Intern Orientation 2012

Welcome Dr. Richard Walsh Chair, Department of Medicine Chief of Medicine, UH Dr. Robert Bonomo Vice Chair for VA Chief of Medicine, VA

Keith Armitage, MD Program Director Carla Harwell, M Associate Program Director  Primary Care, Health Care Disparities, Woman’s Health Simran Singh Associate Program Director  Ambulatory Programs, Woman’s Health Armand Krikorian, MD Associate Program Director  Quality, Pt Safety Lisa Arfons, MD Associate Program Director  Clinical Skills Block Ronda Mourad, MD Associate Program Director  Ambulatory Block curriculum Program Leaders/Administration Deena Segal Administrative Coordination for Educational Programs Tyler Estell, Jim Barry VA Housestaff Office Barbara Bonfiglio UH Housestaff Office  Notary  Historian  Copy machine queen  Amateur psychiatrist  Provider of batteries

Most Importantly: Chief Residents Morgan Oberle  UH Hiloni Bhavsar  Ambulatory Brandon Kellie  VA Dana Angelini  Pt Safety Gigi Gaudiano  Med-Peds

Chiefs….. Q 3 month rotation (except MP) UH31250 VA Ambulatory Med-Peds Patient Safety and Quality 36644

Who are you? 34 Categorical IM 5 Med-Peds 6 IM Prelims 12 Neurology Prelims 12 Anesthesia Interns

Who are you? PhD (4) MPH (5) Masters (3) Languages Arabic, Aramaic, Russian, Macedonian, Hindi, Filipino, Ilocano, Mandarin Chinese, Konkani, French, Gujarati, Spanish, German, Taiwanese, Bengali, Thai, Sign

Who are you? Hobbies/Interests Karate, soccer, comic books, rock climbing, volleyball, photography, hiking, sky diving, golf, travel, cooking, movies, skiing, piano, tennis, biking, history, literature, art, jogging, yoga (6), science fiction, model building, Indian classical dance, basketball, baking, karaoke, violin, kayaking, snowboarding, singing, clarinet, London, ND football, quilting, coffee, theatre, guitar, biking, spinning, weightlifting, swimming, wood working, water skiing, building radio controlled vehicles, softball, touch football, dog rescue, meditation, keyboard, Cleveland sports, water color, technology/computers, investing, triathlons, wine tasting, racquetball, ultimate frisbee, crossword puzzles, horseback riding, auto shows, lacrosse, reef aquariums, canoeing, lawn mowing…..

The goals of internship Learn Patient Care Supervised clinical experience 36,000,000 admissions/year  You will do about 200 Fund of Knowledge Career Goals Subspecialty training Primary care Research Other

The ‘curriculum’ of Internship The goal- gain clinical competence in the care of adult patients (ACGME Competencies) “the patient is the curriculum” General medicine and specialty wards; ICU and ambulatory rotations, clinical skills block, neurology Noon conference Other conferences Attending rounds; walk rounds Morning report Grand Rounds Reading

ACGME Competencies Patient Care Medical Knowledge Practice Based Learning and Improvement Communication Professionalism Systems Based Practice

Research and Elective Time No “assigned” elective Be available 8-5, M-F; let the Chief Resident know about other time away Dr. Walsh, Dr. Bonomo, Program Directors and Chief Residents can assist in picking elective and research mentors GI Elective/Jeopardy

Annual Events Intern Mini-retreat- October/November Getting feedback on the program Professional Development Bronson Day Holiday Party Spring Dinner – May 23, 2013 Intern Retreat- June, 2013 End of the Year Picnic- June 2013 End of Internship- June 23, 2013 Last week of June = 5th week vacation

Evaluation and Feedback: Getting and giving “Self feedback” Electronic- Attending feedback! Rotation and program feedback On-going feedback about the way things are going Semi-annual review Doors of Program Directors are always open (honestly)

Faculty Mentors Meet with Dr. Walsh this fall Be on time Meet December or January with one of the program directors Dr. Walsh, Dr. Bonomo, and Chief Residents can help select mentors Meeting with subspecialty directors, fellows and peers New Fellowship time line…. Picking a faculty advisor

Duty Hours 80 hour work week Averaged over rotation 16 hours  Work flow, efficiency  There will be a ‘system learning curve’ 8-10 hours out of the hospital- between periods of duty  Should leave at 9; must leave by 11 1 in 7- averaged over 28 days

Duty Hours Monitoring Rotation evaluations Web based surveys (program and acgme) Signout rounds with Chief Residents and Program Directors Each Block- one week audit via

Duty Hours Days off- be proactive Please let me know if you feel you are not in compliance com

Misc. Stuff all communication from the residency, hospital GME office, etc. will be to uhhs.com or UHhospitals.org mail.uhhs.com; outlook Patient related s- UH or VA only!! HIPPA Switch dates/block schedule Clinic Maternity/Paternity leave Vacations

Misc. stuff, cont Meal tickets/swipe card Jeopardy schedule (“safety net” for urgencies) Step III- must be done by end of PGY2 year Dictations- must be done the day of discharge

Misc., Medical records Typical daily schedule 7:15 -8Preround- not on call day 8-10:30Work Rounds 10:30-11:30Morning Report (residents M,W,F; interns Th) (10-11 VA) 11-12Attending Rounds* 12-1Noon Conference (M&M- Tu. UH, Wd VA) Grand Rounds, M and Ms 1-2Attending Rounds* 2Post call interns signout and leave What are “pre-rounds” Leave/Sickness-

Misc. Computer resources Core Library Dress Code Intern Orientation Handbook

My advice…….. Ask questions……………… Know Your Limitations; Ask for Help You NEVER have to be Alone Learn to say “I don’t know” (don’t make it up) Have fun Always take a patient centered approach Develop Effective Time Management and Teamwork Skills

More Take Home Points * Yes, the Schedule will may change ** Avoid Cynicism & Negativism … They are Infectious Diseases that will Fatigue You * Focus on: H & P's and Attentive Patient Follow-up Knowing Where Your Limits Are Asking “Why?” *As I said………….Expect to Work Hard... AND HAVE FUN!

Intern orientation…