Enhanced Skills Program: Hospital Medicine Goals and Objectives Community Hospital Rotation
Goals and Objectives: PGY-3 FM-Academic Hospital Medicine
1. Medical Expert
By the end of the rotation the resident will:
- Independently assess patients, completing admission assessments, providing follow-up inpatient care and preparing for discharge
- Demonstrate an approach to common general medical conditions requiring hospitalization (the following is a guideline and is not exhaustive):
- Cardiovascular: Angina, heart failure, acute coronary syndrome, arrhythmias, hypertension, hyperlipidemia, syncope
- Dermatology: common inpatient problems, drug reactions
- Endocrinology: diabetes, thyroid disorders, lipid disorders, osteoporosis
- Gastrointestinal: GI bleeding, diarrhea, constipation, acute/chronic liver disease, abdominal pain
- Geriatric: dementia, delirium, recurrent falls, weight loss, polypharmacy, urinary incontinence, chronic pain, decubitus ulcers
- Hematology: anemia, coagulation disorders, cytopenias, lymphadenopathy
- Infectious Disease: acute infectious illness (sepsis, meningitis, encephalitis, pneumonia, endocarditis, gastroenteritis, cellulitis, urinary tract infection, pyelonephritis), tuberculosis
- Neurology: headache, seizure, stroke, vertigo, syncope, movement disorders
- Nephrology: acute kidney insufficiency, chronic renal insufficiency, electrolyte disorders, acid-base disorders
- Oncology: approach to workup of mass NYD, appropriate screening tests
- Palliative: end of life care, symptoms control
- Respiratory: obstructive airway disease, pleural effusion, infections, interstitial lung disease, malignant disease, thromboembolic disease
- Rheumatologic: acute/chronic monoarthritis and polyarthritis, vasculitis
- Make appropriate use of antibiotics/antibiotic stewardship,
- Recognize disease presentations that deviate from common patterns and requires complex decision making
- Modify differential diagnosis and care plan based on the patient’s clinical course and available investigations, in the context of patient centered care
- Correctly interpret laboratory tests, chest radiographs, ABGs and ECGs
- Demonstrate familiarity and intermediate competence with procedures, including but not limited to arterial puncture for blood gas, joint aspiration/injection, nasogastric tube insertion, paracentesis, thoracentesis, lumbar puncture
- Manage, with minimal supervision, general medical patients with a broad spectrum of clinical disorders. Recognizes limitations and asks for assistance appropriately
2. Communicator
By the end of the rotation the resident will:
- Demonstrate an organized approach of gathering historical information from patients and their family
- Ensure patient centered communication regarding diagnosis, prognosis, medical status and treatment options occur with patients and their families
- Appropriately counsel patients about benefits and risks of in hospital tests and procedures
- Participate in patient handover to on-call staff/residents outlining patient status and potential areas of medical concern
3. Collaborator
By the end of the rotation the resident will:
- Develop strong and effective working relationships with allied health staff, nursing and physician colleagues
- Utilize consultation with other services appropriately and effectively, and judiciously puts into practice their recommendations
- Demonstrate effective collaboration with medical and allied health team members to ensure comprehensive, efficient and safe discharge planning occurs
4. Manager/Leader
By the end of the rotation the resident will:
- Demonstrate time management skills to reflect and balance priorities of patient care, outpatient practices, academic demands and sustainable practice/personal life.
- Demonstrate an efficient approach to being the most responsible physician to large number of inpatients
- Demonstrate an approach to inpatient billing practice
5. Health Advocate
By the end of the rotation the resident will:
- Assess, individualize and respond to inpatients health concerns using a biopsychosocial model
- Mentor advocacy to team members throughout inpatient admission and through planning outpatient discharge plans
- Minimize unnecessary test, procedures and therapies