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-Study the guidelines!
-Show up early each day to work up patients because you don't know how many patients you'll have or how complicated they may be.
-Take advantage of all of the resources provided to you.
-You are going into the best rotation block, so make the most of the preceptor/medical residents/physicians and ask lots of questions!
-Don't be afraid to try out different systems for working up patients for rounds to make you more efficient and able to build on work that you have already done. Be sure to ask for advice if you think your system could improve.
-If the residents invite you to lunches or to spend more time with them, do it. They are trying to get to know you too and building that relationship allows for a better team based approach and acceptance of your recommendations.
-Don't be afraid to ask questions, you are students now and this is the opportunity for you to learn and make the most of the internal medicine rotation
-Start on projects and assignments early.
-If you know there is a topic to be discussed, make sure to research and familiarize yourself with the subject matter prior to going into the topic discussion. It allows you to see what you know, but also prompts you to ask additional questions during the topic discussion that you may not have had prior to researching the topic.
-Include fun facts or questions for the audience if you will be presenting a topic discussion yourself. This keeps the audience engaged and makes whatever topic you make be speaking on much more enjoyable (and less boring, if it's not a fun topic!)
-Students should try to pick or select patients who seem to have more complications, because that is how they learn more about different disease states and treatment course for them.
-Students should be organized especially as they pick up more patients, so that they don't mix up information on patients, and this will also help them stay on track with follow up therapy through the patient's stay in the hospital.
-Students should ask questions especially when confused about how or why a treatment regimen was used on a patient; this is another way to help them learn.
-Take advantage of this opportunity to cover topics that you are weak in because you are probably not the only person who will benefit from it. Use this as a review session towards increasing your knowledge base for yourself and in preparation for your boards exam.
-Try to get to know the medical residents because this will make it easier to get important information regarding the patients you are covering. If they have any medication concerns or questions, they can come directly to you, which may assist you in completing your portfolio assignments.
-I would highly recommend looking over Rose’s protocol sheets (i.e.; antimicrobial stewardship handout, anticoagulation handout) because while Lexi and Micromedex are good resources to have, they may or may not recommend the same things.
-When looking for patients to pick up, try to pick up harder, more interesting patients because it will make it a more learning experience. Don’t just pick up the easy ones because you won’t get much out of them when compared to someone requiring more time.
-Don't be afraid to make recommendations on rounds. The family medicine team is very receptive to the student's opinion. Try to absorb as much as you can on rounds, even when the team isn't discussing your patient. It is helpful to get experience with as many patients as possible while on the rotation.
-Try to delegate a little bit of time each day throughout the week to work on assignments. If you don't have an assignment due that week it doesn't mean you shouldn't be working on something. It is a lot easier to spread the workload over the entire month than wait until the end to be working on three different things at the same time.
-Don't wait until internal medicine II to pick a patient for your final patient case presentation. If you have an interesting patient try to come up with a clinical question for them so you aren't trying to come up with a topic two weeks into internal medicine two. On that note, it is helpful to keep all the information you gathered for each patient. Don't throw everything away once they get discharged. You may find that you need to look back at them for different assignments.
-Don't be afraid to ask questions. Dr. Biehle is more willing to answer any questions that you may have. This rotation is an opportunity to learn so if there is a topic you feel weak in then ask about covering it. She always accommodates the students and tries to structure the rotation around what you want to learn so take advantage of that!
-This rotation is challenging and requires good time management. Expect to do some work in the evenings and on weekends. Come in the morning expecting to be very busy for the first few hours. You will become more efficient as the rotation progresses.
-The rotation will go by very quickly and you will get out of it what you put into it. So work hard and try your best. This rotation is an ideal learning environment and is a great opportunity to apply what you've learned in school.
-I would probably have to to suggest staying on top of assignments, interventions, and portfolio assignments.
-Also, would recommend starting to work on the case presentation early. It's difficult to remember everything if the patient was from internal med I.
-This rotation is extremely beneficial and you will learn a lot. Everyone you work with is very friendly and helpful. The work load during the rotation is steady but doable. My advice is to always stay caught up with everything and to plan your topics for your assignments well in advance. Each day at this rotation is different and your time to work on assignments can fluctuate.
-Dr. Biehle is extremely helpful during this rotation so don’t be afraid to ask her questions. Dr. Biehle is very enthusiastic about teaching so I recommend taking advantage of this while you’re here.
-Select the more complex patients with unique disease states or ones that you know less about. You will discuss appropriate treatment of common conditions such as hypertension and diabetes frequently, so go for the conditions or medications that you don't know. You will be able to increase your knowledge base this way.
-Decide what you want from this rotation. You can come out of the rotation just average or you can put in the time and effort to be above average. You will put in more than 40 hours per week on this rotation, but you will get so much out of it.
-Take the assignments seriously. I learned so much by putting lots of effort into the assignments. They give you a chance to utilize available resources and practice your critical thinking. They ultimately help you develop as a professional.
-Lauren is an amazing resource to develop as a professional. Ask her about topics you're interested in and then take advantage of the opportunities she presents you.
-Have confidence in your recommendations to other healthcare-professionals, this is a time to practice your communication skills as well.
-When working up patients before rounds, be succinct in your recommendations and know dosages and dosing frequency for drugs you are making recommendations on.
-Find a way to memorize the duration of treatment for common infections seen, such as pneumonia (CAP/HAP/VAP) and UTI’s (uncomplicated and complicated). This will come up a lot so if you can memorize the length of treatment, this will save you time by not having to go back and look up it up repeatedly.
-The earlier you can come in, the better! More prepared, less stressed, better outcomes :)
-Be prepared. Review guidelines and memorize them! You will use them every day!
-Start your assignments and project early. They are much longer than you think :)
-Build up a reference folder and collect all handouts and guidelines together. Every morning will be super fast. You need to be able to access these papers as fast as possible.
-Challenge yourself to learn something new or review something every day
-Take advantage of as many opportunities as you can
-Pick a patient for your SOAP note and get started ASAP. Do not wait until the week it is due to start. You need access to the EMR to complete the assignment and it cannot be completed from home.
-Try to pick patients with different disease states every day to get the most out of your patient work-up process. Review the guidelines each and every time you work-up a disease state- you will learn something new each time you review them.
-Brush up on CHEST guidelines, CAP/HAP/VAP, and Sepsis as soon as you can- you will see these daily
-Try to always be thinking about transitions of care when patients are discharged and how you can help them to be as successful as possible. This may mean patient education, recommendations for outpatient follow up, or evaluating the appropriateness of each medication.
-It's never to early to start your projects! It can feel like they are a long ways away but that time will go really fast.
-Keep a little notebook full of the things you look up or learn during rounds, topic discussions, or anywhere else on Internal Medicine. You will likely find that you have a great reference to come back to later in the rotation and even in your future rotation.
-Don't be afraid to provide recommendations to the residency team. They are very supportive and receptive to what pharmacy has to recommend.
-Make sure to stay on top of all your assignments.
-Show up eager to learn every day and go the extra mile to read guidelines in entirety and articles on your own that you find or Dr. Biehle sends you, this is your time to learn and grow.
-Take advantage of opportunities to go above and beyond the requirements of the rotation.
-Take the Feedback Fridays seriously. This is where you can plan to make real changes in your practice.
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