Welcome to the Department of Medicine!SI 270.2 Straight Internship in Medicine

Dr. Iris Thiele Isip TanDr. Adrian Paul Rabe

A little history ...

Straight internship program in the 1980s before the INTARMED program was established

Straight Interns were the JAPODs - term survived even if straight internship program was discontinued

A program in evolution...

Lesser students

More duties

More electives

SI 270.2 Straight Internship in MedicineCourse Description

Rotation in medicine and its subspecialties with opportunities for self-directed learning and direct patient care as junior admitting physicians

Refinement of knowledge and skills learned in LU 5 and LU 6 as health practitioner, leader/manager, researcher, health educator and social mobilizer

Education in medical informatics will be integrated in the rotation

Instill the knowledge, skills and attitudes of information management

SI 270.2 Straight Internship in MedicineTerminal Competencies

Recognize and diagnose common and some uncommon medical problems/ diseases/ emergencies

Manage common and some uncommon medical problems/ diseases/ emergencies using sound clinical judgment, logical decision-making strategies and evidence-based medicine

Completely document patientsʼ cases including the medical history, physical examination, course of illness and management plan

Submit a completed research work

SI 270.2 Straight Internship in MedicineTerminal Competencies

Formulate a plan for patient education based on perceived need

Demonstrate the proper attitudes and values of a humane and community-oriented physician

Effectively communicate with patients, their caregivers and colleagues

Demonstrate harmonious working and professional relationships with other members of the health team (superiors, peers, subordinates and paramedical personnel)

Acquire essential informatics skills

44 weeks in Medicine8 weeks in community rotation

OPD: General medicine, Hypertension, Geriatrics, Subspecialty clinics (not covered by subspecialty rotation)

Mandatory subspecialties: IDS, Endocrinology, Cardiology, Pulmonology, Gastroenterology, Nephrology

ER (4 weeks)MICU (4 weeks)

Wards (12 weeks)

OPD (8 weeks)

Elective subspecialty (4 weeks)

Mandatory subspecialty (12 weeks)

ER Rotation

PM

Pre-duty

(7 am- 7 pm)

Post-duty(Day off)

24-h DUTY

Pre-duty

(7 am- 7 pm)

Post-duty(Day off)

24-h DUTY

Pre-duty

(7 am- 7 pm)

AM

SunSatFriThursWedTuesMon

On pre-duty day, decked 2 old patients to manageOn duty day, decked 2-3 new patients (1 patient every shift) and 1-2 old patients to manageMaximum patients allowed: 5No continuity clinic; only one duty intern per day

4 weeks

Ward work

D U T Y

PREDUTY Blood bank

screening

Ward work

Ward work

Blood bank screening

Straight Intern’s hourWard work

Blood bank screening

PREDUTY

D U T Y

MICU Subspec rounds

MICU Team Captain rounds

MICU Subspec rounds

MICU Subspec rounds

Ward workAudit/ Grand

RoundsWard workWard

work Ward work

Ward work

Endorse ment

rounds

Endorsement

rounds

Endorse ment rounds

Endorse ment

rounds

Endorse ment

rounds

TIME OFF

TIME OFF

Ward work

Ward work

PM

PREDUTY

Endorsement

rounds

Endorse ment

rounds

Endorsement

rounds

Endorse ment rounds

Endorse ment

rounds

Endorse ment

rounds

AM

SunSatFriThursWedTues Mon

MICULast 2 weeks: one Straight Internʼs hour (case management conference) per week

Ward rotation

1st week of 1st 4-week block: JAPOD

Decked 2 old service patients to manage under direct supervision by senior medical resident (countersigns all orders) and service consultant

APOD duty: decked 2 new patients to manage

During duty, will manage decked patients at ER while awaiting admission under direct supervision by ER medical resident

WAPOD duty: answer all ward referrals under direct supervision by ward resident

12 weeks divided into 4-week blocks

Continuity clinic

Service rounds

Ward workService rounds

Ward work

Endorse ment

rounds

TIME OFF

Endorse ment conf

Sat

Endorse ment

rounds

Consultant rounds

Ward work

Audit conference/

Grand Rounds

Endorsement rounds

Ward work

Endorsement rounds

Service rounds

Ward work

Ward work

24h

WAPOD

DUTY

Endorse ment rounds

Consultant rounds

Endorsement rounds

TIME OFF

Ward WorkWard WorkWard Work

Ward WorkWard Work

PM

Ward work

Endorsement conf

24h APOD

DUTY

Endorsement confEndorsement

conf

Endorse ment confEndorsement

conference

AM

SunFriThursWedTuesMon

Attend continuity clinic

Submit two case write-ups per block of rotation (comprehensive discussion with appended literature review)

OPD rotation

Mainly general medicine clinicMay substitute 10 half-days with consultantsʼ private clinics

4 half-days eachGeriatrics

Hypertension

Subspecialty clinics (not covered by mandatory/elective rotations)

8 weeks divided into 4-week blocks

OPD rotation

Attend continuity clinic

Go on duty: ER, SCU-POD, SAPOD

ECG readingWeek 1-2 of first 4-week block: ECG reading homework

Remaining weeks: Decked 5 ECGs to read after every OPD day, counter-signed by medical resident

8 weeks divided into 4-week blocks

Night DutiesOPD/Subspecialty rotations (24 weeks)

7 pm to 7 am

4 weeks: ER duty

4 weeks: Pay duty

8 weeks: SAPOD duty

8 weeks: SCU-POD duty

Post-duty status: May go home after 12 nn

Subspecialty rotation

12 weeks mandatory rotationIDS, Nephrology, Cardiology, Endocrinology, Gastroenterology, Pulmonology

4 weeks elective rotation4 one-week blocks, 2 two-week blocks, one 2-week block and 2 1-week blocksAllergy, Adult Medicine, Medical Oncology, Rheumatology, Hematology, Neurology

16 weeks

Subspecialty rotation

Consultant buddySigns learning contract, gives end-of-rotation grades, goes on pay rounds

Learning contract for each rotationSectionʼs blueprint PLUS what youʼd like to do

Continuity clinic Night duties: ER, Pay, SCU-POD, SAPOD

16 weeks

Google Group

Feel free to post - letʼs document the journey

Main mode of submissions for requirements - I hate paper!

Research

Patient log

Venue for announcements

Logbook

Document attendance

Document all patient encountersCannot upload patient log with identifiers

Research

Research adviser

MilestonesWeek 11: completed research proposal

Week 22: progress report

Week 33: preliminary report

Week 44: final research paper

Informatics sessions

Baseline computer literacy surveyMonthly brown bag/lunch sessions (lecture/demo)

Discuss results of computer literacy survey

Introductory lecture on health informatics

Literature search using PubMed (mobile access to PubMed)

BIBUS (open source bibliographic software)

PDA use in medicine

Evaluating medical information on the Internet

Patient resources on the Internet

Decision support tools

Continuing medical education on the internet

Basic database operations

The program is what YOU make it!

Just ask and you can ...

Have more patients

Do procedures

Attend subspecialty conferences/conventions

Go to consultantsʼ private clinics (near PGH)

A little about myself ...

A little about myself ...

Anything you’d like to tell me?

Thank You

+639285030986isiptan@gmail.com

http://www.endocrine-witch.info