Resident Handbook - UC Davis Health System

INTERNAL MEDICINE SERVICEA. Service GoalsThe service provides resident physicians with experiences in general medicine, primarilymanaging common medical problems. Additionally, residents will learn to recognizeuncommon problems, obtain consultations as needed or make referrals to facilities fortreatment not locally available. Residents are expected to develop the full set of definedMedicine Competencies over the course of their three years’ experiences. (See alsoResidency Goals and Competencies)B. Service DescriptionThis service is staffed by 2-4 residents. The internal medicine preceptors cover for 7 daysat a time. At times medical students and FNP/PA students also participate on the service.The medicine chief resident is charged with coordinating admissions and assigningpatients as well as providing research on topics relevant to patient care. The service willbe assigned every-other unassigned admission from the ED, although the preceptor maydetermine that the service is "closed" (i.e., accepting no more patients) depending on thecircumstances of number of residents and patients. When admitting a patient to theservice, the ED should page the primary medicine resident, (via the medicine pager).Residents are responsible for ward work, including daily notes and close monitoring ofpatients.Residents will pre-round on their patients each morning. During teaching rounds (usuallystarting at 8:30am in the Lower Level Conference Room) the preceptor will carefullyreview new patients or those with acute problems and review existing patients as well.The senior will then be responsible for overseeing and assisting daytime work, consultingwith the preceptor as needed. Preceptors will provide the ultimate supervision of patientcare.Between 5 p.m. and 8 a.m., and on weekends, the preceptor will be consulted promptlyabout any admission, with discussion of the assessment and plan. Medicine serviceconsultation requests by other specialists will be directly handled by the senior residenton service with approval of the attending physician. The senior resident will promptlysee the patient, and provide a consultation note and dictation including the elements of apertinent history and physical. The medicine service will then follow the patient as usualuntil discharge or the attending decides that signing off is appropriate.Please be sure to document preceptor involvement in patient charts. Dictate thepreceptor’s name on admission H&Ps, discharge summaries, and procedure notes.Discharge orders must include the current attending and the physician or clinic assumingresponsibility for the patient’s care after discharge. Please also send a copy of thedischarge summary to the outpatient physician. Any significant communication with thePage 52 of 153C:\Documents and Settings\dhutak\Desktop\rshb13.doc