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UH IM Clerkship Orientation
UH IM Clerkship Orientation
Today’s Schedule
• General Overview of UH IM Ward
• IM Ward Basics• Weekly Schedule• Daily Schedule
• Documentation
• Education
• Join Your team!• Schedule• Pick up patients• Prep for AM
What is IM Ward?
The MSIII• Follow 2-4 patients, but START with 1-2
• Only write 2 notes a day in the chart (see documentation section)
• One progress note is billable with addendum from intern/resident & attending
• Should have all of their patients seen by another member of the team prior to rounds every day.
• One day off per week (usually non-call day).
• 5 days off on “switch weekend” (usually Wed-Sun)
• Resident can sign your passport (except H&Ps)
• Need to have attending sign off on required H&Ps
Weekly Schedule
4 Day Call Cycle
Long Call Drip Drip Protected
The Flexible Drip
Makes sure no one team is seeing a significant amount more than another team. Protects you from extreme variability. Equity of work.
• Q4 "Long Call" Admitting from 3-6• Q4 "Pre-call" No admitting, only patients from night float if your team went
in with <12• Q28 "Short call" on Thursdays admitting from 11-3• Weekends/holidays are not different
• No designated MICU accept, or Night Accept• New "Touch Cap" of 18
The Flexible Drip
• MICU and other transfers:• Flow through just like admissions, all intake is equal.
• Non-medicine transfers that were consults will still be transferred by the consult service.
• Night float admissions:• Will be signed out in the mornings to the teams.
• A member of the teams is expected to be there.
Daily Schedule
Long Call
• Applies to both weekdays and weekends
• Start day with new patients from night only if you went in with <12 OR if all other teams capped you may get two more -> 14
• 7am – 3pm: Round and finish tasks and discharges
• 3pm – 6pm: New admissions performed by your team
• 6pm – 7pm: Staff new patients with attending, finish H&P
• Touch Cap of 18
Pre-Long Call (kind of protected)
• Applies to both weekdays and weekends
• Only patients from night if you go in with < 12 patients (max 2)
• You DO NOT admit or transfer any of your own patients.
• You may have additional patients admitted to you by the triage team (Gray).
• 4 of these days a month will be upper level days off.
Non-Long Call (The 2 other days)
• Applies to both weekdays and weekends
• Up to two patients in the morning from nightfloat (up to 4 if you went in with 10).
• 11am – 3pm: Responsible to perform a maximum of 2 admissions/transfers.
• You may have additional patients admitted to you by the triage team (Gray).
Short call
• Q28 or once a month
• Only on Thursdays
• Similar to a normal non-long call day
• Admit patients from 11am – 3pm to allow other two teams to go to Thursday school
• You have to stay with your team until the short call is done
Documentation
MS3 (Phase II) Documentation
• Procedure note is not billable
• H&P in “Student Note” is not billable
• Progress note• 1 note in “inpt progress note” is billable -> resident to addend (=resident+MS)
-> attending to addend (=attending_MSandResident)
• 1 note in “student note” in for education ONLY
• NO Discharge/Transfer Summaries
Education
Today’s Schedule
Visit us in our office(across the hall from Dr. Jernigan’s Office)
Chih-Wei [email protected] (cell)Reed [email protected]
Questions?
