Intern Orientation- Some Intern Orientation- Some Helpful InfoHelpful Info

Seth YandellSeth Yandell

Chief ResidentChief Resident

WelcomeWelcome

Important contacts for questions or Important contacts for questions or problems:problems:

MyselfMyself Your residentsYour residents Tracie, Sherie, and JulieTracie, Sherie, and Julie In the clinic- Gayle, Nancy, SonyaIn the clinic- Gayle, Nancy, Sonya Dr CarrollDr Carroll Dr QuicenoDr Quiceno Dr FeldmanDr Feldman

Day to Day Activities On WardsDay to Day Activities On Wards Day starts at 7amDay starts at 7am On call you are responsible for admissions and On call you are responsible for admissions and

codes from 7am-7am so you must be here codes from 7am-7am so you must be here during those times without exceptionduring those times without exception

We cap at 5 new patients per intern (plus a total We cap at 5 new patients per intern (plus a total of 2 handoffs) on a call night, or an intern can of 2 handoffs) on a call night, or an intern can cap if he/she has a total of 12 patients at the end cap if he/she has a total of 12 patients at the end of the day (patients discharged earlier in the day of the day (patients discharged earlier in the day do not count towards the 12 total)do not count towards the 12 total)

On your post call day you round, attend On your post call day you round, attend attending rounds at 10:30 if it is a M/W/F, attend attending rounds at 10:30 if it is a M/W/F, attend conferences then leave the hospital by 1pmconferences then leave the hospital by 1pm

contcont Daily- round on patients and speak with each attending daily Daily- round on patients and speak with each attending daily

regarding pt assessment/plan (speak with your resident before regarding pt assessment/plan (speak with your resident before calling an attending for the first few months so you know you are calling an attending for the first few months so you know you are calling the attendings with the pertinent info/plan)calling the attendings with the pertinent info/plan)

Conferences- mandatory, we have them daily at noon M-F (always Conferences- mandatory, we have them daily at noon M-F (always catered), we also have Wed morning conference at 7:30am and catered), we also have Wed morning conference at 7:30am and Coffee with Cardiology on Fri at 7:20am. If you fall below 75% Coffee with Cardiology on Fri at 7:20am. If you fall below 75% attendance of these you can be subject to disciplinary action (up to attendance of these you can be subject to disciplinary action (up to and including non-advancement).and including non-advancement).

Checkout- list is kept current on Caregate then checkout is Checkout- list is kept current on Caregate then checkout is performed prior to leaving hospital (you are listed with your checkout performed prior to leaving hospital (you are listed with your checkout interns on the calender). Include pertinent information and any work interns on the calender). Include pertinent information and any work to be done (it is a good idea to keep meds/allergies updated on to be done (it is a good idea to keep meds/allergies updated on these lists).these lists).

Pagers- You have to call the page operator daily to check out your Pagers- You have to call the page operator daily to check out your pager, you are responsible for your pt’s till 5pm daily during the pager, you are responsible for your pt’s till 5pm daily during the week and noon on the weekends (and 1pm postcall) so do not week and noon on the weekends (and 1pm postcall) so do not check out your pagers until those times. (i.e. this is Dr Yandell and I check out your pagers until those times. (i.e. this is Dr Yandell and I need to check out my pager to Dr Das till 7am tomorrow)need to check out my pager to Dr Das till 7am tomorrow)

contcont Attending Rounds- While on wards you have them M/W/F from 10:30am-Attending Rounds- While on wards you have them M/W/F from 10:30am-

noon so plan on being done rounding in time for thisnoon so plan on being done rounding in time for this Interns conference- with Dr Feldman every Tues at 11am, one intern will be Interns conference- with Dr Feldman every Tues at 11am, one intern will be

scheduled every month to assign the other interns to present during the scheduled every month to assign the other interns to present during the month, this is a required conference for interns on wards but everyone is month, this is a required conference for interns on wards but everyone is invited and your attendings will let you leave to attend this conference- you invited and your attendings will let you leave to attend this conference- you will not learn more in any conference all year than you will in intern will not learn more in any conference all year than you will in intern conferenceconference

