Rotation Coordinator: Dr. Vivan Ng vivian.ng@nygh.on.ca
Site/Medical Education Administrative Assistant: Jordan Hoeller Jordan.hoeller@nygh.on.ca
Your GIM rotation is a composite of inpatient ward, ER consultation and ambulatory week.
You will be assigned to a general internist for 2 weeks and work one-on-one with your preceptor during this block. You will mostly be on 7 or 8 South-East. You will admit, manage, and discharge patients with a variety of medical problems. There is no overnight in-house or home call. However, you are expected to round for one weekend (Saturday and Sunday during the day) with the assigned general internist during the rotation.
This block consists for 3 evening shifts (one overnight and two evenings). You will work directly with the general internist on that shift. Responsibilities include new consultations for undifferentiated patients, as well as covering the inpatient medical wards and participating in Code Blues.
This week consists of participating in the General Medicine Clinic for one week. You will be directly supervised by the staff attending in the clinic. This clinic functions as a rapid referral clinic from the ER and a post-discharge clinic from the wards.
The goal of this rotation in General Internal Medicine is to fulfill the CanMEDS roles.
Medical Expert:
Assessment of patients presenting with undifferentiated medical complaints/problems including eliciting a relevant history, performance of the appropriate physical examination and evidence-based use of diagnostic testing.
Evidence-based management of common medical illnesses.
Effective, integrated management of multiple medical problems in patients with complex illnesses.
Performance of common bedside procedures used in diagnosis and management of medical patients.
Interpreting common tests such as ECGs and CXRs.
Communicator:
Obtaining a thorough and relevant medical history.
Oral presentation of a patient's medical problems at the bedside.
Discussion of diagnoses, investigations and management options with patients and their families.
Obtaining informed consent for medical procedures and treatments.
Communication with members of the health care team.
Collaborator:
Demonstrate proficiency in working effectively within the health care team.
Demonstrate appropriate use of consultative services.
Recognize and respect the roles of other physicians, nursing staff, PT, OT, nutritionists, pharmacists, social workers, secretarial and support staff, and community care agencies in provision of optimal patient care.
Manager:
Oversee provision of care and implementation of decisions regarding patient care, including effective delegation of care roles.
Utilize health care resources in a scientific, ethical and economical manner.
Health Advocate:
Understand important determinants of health including psychosocial, economic and biologic.
Recognize situations where advocacy for patients, the profession or society are appropriate and be aware of strategies for effective advocacy at local, regional and national levels.
Scholar:
Develop the knowledge and skills to be able to recognize and assess the extent of underlying medical disease.
Demonstrate the ability to generate clinical questions related to patient care and utilize and analyze available resources to develop and implement evidence-based solutions to such questions.
Present cases in morning report and give one formal rounds.
The structured teaching sessions are as follows:
Hospital Medical Grand Rounds occur Tuesdays from 8AM - 9AM in Auditorium 2 (ground floor behind the gift shop).
Morning Report on Thursday morning (details TBD).
Staff facilitated Journal Club on the last Tuesday of the month in the evening. The time and place varies. Residents are encouraged to attend.
Read about your patients' illnesses using any standard textbook for Internal Medicine, supplementing from the literature as needed.
Present noon rounds once during the rotation and present cases at morning report.
Ask faculty for regular feedback.
Take as much responsibility for patients as possible without jeopardizing the patients' safety or comfort.
Be respectful of patients and the entire health care team.
Complete an evaluation form at the end of the rotation.
Vacation Requests
Vacation requests should be submitted using the appropriate form at least one month prior to the onset of the rotation. The organization and scheduling of the rotation is a complex matrix that takes into account not only ALL residents’ requests/education needs but also the staff schedule. As a result, the schedule is finalized approximately one month in advance of the rotation, and requests for particular weeks as vacation cannot be accommodated. You are welcome to take vacation time during the block, but the schedule cannot preferentially accommodate for your vacation to fall during one of the ward weeks. Even if you submit your vacation request earlier, it will not impact the composition of the schedule.
If you are ill, you must notify your staff that you are working with as well as the education director (Dr. Ng). See the IM Contact List for list contact information.
If conflicts or problems arise during your rotation, discuss them with the education directors as soon as possible. Please do not wait until the end of the block. We are here to ensure an excellent educational experience.