Family Medicine Sub-Internship

Department of Family and Community Medicine

  • Course Information

    Course Number: RFCM680

    Prerequisites: Completion of all Phase 2 clerkships

    Length of Time: 4 weeks

    Phase Availability: Phase 3

    Credit Type: Physician Assessed Patient Facing (PAPFE), Sub-Internship (Sub-I), or Open

    Call: No

  • Contact Information

    Program Director: Aarohi Munshi, MD

    Coordinator/Scheduling: Allison King (aking75@uic.edu)

    Locations: UW Health Hospital (1401 E State St., Rockford, IL 61104 and Mile Square Health Center – LP Johnson (1221 E State St., Rockford, IL 61104)

Narrative Description: The overarching goal of this Sub-I is for the student to develop the appropriate skills to be ready for the transition to residency. As such, he/she will work directly with attending physicians on the Family Medicine service on a daily basis, learning the skills and responsibilities of a resident physician and may follow-up patients in their clinic. The goals of this rotation are to continue to sharpen skills as future diagnosticians and improve interviewing and note writing skills, formulate detailed assessments and plans in an inpatient and outpatient setting, and to prepare for a residency.

Learning Objectives:

  1. Time management skills
    1. Organize a daily patient care task list for each patient in a structured and systematic way so that required tasks (e.g., daily notes, orders, etc.) are not overlooked.
    2. Prioritize daily patient care task lists according to degree of importance/urgency.
    3. Prioritize patients’ clinical problems according to degree of clinical importance/urgency.
    4. Recognize one’s own limitations and call on other team members to help.
  2. Communicating effectively within healthcare teams
    1. Write accurate, concise, and well-organized consult and progress notes; and where applicable, transfer notes, discharge summaries, and cross-cover notes
    2. Provide an oral presentation of a clinical encounter, tailoring length and content according to context.
    3. Give and receive patient handoffs (both in writing and verbally) to transition care responsibility.
    4. Speak with specialist/subspecialist colleagues to request consultation.
    5. Communicate collaboratively with nursing and pharmacy staff to enhance patient care.
    6. Communicate effectively with team case manager, social worker, and outpatient care to facilitate discharge planning
  3. Patient evaluation skills—recognizing sick vs. non-sick patients
    1. Gather appropriate clinical data from all appropriate sources (e.g., patient, family, nurse, medical records) in hypothesis-driven fashion to address the main clinical problems (Reporter function of RIME)
    2. Analyze and synthesize the collected clinical data set to formulate a prioritized differential diagnosis for the main undifferentiated problems (Interpreter function of RIME)
    3. Recognize which clinical situations require additional assistance from upper level resident, faculty attending, and/or specialty consultants.
    4. Develop initial diagnostic and/or therapeutic management plans for the main clinical problems (Manager function of RIME)
    5. Prioritize problem list according to degree of clinical importance (Interpreter function of RIME).
  4. Knowing when to ask for assistance
    1. Recognize various techniques that can enhance and develop metacognitive skills
    2. Generate clinical questions and retrieve evidence to advance patient care
    3. Identify clinical and contextual situations that require assistance from clinical supervisors
    4. Utilize a communication framework when calling for clinical support

Daily Responsibilities:

  1. Performing a full history and physical on admission, formulating a differential diagnosis, and developing preliminary evaluation and treatment plans for all new patients assigned to him/her, with review by the attending physician. [the sub intern should admit no more than 2 new patients a day].
  2. Bedside presentation of their patients and written daily SOAP progress notes and orders [the sub intern may provide continuity of care to no more than 5 patients per day].
  3. The student may call for consults consistent with hospital policy.
  4. Review of daily orders with the attending physician.
  5. Night call not currently scheduled
  6. Communicating with their patients, families, nurses, ancillary staff and other providers about the day-to day needs and action plans as reviewed with the attending physician.
  7. Beginning discharge planning, discussing with discharge planners [case managers, social workers] regarding outpatient therapy (OPAT) and assisting in the process of obtaining the resources and referrals needed for a safe discharge.
  8. Generating a discharge summary for their patients which will be reviewed and signed by the responsible attending physician.
  9. Contacting the PCP at discharge re: follow-up plans if requested by the attending.
  10. Participate fully in family meetings, end of life and code discussions, and emergent bedside management of their patients.
  11. Participate in all educational sessions scheduled during the sub-Internship.
  12. Keep a log of patients seen and lessons learned from the patients.

Specific Family Medicine Objectives and Learning Activities:

  1. Write complete and detailed notes on an inpatient or outpatient basis, including labor and delivery.
  2. Research and discuss family medicine topics in detail.
  3. Perform advanced history and physical exam skills.
  4. Work in a team with M3 students and residents.
  5. Effectively utilize electronic health record to obtain information and enter orders.
  6. Sharpen assessment and plan skills.

Learning Activities:

  1. Perform history and physical examinations as well as focused outpatient evaluations.
  2. Formulate a differential diagnosis and assessment of each patient that is evaluated.
  3. Formulate management plans for each patient.
  4. Orally present patients that have been worked up.
  5. Write detailed notes about the patients worked up.
  6. Follow inpatients on a daily basis and write daily progress notes.
  7. Research and discuss family medicine topics in detail. Present this information to the preceptor and M3 students.
  8. Keep a log of patients seen.
  9. Have a weekly session with the preceptor providing feedback regarding the student’s progress and performance.
  10. Attend conferences at Swedish American hospital or the FHC.
  11. Supervise M3 students on the FP inpatient service and provide them with feedback and teaching.
  12. Observe and if possible participate in code blue resuscitations in the hospital.
  13. Schedule will mirror that of an intern and during their office hours they will, ideally, pair up with the same senior resident/attending each week during the rotation.

Method of Assessment:

  1. The student will be evaluated in areas of professionalism, interest in clinical work, history taking and physical examination skills, differential diagnosis skills, management planning skills, oral and written communication skills, and interpersonal collaboration.
  2. Student will also be evaluated regarding interpretation of medical literature.
  3. Patient Log will be reviewed by a supervising provider.
  4. Direct faculty evaluation of performance and standard UIC evaluation form completed and submitted.

Required Reading: Students are expected to utilize appropriate online sources, medical textbooks, and medical journals in researching and learning about the patients they see. Students are expected to utilize appropriate sources such as UpToDate, DynaMed, medical textbooks, and medical journals in researching the patients they see and in presenting journal article.

FM Sub-I General Scheduling:

Students will typically spend one week with the Medicine team, one week with the OB team, one week in the clinic, then finish with another week with the Medicine team.

Week 1:
  • Medicine Team – Hospital Medicine
Week 2:
  • OB team – Hospital OB
Week 3
  • Clinic All Day
Week 4
  • Medicine Team – Hospital Medicine

Additional Resources: None