Each third year student will be assigned to one of our 4 general internal medicine teams working in Huntsville Hospital. Most teams will be comprised of an upper level family medicine resident, a family medicine intern and up to 2 third year students. Occasionally, there may be a fourth year student on the team. An internal medicine faculty member will make rounds with the team each day. Each team is responsible for a select group of patients on a daily basis including daily patient visits and notes in the chart.
Each third year student is expected to see 2 new patients while on call. The patients may be floor admissions, ICU admissions or consults. They are expected to do a full history and physical on each new patient. The history and physical should be written out in detail and placed in the patient’s chart. The assessment section should be thorough, should include the differential diagnoses, and should reflect active reading on the part of the student. Additionally, a copy of the written note should be turned in to the internal medicine office for faculty review until the student is notified by the department that he or she is performing adequately in this area.
Students are expected to continue see their patients daily and write a daily note on their patients unless otherwise directed. Generally, students should follow 4 to 5 patients on a daily basis. They are expected to be involved in all aspects of their patients’ care including family meetings and procedures. Students are encouraged to participate in any available procedure. If a procedure is done by a physician, the student should ask their resident or attending to speak with the physician doing the procedure in advance to request permission. No matter how small the procedure is, no procedures are to be done by students without direct supervision. Third year students are not allowed to dictate. Third year students are not allowed to write verbal orders. Third year students may learn to write orders and keep the check out sheet as part of the rotation, but they should remember that these skills are not part of their final evaluation.
Students are expected to present their patients to the attending each day on rounds in an organized and appropriately concise manner. They should be knowledgeable about all details regarding their patients should questions arise, even though the details may not be directly pertinent to their presentation. Students should read about issues pertaining to their patients on a daily basis. They should be prepared to answer knowledge and patient care questions related to their patients in detail. Additionally, students are expected to have a broad knowledge base and should continue to build on this during the rotation as any knowledge question about any patient is “fair game” on rounds or in morning report. Students should actively participate in the decision-making process regarding their patients based on their knowledge of the patient and their understanding of the literature.