Phase 2 Orientation

1
Phase 2 Orientation

• Pam Shaw MD

2
Opening Remarks

• Dr. Pam Shaw Pediatrics
• (Director of Phase 2 Curriculum)
• KU School of Medicine Catalog
• Clerkship outline
• ICM 900
• PDA logging-Sprint phones
• E-Value
• Advisors-Academic Society
• Professionalism
• Conduct
• Attire-dress code
• How to identify yourself
• Patient secrets
• Hand-washing and infection control

3
Outline

• General Discussion of Clerkships
• Structure of each clerkship
• Introduction of the clerkship coordinators
• Grading in the clerkships

4
Caveats in Clerkships

• Organization
• Attending physicians
• Fellows
• Supervising residents
• Interns
• Sub-interns
• Students

5
Student Role

• What are your responsibilities?
• What are your goals for the rotation?
• With whom will you be working?
• What is the schedule?
• Offer feedback to your teachers
• Take every rotation seriously
• Education is a two-way street-communicate early
  and often

6
Team Work

• Good for Patients
• The best thing for an Attending is for their
  Residents and Students to
• FUNCTION AS A TEAM
• Good for Students
• Playing the competition game at this level almost
  never creates any winners

7
Time Demands and Time Management

• Expectations of the amount of time involved
• Preparation for rounds
• Rounding
• Work of the day
• Reading

8
Expectations

• Know your patient
• Know your patient
• Know your patient
• Read on the medications of your patient
• Read on the treatments of your patient
• Read on the diagnostic testing of your patient
• Read on the diseases of your patient
• Read on the diseases of patients on your service

9
Documentation

• Hospital
• HP
• Daily Notes
• Procedure Notes
• Discharge Summary
• Off-service Notes
• Orders
• Consults

10
Documentation

• Ambulatory Clinics
• SOAP notes
• Established patient
• New patient
• Lab orders
• Xray orders
• Referrals

11
Use of Interpreters

• Family as interpreters
• Expense of interpreters
• Try your own skills!!

12
Organization

• Come up with a system
• Have patient information at your fingertips
• Dont read your notes in rounds
• Time Management

13
Traps and Pitfalls

• Dont be 100 sure of anything
• Always have a small degree of skepticism
• Be a critical thinker
• Tendency to arrive at early closure
• Diagnosis too early and then build a case for it
• Instead keep your differential handy
• Narrow it to the working diagnosis
• Patient comes in with the diagnosis
• Sometimes from the INTERNET
• Problem isthey might be right!

14
ICM 900

• Ran jointly by the Office of Student Affairs and
  the Department of History and Philosophy of
  Medicine
• Meets once a month starting in September
• Excused from clinical duties to attend
• 10 sessions that are two hours long are required
  to pass

15
PDA logging and Sprint phones

• Required in each clerkship
• Based on ICD-9 system
• Can be done on line (E-Value) or on phone

16
E-Value for evaluations

• Mid-clerkship evaluation
• Electronic or written evaluation
• Every clerkship uses the same clinical
  performance rating form

17
Clinical Skills Lab

• Standardized patients in clerkships-Family
  medicine, Geriatrics, Ob-Gyn, Internal Medicine,
  Neurology
• CSA (Clinical Skills Assessment) held at the end
  of third year-more info to be given to prepare
  for CS exam

18
Professionalism

• Conduct
• Dress Code-attire
• How to identify yourself
• Patient secrets
• Infection control-hand washing

19
Balance your life

• Important to take time for Family
• Exercise
• Get enough rest
• Time management is important
• Feeling overwhelmed?
• Contact Student Health Services

20
A Few Words Before you Go

• Treat patients as you would like to be treated
• Try to avoid treating this as a means to an end
• Do the right thing.
• Mistakes happen.
• Never be afraid to ask questions.
• Never be afraid to be thorough-even it takes more
  time.

21
A Few Words Before you Go

• Learn from your patients.
• Become involved
• Follow up your patients
• Keep your eyes open for interesting patients
• Challenge yourself and ask why?
• Give other providers the benefit of the doubt

22
A Few Words Before you Go

• Become comfortable with the phrases, "I don't
  know" and "I need help."
• Try to read something medical every day for 1-2
  hours.
• Realize that you are responsible for you.
• Push yourself to become well-read and
  well-rounded
• Be kind to others and yourself
• Have fun!