Ambulatory Rotation for 4th Year Students
Location: Internal Medicine Clinic, TTUHSC
Duration: 4 weeks
GOALS
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.
OBJECTIVES
(A) 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.
(B) 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.
(C) 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.
(D) ATTITUDE
The student should
Learn care coordination with nursing staff and other ancillary services.
Discuss ethical issues, including end of life care where appropriate.
EDUCATIONAL METHODS AND RESOURCES
The student will be rotating through general internal medicine and some subspeciality (Endocrine/ Infectious disease/ Pulmonary/ Nephrology) clinics as follows:
Day AM PM
Monday Endocrine (Dr. Lado) Study Time
Tuesday Pulmonary (Dr. Jumper) Study Time
Wednesday Infectious Disease (Dr.Winn) Study Time
Thursday IM (Dr. McDonald) Study Time
Friday Nephrology (Dr. Bello-Reuss) Ambulatory Exam
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.
EVALUATION METHODS
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.
RESPONSIBILITY AND SUPERVISION
The student should
Manage patients under the supervision of senior resident or attending.
Demonstrate high standards of professionalism during patient care.
EVALUATION OF ROTATION
The student should sit with the 4th year director at the end of the rotation to discuss and fill out an evaluation form.