Date Issued: 06/23/2002
Prior Revision Date:03/02/2009
Date Reviewed and Revised: 07/26/2010
Department: Internal Medicine
Faculty Coordinator: Jorge Cheirif, M.D / John Harper, MD
Hospital: Texas Health Presbyterian Hospital Dallas
Periods offered: All
Length: 4 weeks
Max no. of residents: 3
First Day Contact: Tony Locklear 214-361-3415 (Dr. Cheirif) / Denise Chapa 214-345-6000 (Dr. Harper)
First Day Time: 8:00 am
First Day Place: Non Invasive Cardiology Lab, First Floor, Hamon Building (Dr. Cheirif) / PB3, Suite 204 (Dr. Harper)
Requirements: Monday through Friday 7:00 am
to 6:00 pm
Weekends: check with attending, no more than
Residents will work with a cardiologist with a busy in-patient and out-patient practice.
They will be exposed to a wide variety of cardiac diseases and will see patients in consultation, perform non-invasive
procedures and monitor intensive care patients in the CCU.
Course 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: Resident will demonstrate skill in obtaining a complete
history and physical exam on the patient with cardiovascular disease.
informed recommendations about preventives, diagnostic and therapeutic options
and interventions that are based on clinical judgement, scientific evidence,
and patient preference. Examples: Resident will be able to advise patients with angina,
congestive heart failure, aortic stenosis, etc. about the appropriate interventions
- Develop, negotiate and
implement effective patient management plans and integration of patient
care. Examples: Resident will work with
the patient, family and other health providers to develop and implement
a plan to manage the patient with congestive heart failure, inoperable CAD,
multiple cardiac risk factors, etc.
- Perform competently the
diagnostic and therapeutic procedures considered essential to the practice
of internal medicine. Examples:
Resident will develop skills in reading EKG's, echocardiograms, inserting
a Swan-Ganz catheter and interpreting the data.
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 the education of others.
- Apply an open-minded, analytical
approach to acquiring new knowledge. Examples: Resident will actively pursue readings pertaining to
the patients they have seen or assigned by the attending.
- Access and critically evaluate
current medical information and scientific evidence. Examples: Resident will develop the skills to assess the medical
literature through their attendance at Journal Club. He/she will use these
skills to evaluate cardiology literature.
- Develop clinically applicable
knowledge of the basic and clinical sciences that underlie the practice
of internal medicine. Examples: Resident
will build a firm knowledge of cardiac anatomy and physiology, the pathogenesis
of hyperlipidemia and hypertension, etc. and apply this knowledge to the
clinical care of their patients with cardiac dysfuntion.
- Apply this knowledge to
clinical problem-solving, clinical decision-making, and critical thinking.
Examples: See above.
Residents are expected to be able to use scientific evidence
and methods to investigate, evaluate, and improve patient care practices:
- Identify areas for improvement
and implement strategies to enhance knowledge, skills, attitudes and processes
of care. Examples: When areas
of weakness are identified, the resident will work with the attending to
develop a plan to improve in those defined areas.
- Analyze and evaluate practice
experiences and implement strategies to continually improve the quality
of patient practice. Examples: Resident will learn the processes of care provided in a busy private cardiology
practice and apply that knowledge to improve the care of his/her patients
in the Internal Medicine Clinic.
- Develop and maintain a
willingness to learn from errors and use errors to improve the system or
processes of care. Examples:
Resident will demonstrate an open mind when an attending or peer identifies
and error in judgement or practice. He /she will quickly work to correct
- Use information technology
or other available methodologies to access and manage information, support
patient care decisions and enhance both patient and physician education.
Example: Resident will demonstrate expertise in obtaining medical
literature from the internet, especially using CareGate resources.
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 care teams.
- Provide 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:
When working as a cardiology consultant, the resident will provide timely,
accurate information to the referring physician and work with him/her to
manage and educate the patient.
- Use effective listening,
nonverbal, questioning, and narrative skills to communicate the patients.
Examples: Resident will be
skilled in obtaining a history using the above technique. He/she will effectively
educate and inform the patient regarding their disease state.
- Interact with consultants
in a respectful, appropriate manner. Examples: See above.
- Maintain comprehensive,
timely, and legible medical records. Examples: Resident is responsible for dictating the consult on inpatients and
writing a daily, informative, organized, legible note.
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.
- Demonstrate respect, compassion,
integrity, and altruism in relationships with patients, families, and colleagues.
- Demonstrate sensitivity
and responsiveness to the gender, age, culture, religion, sexual preference,
socioeconomic status, beliefs, behaviors and disabilities of patients and
- Adhere to principles of
confidentiality, scientific/academic integrity, and informed consent.
- Recognize 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
- Understand, access and
utilize the resources, providers and systems necessary to provide optimal
care. Examples: In caring for the patient with multiple cardiac risk
factors or CHF, the resident will work with nurses, dieticians, and educators
to improve the care of the patient.
- Understand the limitations
and opportunities inherent in various practice types and delivery systems,
and develop strategies to optimize care for the individual patient. Examples: Resident will be able to access the hospital, community
and state resources for patients with cardiovascular disease and limited
- Apply evidence-based, cost-conscious
strategies to prevention, diagnosis, and disease management. Examples: See above.
Methods of instruction:
- Collaborate with other
members of the health care team to assist patients in dealing effectively
with complex systems and to improve systematic processes of care. Examples:
Didactic (schedule, topic, faculty)
Daily residents conference 12:00-1:00 p.m. IM Training Room
Wednesday mornings 7:30-8:00 a.m. Clinical Ground Rounds
IM Training Room
Wednesday afternoons 12:15-1:00 p.m. Internal Medicine Update Haggar
Friday mornings 7:30-8:00 a.m. Coffee with Cardiology IM Training
The resident is expected
to work with a cardiologist seeing both his inpatients and outpatients. He/she
is expected to read EKGs and echocardiograms with the cardiologist.