To make physicians into specialists in Internal Medicine by equipping them with requisite knowledge, skills, character qualities, and habits essential for them to demonstrate competence in inpatient care, knowledge, practice-based learning and improvement, systems-based practice, professionalism, and interpersonal and communication skills relevant to the treatment of health problems in acutely ill inpatients.
Competence Goal
Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems in adults admitted to a general medicine ward.
Learning Objectives - Residents are taught the following patient management skills.
Each resident is given multiple opportunities to demonstrate competence in:

The ability to provide inpatient care across the spectrum of clinical disorders seen in the practice of general internal medicine including the subspecialties of internal medicine in the inpatient setting. PTRMDPC, LSC /GA, CA, Mini-CEX

The ability to take an accurate, complete, and relevant history, including family, genetic, psychosocial, and environmental histories. PTRMDPC, LSC /GA, CA,
Mini-CEX

The ability to perform a comprehensive and accurate physical examination.
PTRMDPC, LSC /GA, CA, Mini-CEX

The ability to arrive at an appropriate differential diagnosis, outline a logical plan for specific and targeted investigations pertaining to the patient’s complaints, and formulate a plan for management and follow-up treatment of the patient.
PTRMDPC, LSC /GA, CA, Mini-CEX

The ability to perform procedures mandated by the ABIM. PTRMDPC/DO, LB
Competence Goal
Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social-behavioral sciences, as well as the application of this knowledge to inpatient care.
Learning Objectives– Residents are taught to be competent in the knowledge of these areas. Each resident is given multiple opportunities to demonstrate competence in:

The knowledge to treat medical conditions commonly managed by internists
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caring for inpatients. PTRMDPC, LSC/GA, ITE

The knowledge to interpret basic clinical tests and images. PTRMDPC, LSC/GA,
ITE

The knowledge to use common pharmacotherapy. PTRMDPC, LSC/GA, ITE

The knowledge to appropriately use and perform diagnostic and therapeutic procedures. PTRMDPC, SDL//DO, LB, ITE
Competence Goal
Residents must demonstrate the skills and habits to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life-long learning.
Learning Objectives – Residents are taught the following skills and habits. Each resident is given multiple opportunities to demonstrate:

Demonstrate the ability to identify strengths, deficiencies and limits in their knowledge and expertise, to set learning improvement goals, to use information technology to locate scientific studies related to their patients’ health problems, to critically appraise clinical studies, to teach and to facilitate the learning of other students and health care professionals. PTRMDPC, LSC /GA, PBLM
Competence Goal
Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.
Learning Objectives - Residents are taught the following skills. Each resident is given multiple opportunities to demonstrate competence in:

The ability to work effectively in an inpatient setting and using the relevant systems in that setting.
PTRMDPC/GA, CA, MSF
 The ability to work in teams and effectively transmit necessary clinical information to ensure safe and proper care of patients including the transition of care between settings. PTRMDPC/CA, MSF
Competency Goal
Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles.
Learning Objectives – Residents are taught to seek and possess the following character traits. Each resident is given multiple opportunities to demonstrate:
 Compassion, integrity, and respect for others.
PTRMDPC, LSC/GA, MSF
 Responsiveness to patient needs that supersedes self-interest.
PTRMDPC,
LSC/GA, MSF
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 Respect for patient privacy and autonomy.
PTRMDPC, LSC/GA, MSF
 Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. PTRMDPC, LSC/GA, MSF
Competency Goal
Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and health professionals.
Learning Objectives - Residents are taught the following skills. Each resident is given multiple opportunities to demonstrate competence in:
 Communicating effectively with patients and families across a broad range of socioeconomic and cultural backgrounds.
PTRMDPC, LSC/GA, MSF
 Maintaining comprehensive and timely medical records.
PTRMDPC, LSC/GA,
MSF

DPC - Practical Teaching and Role Modeling During Direct Patient Care

LSC - Lectures/Seminars/Conferences

Grand Rounds

Noon Conference

Residents Conference

Morning Report

Journal Club

Board Review

DO - Direct observation by qualified faculty guided by explicitly stated performance criteria and standard for proficiency

GA - Global assessment by qualified faculty

ITE - In-Training Exam

LB - Log books for procedures

MSF – Multisource Feedback using formal evaluation forms given to nurses, allied health personnel, and patients who come into contact with the trainees
(360° evaluation).

CA – Chart Audit using a standard evaluation template.

PBLM - Satisfactory presentation and completion of Problem Based Learning and
Improvement module arising from patient care and rounds.

Mini-CEX – Mini Clinical Evaluation Exercise
 The residency program follows the ACGME Duty Hour Requirements.
 Duty hours are limited to 80 hours per week, averaged over a four-week period,
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 inclusive of all in-house call activities.
Residents are provided with 1 day in 7 free from all educational and clinical responsibilities, averaged over a four-week period, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, educational, and administrative activities.
 A 10-hour time period for rest and personal activities should be provided between
 all daily duty periods, and after in-house call.
The maximum of 24-hour continuous call, followed by up to 6 hours for transfer of care and educational activities is strictly implemented.
A. INPATIENT/WARD ROTATIONS
1. Team Composition:
The typical ward team will consist of:
1 Attending (Faculty)
1 PGY-II or PGY-III (Resident)
1-2 PGY-I (Intern)
0-4 Junior Medical Students (JMS)
0-1 Acting Interns (Senior Medical Students, A I s)
Other team members such as Case Managers, Nurses, Dieticians,
Social Workers, etc.
2. Responsibilities of Members: a. Attending:
 Oversees team function and overall patient care
 Teaches house staff and medical students
 Monitors discharge planning and expeditious care of patient
 Accepts ultimate legal responsibility for patient's welfare
 Learns from other team members
 Assures attendance of team members at all required conferences. b. Resident:
 Is directly accountable to the attending for the entire service
 Writes a Resident Admit Note (RAN) on each admission.
 Communicates diagnosis and plan of care to the patient's primary care physician.
 Leads work rounds by evaluating the intern treatment plan
 Plans discharges and coordinates patient follow-up
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 Teaches interns and students, and sometimes faculty
 Assures attendance of self and team members to all required conferences.
Faculty Notification: It is the responsibility of the resident to contact faculty immediately for the following issues:
 Potentially unstable patients
 Transfers to intensive care
 Deaths (expected and unexpected)
 Changes in patient status
 Procedures
 Unpleasant social issues
 Risk management issues
 Patients leaving or declining urgent treatment against medical advice
 Restricted drug/treatment approval
 Potential admissions better served on another service or with short-term outpatient follow-up c. Intern:
 Performs and records the admitting H & P on each patient
 Evaluates patients prior to work rounds so that he/she may develop a treatment plan for each of their patients
 Writes orders and daily notes
 Calls consultants
 "Checks out" the patients to the on call intern
 Teaches students, sometimes teaches resident and faculty

UTMB Library Homepage with access to filtered and unfiltered resources, including: o ACP Pier o DynaMed o Textbooks o Up-to-Date o Cochrane o PubMed
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