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Internal Medicine, Subinternship (Florida)

Prerequisites

  1. Completion of all prior courses and clerkships
  2. Completion of ACLS course
  3. Promotion to fourth-year status

Description

During the subinternship, students will work under the supervision of an assigned Mayo PGY-2 or PGY-3 internal medicine resident at Mayo Clinic hospital, Mayo Internal Medicine Service. Night call will be with the residents on the service. To provide an adequate call experience, subintern will alternate long and short call every third night, only staying in-house every sixth night, irrespective of the number of residents on the service. The subintern will assume first-line responsibility for the patients he/she admits to the service.

The number of patients assigned to the subintern will be determined by the supervising resident (SR) and will depend on the complexity of the cases, size of the students' service, and the students' clinical skills. The residents on the service will provide in-house direct supervision when subintern is on call.

Specific goals

  1. To learn to participate as an integral member of a medical team in the management of adult patients.
  2. To refine history-taking and physical examination skills.
  3. To learn to formulate a problem list and prioritize medical problems.
  4. To learn the judicious selection of laboratory and ancillary tests.
  5. To learn to institute drug and supportive therapy.
  6. To learn to manage acute and chronic medical problems including the utilization of consultative services.
  7. To learn to develop definitive plans for ongoing care and follow-up of dismissed patients.

Activity outline

  • Perform a comprehensive history and physical examination on patients admitted to his/her service.
  • Formulate a complete patient problem list emphasizing differential diagnosis for active problems.
  • Formulate a diagnostic and therapeutic plan for active problems.
  • Discuss the management of each new case with the SR.
  • Present each new admission to the attending and other members of the service.
  • Write all orders for assigned patients.
  • Write progress notes at least once daily on all patients.
  • Visit each patient at least twice daily (before morning rounds and again in the afternoon or evening).
  • Prepare discharge and off-service summaries on all patients and arrange for follow-up care.
  • Assume the care of two or three patients at the beginning of the hospital rotation if a student or resident is rotating off the service at the time.
  • Take in-house call every sixth night. Call and days off should be coordinated with the call schedule of the SR on the service whenever possible.
  • Admit the first two patients assigned to the service and the alternate admissions with one of the residents on the service (assignment of patients is at the discretion of the SR).
  • "Sign out" to the on-call resident when leaving the hospital to inform the on-call resident about the status of the patients on his/her service.
  • Perform procedures on assigned cases.
  • Attend medical grand rounds and conferences and seminars outlined in the Orientation Booklet for the Internal Medicine Hospital rotation.
  • The subintern should wear a nametag at all times.
  • Absences should not be scheduled during the subinternship.

Method of evaluation

The attending consultant, supervising resident and resident all complete student evaluations.

  • ART105035