Intern Orientation 2015
Welcome
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Dr. Robert Salata
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Interim Chair, Department of Medicine
Dr. Robert Bonomo
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Vice Chair for VA
Chief of Medicine, VA
Program Leaders
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Keith Armitage, MD
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Program Director
Carla Harwell, MD
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Associate Program Director
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Ronda Mourad, MD
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Ambulatory Programs, Woman’s Health
Associate Program Director
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Procedures, Inpatient Medicine
Associate Program Director
 Starting July 1
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Patient Safety and Quality
Amanda Clark, MD
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Charles Lopresti, MD
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Associate Program Director
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Ambulatory Block curriculum
Hiloni Bhavsar, MD
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Primary Care, Health Care Disparities, Woman’s Health
Associate Program Director
Associate Program Director
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Simran Singh, MD
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Clinical Skills Block
Crystal LantzDeGeorge, MD
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Associate Program Director
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Starting August 1
Administration
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Dr. Salata
Dr. Bonomo
Dr. Sarah Augustine
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‘runs the VA’
Dr. Raj Chandra
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Gen Med
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Teaching and nonteaching
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Deena Segal
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Carol Bennett
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Administrative
Coordination for
Educational Programs
VA Housestaff Office
Barbara Bonfiglio
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UH Housestaff Office
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Notary
Historian
Copy machine queen
Amateur psychiatrist
Provider of batteries
Most Importantly: Chief
Residents
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Cassandra Kovach
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Brian Hambley
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VA
Jason Tuckerman
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Ambulatory
Dhruti Chen
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UH
Pt Safety
Nathan Stehouwer
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Med Peds
Chiefs…..
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Q 3 month rotation
UH 31250
VA 31533
Ambulatory 31529
Med-Peds 36672
Patient Safety and
Quality 36644
Who are you?
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34 Categorical IM
4 Med-Peds
8 IM Prelims
12 Neurology Prelims
14 Anesthesia Interns
The goals of internship
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Learn Patient Care
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Supervised clinical experience
reflection
36,000,000 admissions/year
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You will do about 200
Fund of Knowledge
Career Goals
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Subspecialty training
Primary care
Research
Other
The ‘curriculum’ of Internship
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The goal- gain clinical
competence in the care of
adult patients (ACGME
Competencies)
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“the patient is the curriculum”
General medicine and
specialty wards; ICU and
ambulatory rotations, clinical
skills block, neurology
Noon conference
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Other conferences
Attending rounds; walk rounds
Morning report
Grand Rounds
Reading
ACP curriculum
ACGME Competencies
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Patient Care
Medical
Knowledge
Practice Based
Learning and
Improvement
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Communication
Professionalism
Systems Based
Practice
And then there are the Milestones….
Research and Elective Time
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No “assigned” elective
Be available 8-5, M-F; let
the Chief Resident know
about other time away
Dr. Salata, Dr. Bonomo,
Program Directors and
Chief Residents can assist
in picking elective and
research mentors
GI Elective/Jeopardy
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Required to go to all
conferences
Annual Events
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Intern Mini-retreat- October/November
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Getting feedback on the program
Professional Development
Bronson Day
Holiday Party
Morale Week
Spring Dinner – May 26, 2016
Intern Retreat- June, 2016
End of the Year Picnic- June 2016
End of Internship- June 23, 2016
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Last week of June = 5th week vacation
Evaluation and Feedback:
Getting and giving
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“Self feedback”
Electronicwww.myevaluation.com
Attending feedback!
Rotation and program
feedback
On-going feedback
about the way things
are going
Semi-annual review
Doors of Program
Directors are always
open (honestly)
Faculty Mentors
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Meet December or January
with one of the program
directors
Dr. Salata, Dr. Bonomo,
Chief Residents
Meeting with subspecialty
directors, fellows and peers
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New Fellowship time line….
Picking a faculty advisor
Duty Hours
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Icompare!
