Enhanced Skills Program: Hospital Medicine Goals and Objectives Family Inpatient Service (FIS)
1. Medical Expert
By the end of the rotation the resident will:
- Independently assess patients and determine fitness for transfer to the FIS service.
- Demonstrate an approach to common general medical conditions requiring hospitalization (the following is a guideline and is not exhaustive):
- Cardiovasuclar: 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: 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 require 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 and ECGs
- Demonstrate familiarity and intermediate competence in procedures including but not limited to arterial puncture for blood gas, joint aspiration/injection, nasogastric tube insertion, paracentesis, thoracentesis
- Demonstrate an understanding of the potential and appropriate use of bedside ultrasound
- Manage, with minimal supervision, general medical patients with a broad spectrum of clinical disorders
2. Communicator
By the end of the rotation the resident will:
- Demonstrate a targeted and organized approach of gathering historical information from patients and their family to allow appropriate triaging and transfer of patients to the Family Inpatient Service
- Work with junior residents and medical students to ensure effective, patient centered communication regarding diagnosis, prognosis, medical status and treatment options occur with patients and their families
- Effectively communicate consultation requests to specialty services and allied health care personnel and judiciously put into practice their recommendations
- 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 senior medical residents and Team A fellows to recruit appropriate patients to the Family Inpatient Service
- Utilize consultation with other services appropriately and effectively
- 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:
- Provide leadership to the Family Inpatient Service, mentoring junior trainees
- Delegate patient care issues to junior trainees, ensuring patient care requirements and educational objectives are met
- Supervise and provide teaching to junior trainees in the assessment and management of complex medical inpatients
- Provide informal and formal feedback to junior trainees at appropriate intervals
- Demonstrate time management skills to reflect and balance priorities of patient care, outpatient practices, academic demands and sustainable practice/personal life.
- Demonstrate familiarity with 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 biopyschosocial model
- Mentor advocacy to team members throughout inpatient admission and through planning outpatient discharge plans
6.Scholar
By the end of the rotation the resident will:
- Maintain and enhance professional activities through ongoing learning
- Participate in point of care resources/evidence based medicine seminars and mentor acquired knowledge to junior trainees throughout the rotation
- Use medical literature in a variety of sources to complement team discussions and teaching
- Understands the principles of adult learning and helps others learn by providing guidance, teaching and by giving constructive feedback.
7. Professional
By the end of the rotation the resident will:
- Recognize the scope of his/her abilities and asks for supervision and assistance appropriately
- Maintain appropriate professional relationships with patients and families