Family Medicine Supervisor (PGY-3)

Description of Rotation or Educational Experience

This rotation is designed to expose the resident to the inpatient practice of Family Physicians, balancing inpatient with outpatient responsibilities as well a learning a cost-effective, logical, and thorough process for providing and coordinating care of the wide variety of patients found on an inpatient service at a community hospital. As the senior resident on the service, you will expand your skills and your level of responsibility in patient management. You should require vital skills necessary to supervise and run a teaching service.

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:

Competencies

• Receive training to perform those clinical procedures required for their future practices in the ambulatory and hospital environments.
• Receive training that focuses on the core principles of Family Medicine: including Continuity of Care, Family-Oriented Comprehensive Care Experience, Family Medicine Center Experience, Patient Care Experience, FMC Continuity and Accessibility, Medical/Surgical Experiences, and Inpatient Experiences.

Objectives

By the end of the rotation the resident is expected to:

• Lead the resident team in patient care for all beds on the family medicine inpatient service.

The resident is encouraged to familiarize themselves with the following procedures:

• Central venous line insertion
• Arterial line insertion
• Thoracentesis
• Paracentesis
• Lumbar puncture
• Nasogastric tub placement
• Arterial puncture
• Urinary catheter placement
• Arthrocentesis
• Decubitus ulcer debridement

Medical Knowledge

Goal

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:

Competencies

• This rotation fulfills family medicine-specific training and educational requirements in Adult Medicine and Human Behavior and Mental Health.

Objectives

By the end of the rotation the resident is expected to:

• Act as a resource and a role-model for having and acquiring medical knowledge as needed, in an efficient manner.

Practice- Based Learning and Improvement

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

Competencies:

• Work effectively in various health care delivery settings and systems relevant to their clinical specialty
• Coordinate patient care within the health care system relevant to their clinical specialty

Objectives

By the end of the rotation the resident is expected to be able to:

• Lead his/her team through rounds, laying out expectations and developing an efficient and personalized approach to managing care on the inpatient service.

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

Competencies:

• Work effectively in various health care delivery settings and systems relevant to their clinical specialty
• Coordinate patient care within the health care system relevant to their clinical specialty

Objectives

By the end of the rotation the resident is expected to be able to:

• Serve as the face of leadership on the inpatient service, showing other residents how to interface with the consult and other service systems in the hospital.

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:

Competencies:

• Respect for patient privacy and autonomy
• Sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation

Objectives

By the end of the rotation the resident is expected to be able to:

• Moderate disputes, assist in work load, and help provide a safe learning environment for the residents under his/her charge.

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:

Competencies:

• Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds
• Communicate effectively with physicians, other health professionals, and health related agencies

Objectives

By the end of the rotation the resident is expected to be able to

• Demonstrate his/her ability to communicate in a leadership role
• Role-model effective communication with patients, families, attendings, support staff, and members of the health care team.

Teaching Methods

What teaching methods are you using on this rotation or educational experience?

• Didactic lecture
• Direct role-modeling and observation
• Education-centered rounds
• One-on-one guidance from attending physician in management skills

Assessment Method (residents)

How do you measure the resident’s performance on this rotation or educational experience?

• Faculty evaluations of the rotator’s performance
• Real-time feedback during direct observation
• Resident is to generate self-observed behavior reports in each competency at least weekly over the course of this rotation.

Assessment Method (Program Evaluation)

How do you evaluate whether this educational experience is effective?

• Resident evaluation of rotation

Level of Supervision

How is the resident supervised on this rotation?

· Directly by attending physicians

Educational Resources

List the educational resources

• Relevant orientation materials are indicated and/or given at the beginning of the rotation and used throughout.

As senior, prior residents have found making certain expectations of their team (interns and night float) explicit helps establish and maintain a smooth working environment:

• Team members should inform senior before making any major decisions.
• Keep discharge summaries updated before signing out.
• Keep sign out list updated.
• Always do a thorough sign out to the on-call resident.
• Always be on time.
• Check pm labs as soon as possible the following am.