Student Intern Expectations

STRUCTURE OF RAH MEDICINE TEAMS

1. Medical Admissions Team (MAT) which is composed of a dedicated team of GIM staff, 1-2 Nurse Practitioners, and a Senior Resident (i.e. MAT Senior) to look after the MAT GIM patients who were recently admitted, until the patients are assigned to a Medicine team the following day. The MAT Junior Resident starts their call at 1600 hr and participates in the 1600 hr sign over rounds. There is a pharmacist and other allied health professionals on the team. Nighttime coverage of MAT patients will be by on-call staff, Senior Resident (MAT/ED Consults Senior) and on-call MAT Junior Resident. There will be a formal sign over in the format of a morning report at 8 am the next day between the post-call Residents/Staff with the on-call MAT team. 

2. The inpatient service has 11 teams. The GIM 1, GIM 2, GIM 3, GIM 4, GIM 5, GIM 6, GIM 7, GIM 8 teams are non-teaching and there are no housestaff attached to these teams. The other teams (Gold Team, Red Team & Green Team) usually include 1 GIM staff, 2 or 3 junior residents and 1-3 students. The names of the teams and the allocated for admitted inpatients are as follows:

   • Gold Team on 6W Robbins/Obs, Robbins Overflow

   • Red Team  on 3E/6E Robbins, Robbins Overflow

   • Green Team on 5E Robbins/Obs, Robbins Overflow

   • GIM 1  on Unit 42 & 43

   • GIM 2 on Unit 42 & 43

   • GIM 3 on Unit 41, 51, 52, 53

   • GIM 4 on Unit 41 & 44

   • GIM 5 310 OSC, 410 OSC, Units 21, 22, 23, 24, 31, 32, 33, 34

   • GIM 6 on Unit 54/5th floor Overflow

   • GIM 7 4th floor ATC

   • GIM 8 EIP/CMD, OSC Overflow

This will enhance the multidisciplinary concept of care of patients where there will be more interaction between physicians and allied healthcare professionals. There may be bullet rounds for some wards which are multidisciplinary rounds.

Each team will round on each weekday morning with the staff on sick patients, discharges, and then the rest of the list. All patients should have a discharge summary completed.

EXPECTATIONS

• Patient assignments: You will typically be assigned 3 - 5 patients.  You are expected to know your patients thoroughly.   

• Patient care: You should see your patients every day prior to starting rounds.  If you are concerned about your patient’s status, please let your Sr. Resident or attending physician know right away.  

• Progress Notes: You are responsible for writing a progress note on each of your assigned patients daily. Have your Sr. Resident or Preceptor review your notes.

• Admission histories should be completed within 24 hours of seeing the patient.  

• Discharge summaries: If one of your patients is discharged, you are responsible for writing the discharge summary and completing the discharge medication reconciliation (this will be reviewed by the team pharmacist or senior resident/staff).  If you only looked after the patient briefly and don’t feel comfortable doing the discharge summary, please discuss this with your preceptor.

• On call responsibilities: On-call students should expect to receive afternoon handover on the list from their team, particularly more acute patients or items requiring follow-up overnight.

• Admissions – the Sr. Resident will call you for admissions.  Let them know how soon you will be able to see the patient.  Assess the patient, write up the history, pend admission orders, and review all of these with your senior resident.

• Ward problems – you are first on call for your ward patients.  A Junior Resident will be your back-up.  Please check the call schedule to see who your Junior Resident backup is (noted with a * on the schedule).  Each clinical encounter MUST be discussed with a Junior, Senior or Staff, and all orders must be co-signed by the same.

• If you get a call about a ward problem while you are doing an admission, please have the Senior resident help you prioritize what you should deal with first (ie, acute chest pain should be dealt with urgently).

• You are excused from clinical duties by 10am on the day after call.  Please remind your preceptor/team.

• If you are ill and are not able to do a call day, please enter into Cally, notify the staff, the senior resident and Lori Hawrelak ASAP.  It is YOUR RESPONSIBILITY to try to arrange a switch with another student.  

• Writing orders – Ensure that each and every order is co-signed by a resident or attending physician. You CANNOT give verbal or telephone orders. Please note that when you write admission or transfer orders, you will need to review all previous orders as well, and either continue or discontinue them.

EVALUATIONS

• Each week your preceptor will complete an evaluation for you. Please remind them to complete these. It is ideal that they are completed in person. 

LEAD STUDENT

• We will ask for a volunteer Lead Student from each group of students.  The responsibilities of the Lead Student include:

• Communicating with the Sr. Resident about topics for bedside teaching sessions.

• Filling in the weekly student teaching schedule and emailing it to Lori Hawrelak at the end of each week.

• Monitoring any issues that might arise during the rotation.  Please note them on the weekly reports under comments.

• Overall communication between RAH PTP/Admin and students.

TEACHING SESSIONS

 You will receive via email a teaching schedule one week prior to the start of your rotation.

ALL TEACHING SESSIONS are MANDATORY (excused if you are post call).

ABSENCES

If a student is absent from the rotation for personal or illness reasons, they must notify UME to have the absence approved, AND they must notify their preceptor directly.

Students may not leave a message with a junior or senior resident about absences. It is the responsibility of the student to notify both UME and their preceptor. 

If you are absent during any part of your rotation, please ensure that you notify in writing (via email) your staff, senior, Lori Hawrelak rahgimed@ualberta.ca, PTP and UGME Administrator medugme@ualberta.ca as soon as possible.  As well, all absences need to be entered/approved through CALLY.

CALL REQUIREMENTS

There will be different call requirements for the two rotations within this clerkship:

• 4 weeks on CTU, students will do 3 weeknight (Monday - Friday) overnight calls (0800 - 0800) and 1 weekend overnight call (Saturday).  We will try to avoid overnight calls on Tuesdays if possible (due to AHD on Wednesdays).  If a student is scheduled to do call on a statutory holiday, they will receive a day off in lieu ideally within the same 4-week rotation.  We will try to avoid the students doing weekend call on the last weekend of the rotation.

• 4 weeks on a PLU, students will do 3 evening ED admission shifts (1600 - 2200) and one weekend (or statutory holiday)  0800 - 2000.   If a student is scheduled to do call on a statutory holiday, they will receive a day off in lieu within the same 4-week rotation.  We will try to avoid the students doing weekend call on the last weekend of the rotation. Students will NOT be on call for their home unit patients during the ED admission shifts and will NOT round on their own patients on the weekend ED admission shifts. 

Medicine MED 546 Clerkship Rotation Website