Medical Students FAQ for RESIDENTS

Additional LIC Background

Dr. Lauren Miltenberg, updated Spring '24

General background/info about the LIC year

As part of the Longitudinal Integrated Curriculum (or LIC), medical students spend the majority of their time in outpatient clinics, spending 1 half-day/week in clinic with a provider from each of the core medical specialties (IM, FM, Peds, OB-Gyn, Psych, Surgery). To support their exposure to hospital settings (and acuity), they also spend 4 weeks on a medicine immersion with the hospitalist service, 4 weeks on a surgery immersion with the trauma service and 4 weeks on a Maternal Child Health (Ob-Peds immersion). While on an immersion service they do not attend clinics and their only “non-immersion” weekly responsibility is attendance at their didactics sessions on Wednesday afternoon. Most students complete the Ob-Peds immersion as a combined 4 week rotation at PVH, mirroring to an extent the diversity of the Ob-Peds residents in caring for antepartum, laboring, and post-partum women, well newborns and sick pediatric patients. A few students (2-3 per year) will have their immersion divided, spending 2 weeks with the OB providers at Greeley hospital, then 2 weeks focused on newborn nursery and pediatric patients at PVH.

Student Expectations

During the immersions, the students are given the expectation of functioning as the primary provider for their patients, with a goal of developing a strong therapeutic alliance with patients and families. The average patient load for each LIC students should be 2-4 patients (balanced between peds, newborn and OB patients if applicable). Students should pre-round, perform daily examinations, prepare oral presentations for rounds and complete progress notes. When time allows, particularly in the first week of the rotation, the student will benefit from practicing their presentation with the senior resident or intern prior to rounds. Student shifts are day shift (6am-5pm on weekdays, 6am until work is done on the weekend, typically around noon) with the expectation for students to be present 6 days/week during their rotation.

Resident Expectations

The interaction of the students with the resident service is a valuable resource, with many students seeing residents they work closely with as guides and mentors. Since the LIC students typically spend all 4 years of medical school at the CSU branch campus, you may be the only residents that students overlap with during their learning! Since the attendings change, potentially from patient to patient (Ob to FM to Peds) and certainly from week to week, the students often feel most comfortable working with and learning from the residents. Here are some ideas for maximizing your time and their learning:

• Teaching: While every patient interaction can be a teaching opportunity, every patient interaction doesn’t have to include every teaching opportunity. When time allows and you can discuss the case, diagnosis, treatment plan and prognosis in detail with the student- awesome; when the hospital is busy, ask the student to take the history and provide feedback on 2 “can’t miss” questions for this presentation, have the student brainstorm a 3 item ddx and research/prepare a presentation on the diagnosis they are least familiar with; focus the learning on a portion of the treatment plan (like why you decided for or against an IV, or a bolus, or pit vs. Cytotec) and know that is still valuable teaching, even if you can identify 10 other learning opportunities in the same patient

• Patient support: Students can be a great resource for checking back in with patients after rounds. Even if not one of “their” patients, assign a student to go back and check status/results of a room air challenge, progress of a laboring mom, results of 24 hr bili/wt loss, review ins/outs for a kid with borderline PO intake. This increases their clinical competence and can directly support patient care and an item “on your plate”.

• Clinical Skills: Assist medical students in developing their clinical skills (exam and procedural). Let them perform simple procedures under your supervision when appropriate.

• Multidisciplinary Approach: Teach them the importance of working in a team in a hospital setting. Involve them in rounds, case discussions, and meetings with other healthcare professionals. If you trust their familiarity with a patient/case, students can be great patient advocates in calling a consult (CHCO providers frequently get consultations from medical students working in the hospital at Anschutz). Students can also reach out to dietitian, lactation, social worker or therapy (PT, OT, ST) providers for recommendations when needed.

• Feedback and Evaluation: Provide constructive feedback regularly to help medical students improve their skills. Also, encourage them to give feedback about their learning experience. You will also likely be asked to fill out a formal evaluation for students you work with for more than 1 week.