Off Days- already scheduled (you have your pre-call T/Th/Sat/Sun off during Off Days- already scheduled (you have your pre-call T/Th/Sat/Sun off during the month)the month)

Clinic- As a categorical you will have a scheduled clinic day throughout your Clinic- As a categorical you will have a scheduled clinic day throughout your 3 yrs (this day remains the same during your residency), clinic starts at 1:30, 3 yrs (this day remains the same during your residency), clinic starts at 1:30, you can have anywhere from 3-7 patients a day. There is a special you can have anywhere from 3-7 patients a day. There is a special scheduling twist- if you have a Tues clinic and are post call on tues then you scheduling twist- if you have a Tues clinic and are post call on tues then you have to make up your clinic on wed; if you have thurs clinic and are post-call have to make up your clinic on wed; if you have thurs clinic and are post-call on that thurs you have to makeup the clinic on the Monday prior to that on that thurs you have to makeup the clinic on the Monday prior to that thurs. (ex if I usually have clinic on Thursday of the upcoming week but am thurs. (ex if I usually have clinic on Thursday of the upcoming week but am going to be postcall on that Thursday then I will have clinic on Monday of going to be postcall on that Thursday then I will have clinic on Monday of the upcoming week instead). If as a prelim you are interested in the upcoming week instead). If as a prelim you are interested in participating in clinic for the year let me know in the next couple of weeks participating in clinic for the year let me know in the next couple of weeks and you can be set up with myself or another 3and you can be set up with myself or another 3rdrd year resident to work with year resident to work with in clinic through the year. We had a prelim do this last year and she found it in clinic through the year. We had a prelim do this last year and she found it very educational.very educational.

Patient CarePatient Care

Forms, Forms, Forms……Forms, Forms, Forms…… There is one for everythingThere is one for everything

DKA protocols, Stroke protocols, Acute DKA protocols, Stroke protocols, Acute Coronary Syndrome, Electrolyte Sliding Scale Coronary Syndrome, Electrolyte Sliding Scale for K/Mg/Phos repletion, Insulin Sliding Scale, for K/Mg/Phos repletion, Insulin Sliding Scale, Restraints etc……Restraints etc……

SamplesSamples

Admission Admission ordersorders

Insert sampleInsert sample

Green StickersGreen Stickers

Insert pictureInsert picture

Patient Name

MR#

DOB

Discharge FormsDischarge Forms

Insert sampleInsert sample

Discharge Summaries/RecordsDischarge Summaries/Records Discharge Summaries- Brief summary of pertinent hospital Discharge Summaries- Brief summary of pertinent hospital

course/findings/resolutions with medications and discharge course/findings/resolutions with medications and discharge instructions/f/u- Do not run on forever (hint- figure out what you will instructions/f/u- Do not run on forever (hint- figure out what you will say before you start, use the pause button, and try to do it with the say before you start, use the pause button, and try to do it with the chart and discharge form in front of you so you can dictate chart and discharge form in front of you so you can dictate meds/pertinent labs/dates etc straight from the chart)meds/pertinent labs/dates etc straight from the chart)

Records- Stay up to date with your charts by calling medical records Records- Stay up to date with your charts by calling medical records (on the lower level on the way towards Jackson) once weekly to see (on the lower level on the way towards Jackson) once weekly to see if there are any records they need to pull for you for you to finishif there are any records they need to pull for you for you to finish

Clinic Records for Categoricals- Our clinic has there own paper Clinic Records for Categoricals- Our clinic has there own paper record which has to be kept up regularly. Go to the clinic’s medical record which has to be kept up regularly. Go to the clinic’s medical records (across the hall from the ACC) once weekly and sign off on records (across the hall from the ACC) once weekly and sign off on labs and call patients with follow up when needed.labs and call patients with follow up when needed.

