Medicine-MED412: Medicine: Pulmonary Diseases
Elective/Selective
Critical Care Selective
Course Title
MED 412 Pulmonary
VA Medical Center
Director
Naresh Dewan, M.D.
Contact person
Linda Spencer
Department of Medicine
CUMC - Ste. 5850
280-4512
fax: 280-4158
e-mail: lindaspencer@creighton.edu
Length of Course
Four Weeks
Frequency of
Presentation
Continuously
Maximum Number
of Students
Two
Course Description
The Pulmonary Care Medicine Selective for Senior Medical Students include the
expansion of knowledge gained as sophomore and junior students in the
fundamentals of physical diagnosis and disease recognition, evaluation and
management. Since the Pulmonary Medicine has both primary care patients and
patients who are being evaluated in consultation, the student has the opportunity
to evaluate and learn about both types of patients. The students are closely
supervised in these activities by junior and senior medical residents, pulmonary
fellows and pulmonary medicine attending physicians. The students are provided
initial responsibility for evaluating primary care patients and patients seen in
consultation with careful critique of their findings and close supervision of their
day-to-day clinical decisions.
Students receive didactic presentations on a daily basis and are also assigned
topics for their own review and presentation. Attending physicians spend
approximately four hours each day with the medical students and are integrally
involved in the educational process. The didactic hours for each student include
approximately 20 hours lectures each month, 2-3 hours of rounding each day,
discussion of new patients each day and a one-hour chest conference each week.
Additionally, Journal clubs are available during each rotation. During the rotation
students are encouraged to participate in specialty procedures being performed
by fellows and faculty, and they are also encouraged to become more familiar
with the pulmonary function studies that are performed in the pulmonary
laboratory.
Course Objectives
1. The student will manage the assigned patients under the supervision of the
supervising resident and the attending physician and complete the required
medical documentation.
2. The student will attend all required work rounds, daily didactic sessions, and
daily teaching rounds where admissions and consults are presented in detail and
are reviewed by the attending physician. They will also attend department
conferences, weekly Medicine Grand Rounds, and pulmonary/critical care grand
rounds.
3. Review and Understand End of Life Objectives.
4. The student will demonstrate mastery of specific clinical competencies
Clinical Knowledge
- The student will identify the pathophysiology is causes of hypoxemia in the
common types of acute respiratory failure
- The student will select the appropriate oxygen delivery devises to correct
hypoxemia in the common types of acute respiratory failure
- The student will recall the indications of mechanical ventilation
- The student will be able to adjust mechanical ventilation in response to patients'
needs utilizing appropriate physiologic measurements
- The student will recognize the complications of mechanical ventilation
- The student will recognize the pulmonary function abnormalities that
characterize restrictive and obstructive lung diseases
- The student will identify causes of pulmonary hypertension and primary right
heart failure
- Using the data the student has obtained by physical examination, the student
will identify normal and abnormal physical findings and will interpret them
correctly
- The student will identify and recognize the clinical, radiologic, laboratory and
therapeutic features of the common diseases that cause acute and chronic
respiratory failure
Clinical Skills
- Assessment of patients with common pulmonary diseases in the ICU and at
other sites in the hospital
- Management of ventilators
- Monitoring of ICU patients
- Management of acute respiratory disorders non-ICU hospital units
4. The student will demonstrate mastery of the knowledge, clinical skills and
therapeutics relevant to the following conditions:
- ARDS, including Sepsis and noncardiogenic pulmonary edema
- Asthma
- Postoperative Respiratory Complications and Films
- Acute Respiratory Failure
- Carcinoma of the lungs
- Pleural effusions and empyema
- Exacerbations of COPD
- Severe Pneumonia
- Pulmonary Emboli
- Sleep apnea
- Interstitial Pneumonia and Pulmonary Fibrosis
- Hemoptysis
- Common occupational lung disease
Evaluation
1. The attending staff physician, with assistance of the supervising resident, will
complete the evaluation report on the student
2. The attending physician will review and grade admission histories and
physicals (H&P's). Progress notes and procedure notes that the student
completes during the rotation.
3. An end of service exam will be given.
4. An honors grade will be given to the student who receives a superior
evaluation in each category of assessment, as substantiated by the written
comments of the preceptor, no unexcused absence, and honors performance on a
competency based examination.
Schedule
The Students are expected to be available for work and teaching rounds, write
daily notes on patients and present cases, attend teaching session, didactic
lectures, Department of Medicine noon conferences, and pulmonary critical care
grand rounds.
Work Rounds - Monday through Sunday 7:30 - 9:00
Attending Rounds- Monday through Sunday 9:00 - 11-00
Attending Teaching Conf- Monday through Friday 11:00-12:00
Noon Conference- Monday through Friday 12:00-1:00
Allergy Clinic-Monday 13:00-16:00
Attending Teaching Conf-Monday through Friday 14:00-15:00
Presentation of Consults-Monday through Friday 15:00-17:00
Pulmonary Conference-Tuesday* and Thursday**16:00-17:00
*CUMC
**VAMC