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Required Subspecialties
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Hospital/General Medicine Ward Rotation
A ward team consists of one attending, one senior and two interns. The team will provide primary patient care to the patients they admit. During the month each team has 6 long calls, and 6 short calls. Each intern admits 3-5 patients while on long call and 1-3 patients on short call (about 33 admission per month per intern while on wards. Patients are admitted form all over Northeast Oklahoma including several referral hospitals and our ambulatory practice. Each team has 1 ½ to 2 hours of teaching rounds every day with their attending. Additionally, a morning report conference is held four days per week.
The maximum number of new patients an intern will work up in 48 hours will be eight; the maximum number of new patients during any admitting period will average no more than five. The senior resident may work-up additional patients during any admit period, not to exceed twenty patients for the team. The residents will follow throughout the course of the hospitalization the patients they admit. The residents will not work-up patients they will not follow during the hospitalization.
Clinic Rotations Over
one-third of our educational program is conducted in the
outpatient setting. The Internal Medicine ambulatory experience
consists of six months of daily services plus one-half day per
week of continuity services. This equates to over one year of
ambulatory experience within the three year residency training.
This training provides the resident with the opportunity to learn
the primary care knowledge; attitudes and skills needed to
practice ambulatory medicine. The primary
care knowledge, attitudes and skills consist of: The
Ambulatory Clinic Team The learning
team consists of the clinic attending, medical director, senior
residents, interns and non-internal medicine residents. The
clinical attending is the physician who is taking responsibility
for the supervision and direction of the care delivered to the
patient by the resident.
Evaluation
In addition to the monthly performance evaluation for each rotation,
each resident has an annual mini clinical exam (CEX) to evaluate
clinical skills, including history taking and physical exam skills,
patient rapport and diagnostic and decision making skills. Feedback
is given immediately.
ICU Rotation
The ICU rotation is comprised to a day team (6a-6p) and a night
team (6p-6a). Interns are on a ~q7 rotational call
schedule overnight with the night team. Teaching rounds
occur daily in the morning, followed by teaching sessions and
short quizzes. Interns also admit new patients to the ICU
with direct supervision by senior residents and attending
physicians on both the day team and while on overnight call.
The ICU rotation offers intense, hands-on learning on ventilator
management, sepsis treatment, intubation, and numerous
other procedures. There is attending physician support
24/7.
Procedures
Moonlighting Moonlighting is available to second and third year residents who demonstrate academic competency. Moonlighting positions must be approved by the program director and are counted towards the 80-hour work week according to RRC rules.
Comprehensive
evaluation, which emphasizes diagnosis; risk identification;
preventive care; and developing a comprehensive health care plan
to include all the patient’s problems.
Coordination of
care delivered by the health care team of one’s partners, nurses,
consultants, other physicians, laboratories, or other health care
providers.
Continuing care
over time for all the patient’s illnesses and other health
problems, including telephone evaluation and management during
both office and after hours.
Cost-effective
care.
Personal
humanistic care delivered with compassion, respect and integrity.
Providing
consultation with the appropriate tests and recommendations.
Learning the
internal medicine subspecialties, which are primarily ambulatory,
such as endocrinology, rheumatology, primary care, oncology, and
addiction medicine.
Learning the
non-internal medicine specialties needed by a general internist,
such as office gynecology (women’s health), office orthopedics,
allergy and immunology, dermatology, office ears, nose, and throat
(ENT), rehabilitation, adolescent medicine, urology,
ophthalmology, pain management, sports medicine, and other office
procedures, such as flex sig, PFTs, etc.
Learning the
management and treatment of either new or established patients
seeking acute or urgent care. The medical
director is responsible for the day-to-day operations and the
physician’s activity in the clinic. He is responsible for the
monthly schedule and the assignment of residents and attendings to
the general medicine, continuity, block and subspecialty clinics.
The senior
residents have larger panels of patients and focus most of their
continuity clinic time on the continuing, preventive and
comprehensive care of a stable panel of patients. They have more
independence in managing their patients than interns.
The interns will
acquire a panel of patients in transfer from residents who have
left the program and from new patients they discharge from the
hospital or from the emergency room.
Non-internal
medicine residents from Obstetrics and Gynecology and Psychiatry
each take one to two months of ambulatory medicine. These
residents will work in acute care, general internal medicine and
triage situations in the clinic.
All interns complete a comprehensive procedures course during July of the internship. This includes, video instruction, reading, and a written test. Additionally all residents participate in the Fundamental Critical Care course, which includes hands on procedural training. Residents are expected to develop competency in routine internal medicine procedures including placement of central lines, LP’s, thoracentesis, paracentesis and skin biopsy.
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