If you don’t stay up to date with this you will get a nasty letter from If you don’t stay up to date with this you will get a nasty letter from Dr. Rinner about how you are a failure and are fired (Ok I made the Dr. Rinner about how you are a failure and are fired (Ok I made the failure/fired part up, but you will get a derrogoratory letter telling you failure/fired part up, but you will get a derrogoratory letter telling you to update your records or you will lose your privileges)to update your records or you will lose your privileges)

Do you need help?Do you need help?

Social Workers- your best friendsSocial Workers- your best friends PT/OT/STPT/OT/ST PharmacistsPharmacists NursesNurses Nurse Psychiatry LiasonNurse Psychiatry Liason PCT’sPCT’s

Non wards monthsNon wards months

Hours and responsibilities vary depending Hours and responsibilities vary depending on the rotation and attendingon the rotation and attending

Call the attending at least the week prior to Call the attending at least the week prior to starting the rotation to get details on their starting the rotation to get details on their expectations expectations

Ask your fellow residents about their prior Ask your fellow residents about their prior experiencesexperiences

Resident Conferences/Journal Resident Conferences/Journal Club/Potpourri/CPC/M&MClub/Potpourri/CPC/M&M

Everyone gives one 1hr resident conference on Everyone gives one 1hr resident conference on a internal medicine topic of your choice (please a internal medicine topic of your choice (please run your idea past me before you start so I can run your idea past me before you start so I can let you know whether it has been covered in the let you know whether it has been covered in the last year so we aren’t bored with redundancy)- last year so we aren’t bored with redundancy)- try to be somewhat narrow in your topic try to be somewhat narrow in your topic selection so you don’t get overwhelmedselection so you don’t get overwhelmed

3 journal club presentations through the year- 3 journal club presentations through the year- approx 15 minutes for each one, pick large approx 15 minutes for each one, pick large journals or groundbreaking studiesjournals or groundbreaking studies

Might have to present or help prepare a case for Might have to present or help prepare a case for Potpourri, CPC, or M&M conferencesPotpourri, CPC, or M&M conferences

Vacation- Now we’re talkingVacation- Now we’re talking You are allowed to take up to 5 days of vacation on non-wards You are allowed to take up to 5 days of vacation on non-wards

monthsmonths These days should be taken consecutively (barring emergency) and These days should be taken consecutively (barring emergency) and

preferrably either the first or last week of the month (to limit breaks preferrably either the first or last week of the month (to limit breaks in pt care)in pt care)

If you miss more than five days in a month due to some dire If you miss more than five days in a month due to some dire unforseen circumstance (you or someone you love dearly better be unforseen circumstance (you or someone you love dearly better be real sick or dead!) then the extra days will have to be made upreal sick or dead!) then the extra days will have to be made up

If you have left over vacation days at the end of the year you will be If you have left over vacation days at the end of the year you will be paid for the left over hours (you should have at least 5 days worth paid for the left over hours (you should have at least 5 days worth the first year since you can only take 25 of the 30)the first year since you can only take 25 of the 30)

Only one intern/resident can be taking vacation on a rotation at a Only one intern/resident can be taking vacation on a rotation at a timetime

After verifying that no one else on the same rotation is taking After verifying that no one else on the same rotation is taking vacation at the same time, then fill out the vacation request form and vacation at the same time, then fill out the vacation request form and turn it in to Sherie >30 days prior to the start of the vacation (and turn it in to Sherie >30 days prior to the start of the vacation (and really the earlier the better)really the earlier the better)

If you are a catagorical let Sonia in the clinic know as soon as you If you are a catagorical let Sonia in the clinic know as soon as you know when you are going to take vacation so she can block out your know when you are going to take vacation so she can block out your schedule and not schedule patients- this should be done 5-6 weeks schedule and not schedule patients- this should be done 5-6 weeks ahead of time at least to limit inconvenience to your patients and the ahead of time at least to limit inconvenience to your patients and the clinic staffclinic staff

ICU (I Can’t Understand!!!)ICU (I Can’t Understand!!!)