80 hour work week
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Averaged over rotation
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16 hours
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8-10 hours out of the hospitalbetween periods of duty
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Work flow, efficiency
There will be a ‘system
learning curve’
Should leave at 9; must
leave by 11
1 in 7- averaged over 28
days
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Schedule complexity…..
Duty Hours
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Monitoring
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Rotation evaluations
Web based surveys
(program and ACGME)
Signout rounds with
Chief Residents and
Program Directors
Each Block- one week
audit via
www.myevaluation.com
Duty Hours- Icompare
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http://www.jhcct.org/i
compare/default.asp
One year
randomized trial
looking at flexibility
in duty hours on
patient outcomes
+ 80 hours, 1/7
No 16 hours rule for
PGY1s
Duty Hours
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Days off- You may
need to be proactive
if you miss a day
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Please let me know if
you feel you are not in
compliance
Keith.Armitage@uhhs.
com
kba@case.edu
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Misc. Stuff
Email
all communication from the
residency, hospital GME office, etc.
will be to uhhs.com or
UHhospitals.org
mail.uhhs.com; outlook
Patient related emails- UH or
VA only!! HIPPA
Social Media…
PHI
Switch dates/block schedule
Clinic
Maternity/Paternity leave
Vacations
Misc. stuff, cont
Meal tickets/swipe card
Jeopardy schedule (“safety
net” for urgencies)
call offs….
Step III- must be done by
end of PGY2 year
Discharge summariesmust be done the day
of discharge
Misc.,
Medical records
Typical daily schedule
7:00 -8
Preround8-10:30
Work Rounds
10:30-11:30
Morning Report (residents M,W,F; interns Tu,
Th at 11) (10-11 VA)
11-12
Attending Rounds*
12-1
Noon Conference (M&M- Fri. UH, Wd VA)
Grand Rounds- Tuesday starting Sept.
1-2
Attending Rounds*
What are “pre-rounds”
Leave/Sickness-
Misc.
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Computer resources
Core Library
Dress Code
Intern Orientation
Handbook
Lakeside Hospital
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1837. Federal government
appropriated $20,000 for a
Marine Hospital on Lakeside
Avenue.
1866. City Hospital on Wilson
Street.
1898. Lakeside Hospital opened.
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1908. Cost $2.33/day.
Average daily census 212.
Medical staff from WR Faculty.
1992 Lerner Tower
2012 Seidman
UHHS system……
Flexner Report
1910
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1904. AMA and Carnegie
Foundation commissioned survey by
Abraham Flexner.
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Abraham Flexner
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“ The Medical Department of Western
Reserve University is next to Johns
Hopkins University which, for various
reasons, occupies an exceptional
position, the best in the country.”
Letter from Flexner to WRU President Thwing
following his visit.
Visited all 155 medical schools then
operating in US & Canada.
Only two medical schools
considered as excellent in both
clinical and laboratory facilities:
Johns Hopkins and Western
Reserve.
“Excellent laboratories, in which
teaching and research are both
vigorously prosecuted…. Lakeside
Hospital, an endowed institution of
215 available beds, [is] thoroughly
modern in construction and
equipment.”
University Hospitals
Move to University Circle
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Lakeside Hospital & ward circa 1932
1925. MacDonald House.
1926. B&C.
1929. Institute of
Pathology.
1931. Lakeside Hospital
1931. Hanna House
1923. Medical School
moved to University Circle.
My advice……..
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Ask questions………………
Know Your Limitations; Ask for Help
You NEVER have to be Alone
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Learn to say “I don’t know” (don’t make it up)
Ask for feedback
Have fun
Always take a patient centered approach
Develop Effective Time Management and
Teamwork Skills
More Take Home Points
*Yes, the Schedule may
(will) change
*Focus on:
Attentive Patient Follow-up
[nightfloat admissions!]
Knowing Where Your Limits
Are
Asking “Why?”
Support each other!
*As I said………….Expect
to Work Hard ... AND
HAVE FUN!
Intern
orientation…