Date Issued: 07/01/2007
Date Reviewed: 03/02/2009
Date Revised: 03/02/2009
Hospitalist/Medical Consult Curriculum
Department: Internal Medicine
Faculty Coordinator: Steven Walters, MD
Hospital: Texas Health Presbyterian Hospital Dallas
Periods offered: All 12 periods to third year categorical residents
Length: 4 Weeks
Max no. of residents: 1
First Day Contact: Steven Walters, MD (Can be reached through the page operator, please contact prior to scheduling of rotation assignment of an attending)
First Day Time: 8:00 a.m.
First Day Place: MD On Call office
- Course Description:
This elective offered to one 3rd year resident monthly is designed to orient you to the practice of a dedicated hospitalist. The duties while on this rotation would include taking admissions with your attending on their admit days (up till 10:00 pm for no more than 2 days during the month, you will be allowed to leave after conference on the day after your admission day) and follow up on your patients daily. You will also travel to and participate in the care of patients at a long term care facility (LTAC), and take medicine consults on non-admission days. You will meet with your faculty for informal didactic training 2-3 times weekly to discuss the economics of hospitalist medicine (billing, coding, etc), perioperative management, and how to approach the medical consult. You will also be expected to attend morning report daily and all conferences.
- Course Goals and Objectives: (based on ACGME competencies for resident
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.
- Gather accurate, essential information from all sources, including medical
interviews, physical examinations, medical records and diagnostic/therapeutic
procedures. Examples: Demonstration of the above in a dictated history and physical.
- Make informed recommendations about preventives, diagnostic and therapeutic
options and interventions that are based on clinical judgement, scientific
evidence, and patient preference. Examples: Demonstrated by assessments and plans in the progress notes.
- Develop, negotiate and implement effective patient management plans and
integration of patient care. Examples: Demonstrated by the use of other health care professionals appropriately such as SW, Pharmacy, Physical Therapy, Home Health care to implement effective patient care.
- Perform competently the diagnostic and therapeutic procedures considered
essential to the practice of internal medicine as a hospitalist. Examples: central line placement; Airway management; paracentesis; thoracentesis; EKG reading; vaginal culture; joint aspiration; pelvic and pap test.
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:
Demonstrated by active listening and participation during rounds, morning report and conferences.
- Access and critically evaluate current medical information and scientific
evidence. Examples: Demonstrated by reading current literature regarding patients; demonstrated by participation in journal club and residents conference.
- Develop clinically applicable knowledge of the basic and clinical sciences
that underlie the practice of internal medicine. Examples: Demonstrated by showing an understanding of the pathophysiology of disease and the pharmacology of drugs used in treating the disease. Demonstrated by resident's willingness to learn about new developments in the basic sciences by reviewing basic science journals.
- Apply this knowledge to clinical problem-solving, clinical decision-making,
and critical thinking. Examples: Demonstrated by evidence of independent thinking demonstrated in the appraisal and plan.
Practice-Based Learning and Improvement:
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: Demonstrated by a resident's willingness to recognize his/her knowledge gaps and implement strategies to fill those knowledge gaps.
- Develop and maintain a willingness to learn from errors and use errors to
improve the system or processes of care. Examples: Demonstrated by resident having an openness to admitting error and working with the system to analyze and correct the error.
- Use information technology or other available methodologies to access and
manage information, support patient care decisions and enhance both patient
and physician education. Example: Use of on-line resources.
Interpersonal and Communication Skills:
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.
- Use effective listening, nonverbal, questioning, and narrative skills to
communicate the patients.
- Clear, concise, accurate communication in the orders and progress notes.
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 professional colleagues.
- 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 health care.
- Understand, access and utilize the resources, providers and systems necessary
to provide optimal care.
- Understand the limitations and opportunities inherent in various practice
types and delivery systems, and develop strategies to optimize care for the
- Apply evidence-based, cost-conscious strategies to prevention, diagnosis,
and disease management.
- Collaborate with other members of the health care team to assist patients
in dealing effectively with complex systems and to improve systematic processes
III. Methods of instruction:
- Didactic (schedule, topic, faculty)
Daily residents conference 12:00-1:00 p.m. - IM Training Room
Daily Morning Report 9:00-10:00 a.m. - Chairman's Conference Room
Wednesday mornings 7:30-8:00 a.m. - Clinical Grand Rounds - IM
Wednesday afternoons 12:15-1:00 p.m. - Grand Rounds - Haggar Hall
Friday mornings 7:30 - 8:00 a.m. - Coffeee with Cardiology - IM Training Room
2-3 weekly meetings with your attending for discussion of various topics.
Admissions and consults on your assigned days with the Hospitalist staff.
LTAC patient management - At least once during he month with your attending.