7am to 7pm daily7am to 7pm daily Intense rotationIntense rotation Procedures, procedures, procedures- tons Procedures, procedures, procedures- tons

of funof fun Work one weekend during the monthWork one weekend during the month

Speaking of Weekends/HolidaysSpeaking of Weekends/Holidays

Depends on which rotation you are on Depends on which rotation you are on whether you will have to work a weekend whether you will have to work a weekend

Holidays are also dependent on the Holidays are also dependent on the rotation and attending (if you are on ICU rotation and attending (if you are on ICU and are scheduled to work Christmas then and are scheduled to work Christmas then you might as well buy a Santa hat and you might as well buy a Santa hat and beard) beard)

Important Codes/NumbersImportant Codes/Numbers

Physician dining lounge on 1Physician dining lounge on 1stst floor: 214 floor: 214 Physician lounge on 9Physician lounge on 9thth floor: 997722 floor: 997722 Call Rooms: B 231, C 214, D 451Call Rooms: B 231, C 214, D 451 Sherie: 6176Sherie: 6176 Page Operator: 8480Page Operator: 8480 Chief: 8810 office and pager 214-786-2942, if I Chief: 8810 office and pager 214-786-2942, if I

am off then call my cell phone 972-890-2107 or am off then call my cell phone 972-890-2107 or my home phone 972-617-0414 and if I don’t my home phone 972-617-0414 and if I don’t answer leave a message and I will replyanswer leave a message and I will reply

Computer ProgramsComputer Programs Caregate- used daily with web powerchart, Caregate- used daily with web powerchart,

crosscover, and links to resources like MD crosscover, and links to resources like MD consult (full access) and Ovid-pubmed (login to consult (full access) and Ovid-pubmed (login to caregate is network login and password)caregate is network login and password)

Synapse- for accessing radiology images/reports Synapse- for accessing radiology images/reports (login name is texas\networkloginname, (login name is texas\networkloginname, password is same as network password)password is same as network password)

Welford- for the categoricals this is your new Welford- for the categoricals this is your new nemesis (I will schedule a time with you upstairs nemesis (I will schedule a time with you upstairs and walk you through some tricks that I have and walk you through some tricks that I have learned to speed up the process)learned to speed up the process)

More programsMore programs Citrix Program Neighborhood- Can be found in Citrix Program Neighborhood- Can be found in

programs or on desktop of computers at work, programs or on desktop of computers at work, login is same as network login/password. Use login is same as network login/password. Use this program to access copath. To access from this program to access copath. To access from home go to elink.texashealth.org and download home go to elink.texashealth.org and download the citrix program, after that you can access the citrix program, after that you can access copath or welford from home (I will show you copath or welford from home (I will show you how to do the welford access after the first few how to do the welford access after the first few months in clinic)months in clinic)

Copath- sign on and password set up as Copath- sign on and password set up as employee ID#, this is a nice asset to see path employee ID#, this is a nice asset to see path reports which don’t show up on caregatereports which don’t show up on caregate

Couple of finishing points…Couple of finishing points…

Be involvedBe involved Do abstracts/posters- if you need a case just ask and Do abstracts/posters- if you need a case just ask and

I can find you one I can find you one Research- most of our attendings are interested in Research- most of our attendings are interested in

research so just ask them or if you need an idea talk research so just ask them or if you need an idea talk to myself/Dr Quiceno/Dr Carroll/ or Dr Feldmanto myself/Dr Quiceno/Dr Carroll/ or Dr Feldman

Go to talks (free good meals, you can network, and if Go to talks (free good meals, you can network, and if you pay attention you can sometimes learn you pay attention you can sometimes learn something)something)

When we have get togethers with the housestaff show When we have get togethers with the housestaff show up and enjoy your coworkers company outside of up and enjoy your coworkers company outside of work.work.

Let’s have some fun this yearLet’s have some fun this year