articles and apply the results appropriately to patient care.
To become skillful at bedside, formal rounding and conference presentations.
- Present patients to supervising residents, faculty and peers during rounds and at conferences, becoming skilled at both impromptu and more formal presentations.
To develop an understanding of the psychosocial, educational, economic, cultural and religious backgrounds of patients that underlie their diverse belief systems and demonstrate this understanding in the approach to the management of individual patients.
- Undertake to know about the patient’s background as it pertains to the patient’s medical problems.
- Demonstrate an insight into diverse backgrounds during rounds, in presentations and in write-ups.
To develop a sensitivity to and an understanding of the ethical dimensions of patient care, and demonstrate this in the approach to the management of individual patients.
- Demonstrate sensitivity to ethical issues during rounds, in presentations and in write-ups.
- Use the literature and appropriate consultation to research ethical issues in the same way as clinical problems are studied.
To demonstrate skill in the performance of essential technical tasks in internal medicine.
1) Perform or observe, the following:
- arterial puncture
- placement of an indwelling intravenous catheter
- placement of a nasogastric tube
- 12-lead electrocardiogram
2) If the opportunity presents, perform or observe, under supervision, the following:
- dipstick and microscopic urinalysis
- peripheral blood smear interpretation
- Gram or other appropriate stain of sputum and other body fluids
- lumbar puncture
- aspiration of joint fluid
- flexible sigmoidoscopy
- cardiopulmonary resuscitation
- central line placement
- catheterization of the bladder (male and female)
- To develop a professional relationship with patients, peers, and other health care professionals.
- To develop effective communication skills when dealing with patients.
- To develop familiarity with the various functions of the hospital and other health care providers.
- To develop the ability to maximally utilize your time, recognize your limitations and perform appropriately under stressful and fatiguing conditions.
- To demonstrate a humane and sensitive approach to patient’s anxieties and concerns.
- To appreciate the impact of diverse backgrounds on illness behavior and health care belief systems.
- To demonstrate intellectual integrity at all times. Evidence of intellectual dishonesty will be grounds for failing the clerkship.
For UIC students scheduling:
Check the M4 Post Lottery slot availability (https://services.com.uic.edu/studentgrades). If slots are available email [email protected] to request scheduling.
For Visiting Students from LCME accredited institutions:
Check for availability by emailing Kathleen Helling ([email protected]).
For International Students:
IM Sub I is NOT offered, but for availability of other opportunities: contact Kay Spreitzer ([email protected]) in The Office of International Education or visit their website at: https://medicine.uic.edu/education/international-education/
The medical school coordinator for your site will contact students with reporting instructions the week before the elective begins.
Kati Helling ([email protected])
Jesse Brown VA:
Cheryl Conner, MD ([email protected]) & Marci Laragh, MD ([email protected])
Advocate Lutheran Medical Center Hospital:
Marisol Hernandez-Martinez ([email protected])
Advocate Christ Medical Center Hospital:
Ruth Mrochen ([email protected])
Advocate Illinois Masonic Medical Center
DeBorah Anderson ([email protected])
Catherine Clark ([email protected])
Camelia Stanciu ([email protected])