Date Issued: 07/23/2002
Prior Revision Date: 09/05/2008
Date Reviewed and Revised: 03/02/2009
Department: Internal Medicine
Faculty Coordinators: Jaya Juturi, M.D./ Lalan Wilfong, M.D.
Hospital: Texas Health Presbyterian Hospital Dallas
Periods offered: All
Length: 4 weeks
Max no. of residents: 1
First Day Contact: Hematology/Oncology faculty
member you have chosen to rotate with
First Day Time: Contact faculty member a week prior to rotation
First Day Place: Contact faculty member a week prior to rotation
Requirements: 7:30 a.m. to 6:00 p.m. Monday
Weekends: 2 weekends a month
Vacation: 1 week either the first week or last
week of the month
Resident will be working one-on-one with a Hematologist/Oncologist with a busy inpatient and outpatient practice.
At the most there will be one resident rotating with the team. The resident
will be exposed to a wide variety of hematological and oncological disease.
He/she will participate in seeing patients in consultation, following patients
on the oncology floor and attending the faculty member's outpatient practice.
Goals and Objectives: (based on ACGME competencies for resident education.)
Residents are expected to provide
care that is compassionate, appropriate and effective for the promotion of health,
prevention of illness, treatment of disease and at the end of life.
accurate, essential information from all sources, including medical interviews,
physical examinations, medical records and diagnostic/therapeutic procedures.
Examples: One must be able to perform and write a thorough
history and physical on a patient presenting with lymphadenopathy, a woman
presenting with a breast mass, a patient with pancytopenia, etc.
- Make informed recommendations about preventives,
diagnostic and therapeutic options and interventions that are based on clinical
judgement, scientific evidence, and patient preference. Examples: One
must demonstrate his/her ability to evaluate and treat patients with such
problems as a solitary lung mass, a coagulopathy, splenomegaly. He/she must
have a firm knowledge of 1° and 2 ° cancer prevention practices.
negotiate and implement effective patient management plans and integration
of patient care. Examples: A resident should be able to arrange for collaberation
between surgeon, radiation oncologist and oncolgist in the care of a woman
with breast cancer.
competently the diagnostic and therapeutic procedures considered essential
to the practice of internal medicine. Examples: Resident
should gain experience in performing bone marrow exams, reviewing bone marrow
slides and peripheral blood smears.
Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical, and social sciences, and the application of their knowledge to patient care and education of others.
- Apply an open-minded, analytical approach
to acquiring new knowledge. Examples: Learning the genetics of oncology; understanding of
chemotherapy; the indications and complications of commonly used agents.
- Access and critically evaluate current medical
information and scientific evidence. Examples: Resident should demonstrate skills in accessing medical
information regarding current treatment recommendations for specific malignancies.
clinically applicable knowledge of the basic and clinical sciences that underlie
the practice of internal medicine. Examples: Resident
should understand the biology and genetics of oncology.
- Apply this knowledge to clinical problem-solving,
clinical decision-making, and critical thinking. Examples: Apply
understanding of genetics to targeted therapy.
Residents are expected to be able to use scientific evidence
and methods to investigate, evaluate, and improve patient care practices.
areas for improvement and implement strategies to enhance knowledge, skills,
attitudes and processes of care. Examples: Resident
when lacking knowledge should demonstrate an active pursuit of the literature
to obtain the knowledge needed to evaluate and treat a patient.
- Analyze and evaluate practice experiences
and implement strategies to continually improve the quality of patient practice.
Examples: Demonstrate knowledge
regarding the importance of assessing pain control and continuing to try and
improve pain control.
- Develop and maintain a willingness to learn
from errors and use errors to improve the system or processes of care. Examples:
- Use information technology or other available
methodologies to access and manage information, support patient care decisions
and enhance both patient and physician education. Example: See above.
Interpersonal and Communication
Residents are expected to demonstrate
interpersonal and communication skills that enable them to establish and maintain
professional relationships with patients, families and other members of health
effective and professional consultation to other physicians and health care
professionals and sustain therapeutic and ethically sound professional relationships
with patients, their families, and colleagues. Examples: Resident
should demonstrate ability to communicate with the consulting physician in
a clear and effective manner regarding their patient.
effective listening, nonverbal, questioning, and narrative skills to communicate
the patients. Examples: Resident
should demonstrate above skills in all circumstances surrounding the care
of a patient with malignancy.
with consultants in a respectful, appropriate manner.
comprehensive, timely, and legible medical records.
Residents are expected to demonstrate
behaviors that reflect a commitment to continuous professional development,
ethical practice, an understanding and sensitivity to diversity and a responsible
attitude toward their patients, their profession, and society.
respect, compassion, integrity, and altruism in relationships with patients,
families, and colleagues.
sensitivity and responsiveness to the gender, age, culture, religion, sexual
preference, socioeconomic status, beliefs, behaviors and disabilities of patients
and professional colleagues.
to principles of confidentiality, scientific/academic integrity, and informed
and identify deficiencies in peer performance.
Residents are expected to demonstrate
both an understanding of the contexts and systems in which health care is provided,
and the ability to apply this knowledge to improve and optimize health care.
access and utilize the resources, providers and systems necessary to provide
optimal care. Examples: Demonstrate
timely consulting for psychological support, spiritual support, dietary support,
and social support in the patients with malignancy.
the limitations and opportunities inherent in various practice types and delivery
systems, and develop strategies to optimize care for the individual patient.
Examples: Resident should be able to organize all of the consultants
involved in the patient's care and deliver an efficient and effective treatment
evidence-based, cost-conscious strategies to prevention, diagnosis, and disease
management. Examples: Resident should demonstrate use of evidence-based medicine
in screening patients for cancer.
with other members of the health care team to assist patients in dealing effectively
with complex systems and to improve systematic processes of care.
Methods of instruction:
(schedule, topic, faculty)
Daily residents conference 12:00-1:00 p.m. - IM Training Room
Monday Noon Tumor conference 12:00-1:00 p.m. - Haggar Hall
(Resident must attend 2 per month)
Wednesday mornings 7:30-8:00 a.m. - Clinical Grand Rounds - IM Training
Wednesday afternoons 12:15-1:00 p.m. - Internal Medicine Update - Haggar Hall
Thursday Multidisciplinary Breast Care Conference 12:00-1:00 p.m. - Haggar Hall
(1st and 3rd Thursday of each month)
Evaluate and treat patients with oncological disease in the inpatient and
outpatient setting. Perform histories and physicals. Formulate and carrying
out a diagnostic and therapeutic plan and communicate that plan verbally
and/or in writing to the patient, the supporting medical team and the consulting