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To meet the objectives in increasing knowledge and skills and developing professional attitudes and behavior while caring for adult patients on Internal Medicine ambulatory service.

1. KNOWLEDGE

The student should

• Demonstrate ability to evaluate and manage patients with the following chronic conditions such as
• DM type I & II, HTN, CAD, CHF, Thyroid disorders, OSA, COPD, HIV etc.
• And with acute conditions such as respiratory illnesses, pain, common skin infections, drug side effects etc.
• Learn and master the screening guidelines for colon/ cervical/ prostate/ breast cancers, osteoporosis, hyperlipidemia, hypothyroidism, and adult vaccination schedule.
• Recognize alcohol and tobacco dependence problems with appropriate management and referral.
• Learn to order labs in an appropriate manner.
2. SKILLS

The student should

• Develop skills in performing an accurate history and physical with differential diagnosis and management plan with proper time management in a clinic setting.
• Participate in procedures like I/D of abscess, joint injections, skin biopsies etc.
• Develop the ability to interpret labs and ECGs.
• Determine the clinical stability of the patient for appropriate disposition.
3. BEHAVIOUR

The student should

• Establish trust with patient by effective communication skills (as referring patients by their names) and maintaining patient privacy and confidentiality.
• Be sensitive to diverse factors affecting patients and their health care needs as race, culture, income and ethnicity.
4. ATTITUDE

The student should

• Learn care coordination with nursing staff and other ancillary services.
• Discuss ethical issues, including end of life care where appropriate.

The student will be rotating through general internal medicine and some subspeciality (Endocrine/ Infectious disease/ Pulmonary/ Nephrology) clinics as follows:

The student should

• Care for approx. 3-4 adult patients per day with above described disease mix.
• Present cases to the supervising attending with accurate history and physical and with a  differential diagnosis, assessment and plan.
• Present a case at morning report once during the rotation.
• Maintain patient log.
• Attend morning reports, journal clubs and noon conferences.
• Read core ambulatory articles.

 

End of rotation evaluation forms to be filled by faculty attending based on the presentations, patient care and literature review.

Student progress and satisfaction will be assessed weekly.

 

The student should

• Manage patients under the supervision of senior resident or attending.
• Demonstrate high standards of professionalism during patient care.

The student should sit with the 4th year director at the end of the rotation to discuss and fill out an evaluation form.