Pulmonary ICU Sub-Internship

Department of Medicine and Medical Specialties

  • Course Information

    Course Number: RMDN683

    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), Acute Care, or Open

    Call: Saturday or Sunday rotation every week – No overnight calls

  • Contact Information

    Program Director: Abdullah Altayeh, MD

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

    Location: CGH Medical Center (101 E Miller Rd, Sterling, IL 61081)

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, the student will work directly with the attending physicians in the Medicine ICU on a daily basis, learning the skills and responsibilities of a resident physician and may follow up patients in the clinic.

Learning Objectives and Activities:

  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 list 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 transfer/accept 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 providers 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.
  5. Medical student wellness
    1. Utilize a validated tool to assess one’s personal risk of burnout.
    2. Recall multiple evidence-based interventions that may aid in wellness.
    3. Reflect on identified “at-risk” domains and experiment with suggested interventions to improve wellness.
    4. Incorporate helpful techniques into daily practice by creating a behavior change plan (BCP).

Daily Responsibilities:

  1. Performing a full history and physical, formulating a differential diagnosis, and developing preliminary evaluation and treatment plans for all patients assigned to the student, with review by the attending.
  2. Bedside presentation of the student’s patients and written daily notes and orders. The student may call for consults consistent with hospital policy.
  3. Review of daily orders with the attending
  4. Night call not currently scheduled
  5. Communicating with the student’s patients, their families, nurses, ancillary staff and other providers about the day-to day needs and action plans as reviewed with the attending.
  6. Beginning discharge planning, discussing with discharge planners, and assisting in the process of obtaining the resources and referrals needed for a safe discharge.
  7. Generating a discharge summary for the student’s patients which will be reviewed and signed by the responsible attending.
  8. Contacting the PCP at discharge re: follow-up plans if requested by the attending.
  9. Participate fully in family meetings, end of life and code discussions, and emergent bedside management of the student’s patients.
  10. Perform pulmonary consultations and assessments at the discretion and under the guidance of the attending.
  11. Participate in all educational; sessions scheduled during the sub-I.
  12. Keep a log of patients seen and lessons learned from the patients.

Specific Pulmonary Responsibilities:

  1. Performing a focused pulmonary evaluation including full history and physical exam, obtaining relevant past, family, social, and occupational history that may be pertinent to the pulmonary illness, formulation of a differential diagnosis, and developing preliminary evaluation and treatment plans for all patients assigned to the student, with review by the attending.
  2. Learn the management of respiratory failure, sepsis, shock, renal failure and other common critical care presentations.
  3. Learn to interpret CXR and ABG.
  4. Participate in bedside procedures as supervised by the pulmonary attending.

Method of Assessment:

  1. The student will be evaluated by the attending physicians in areas of professionalism, history taking and physical examination skills, differential diagnosis skills, management planning skills, oral and written communication skills, and interpersonal collaboration.
  2. Patient Log will be reviewed by supervising attending;
  3. Standard UIC evaluation form completed and submitted.
  4. Additional evaluation forms for cross-cover notes and discharge summaries may be used for formative evaluation

Required Reading: 

Students are expected to utilize appropriate sources such as UpToDate, DynaMed, medical textbooks, and medical journals in researching and learning about the patients they see.

Additional Resources: None