1. 2010 PRE-RESIDENCY ORIENTATION September 3, 2010 3:00 PM AVR

2. WELCOME to the Dept. of MEDICINE!

3. Post-grad committee Agnes D. Mejia – Chair Francisco Tranquilino – Asst Chair for Post- grad Training Jubert Benedicto – Training Officer

4. Geraldine Racaza – Chief Resident Lowe Chiong – Asst. CR for Post-grad

5. RESIDENCY PROGRAM

6. Residency Training Program 1 st year – Service and Training: Ward, Pay, MICU and OPD rotations, continuity clinic (2x per week) Research: research workshop and meta-analysis

7. Residency Training Program 2 nd year – Service/Training: Subspecialty, ER rotations; answers referrals for clearance and emergency evaluation, continuity clinic (2x/wk) Research: Protocol writing or creative works Administrative job: Learning Units Research Support

8. Residency Training Program 3 rd year – Service/Training: Ward, CENICU, MICU, Subspecialty rotations Research: original studies or creative works Administrative job: Undergrad Postgrad Research Support Services

9. DEPARTMENT OF MEDICINE Service Areas Charity beds – Ward 1 – 50 beds Ward 3 – 52 beds MICU (Medical Intensive Care Unit) –10 beds CENICU (Central ICU) – 2 beds Pay floors – 410 beds CENICU (Central ICU) – 8 beds

10. PRE-RESIDENCY GUIDELINES

11. DAILY ATTENDANCE: - All pre-residents must sign in the attendance sheet to be placed outside the PER. - Cut-off time - 7:00 a.m. M-F; 7:30 a.m. weekends - Dr. Lowe Chiong or one of the seniors will check the attendance sheet everyday

12. ROTATIONS General Medicine Wards (Wards 1 and 3) – 1 ½ weeks 24-hour duty every 3 days - WAPODs (admits and cares for all patients in wards, except those of the APODs’) - APODs (all patients admitted that day fr ER/walk-in belongs to them) OPD/ER/Pay – 1 ½ weeks Subspecialties ER duty Pay duty

13. WARDS Each service: (2-3) 1 st year residents, (1) 3 rd year resident, (2) consultants 2-3 pre-residents per service Each pre-resident should have equal opportunity to work with all the 1 st year residents of the team (no buddy resident for the entire rotation) designation of patients of pre-residents is determined by the senior resident

14. WARDS Duties as pre-RIC: Shall make incoming notes (history, PE, problem list, plan) on all his patients on the first day. Shall make daily entries on the charts of all patients assigned to him. may order in the chart provided that THE RESIDENT-IN-CHARGE COUNTERSIGNS ALL ORDERS.

15. WARDS Duties as pre-RIC: May facilitate management of the patient (running blood, social service, following-up of labs) Shall present patients to the consultant of the service

16. WARDS - APOD Duties of the pre-res APOD: shall see all the patients decked to him during his duty prior to service rounds perform procedures on his patients under direct supervision of the junior/senior resident present the case and recommend management on patients seen at the ER to the senior resident follow-up backlog patients at the ER after the admission day

17. WARDS - WAPOD Duties of the pre-res WAPOD: shall join the afternoon rounds (5PM on weekdays, 12PM on weekends) WAPOD1 : Ward 1 WAPOD2: Ward 3 WAPOD3: Ward 3 (5 pm -12 mn); Ward 1 (12 mn – 7 am) shall assist the WAPOD on all admissions, procedures, and referrals in the assigned ward

18. WARDS - WAPOD Duties of the WAPOD: may perform procedures under direct supervision of the WAPOD shall entertain referrals by nurses and students of the designated ward; shall inform WAPOD of all referrals should inform the nurses’ station of his/her whereabouts at all times.

19. MORNING ENDORSEMENT General Guidelines All are required to attend the morning endorsements at 7:30 am – 9 am (Mondays- Saturdays) May be called to answer questions regarding their ward patient Expect 1 st and 3 rd year residents to attend morning endorsements.

20. CONFERENCES Audit/Grand Rounds Thursdays, 9 am – 10:30 am at the Guazon Hall Journal Club Tuesdays, 12 – 1PM at the AVR (bring your own lunch or order from ma’am Jing of Adult Med)

21. OUTPATIENT DEPARTMENT (OPD) General guidelines: will rotate in the OPD for 1.5 weeks (along with Pay and ER). shall introduce himself to the resident or fellow- in-charge at the start of the OPD clinic. shall chart new or follow-up patients, then present the patients to the resident or fellow

22. OUTPATIENT DEPARTMENT (OPD) General Guidelines: All chart entries must be countersigned by the resident/fellow in-charge of the patient All evaluation forms must be submitted to ma’am Gina at the Chairman’s office on the last day of the OPD rotation.

23. PAY General Guidelines: shall accompany and assist the Pay-ROD in answering referrals, admitting patients, and performing procedures. shall also join endorsement rounds (7am morning endorsement, 5 pm afternoon endorsement) at 5 th floor MROD callroom Endorsements should start on time

24. PAY Shall round with the buddy consultants of the Section of Adult Medicine, along with the 1 st year residents Pre-res 1: SVC A Pre-res 2: SVC B Pre-res 3: SVC C All entries should be countersigned by 1 st years All procedures should be supervised by MRODs. Pre-residents cannot conduct patients.

25. ER General guidelines: Pre-res POD (ER duty): shall see ER consults, facilitate interventions, and present cases to POD and the GenMed service shall assist in the admission of patients to wards Pre-res Day MHAPOD: shall receive endorsements from POD and Night MHAPOD at 7 am at the ER; shall assist the Day MHAPOD in seeing all backlog patients during the day shall assist in the admission of patients to wards

26. ER General guidelines: Pre-res Night MHAPOD: shall receive endorsements from Day MHAPOD at 5 pm at the ER/2 nd yr callroom; Shall assist night MHAPOD in seeing all backlog patients of the Day MHAPOD during the night Shall assist in the admission of patients to wards No interventions will be carried out by ER nurses unless orders are countersigned by the ER-POD

27. EVALUATION

28. OPD evaluation Subspecialties: Fellows (at least 1/subspec) General Medicine (IM New), Continuity: resident (at least 1/OPD day) General evaluation (Pay, ER, Wards) Pay: MROD (or service seniors if with interaction) (at least 2) ER: POD (at least 2) Ward: 1 st yr residents (at least 2); 3 rd yr resident (at least 1) Patient and procedure census

29. EVALUATION Evaluations shall NOT be returned to the pre- resident (evaluator to please submit to ma’am Gina asap) – ideally show the pre-res his/her grade and comments Each evaluation form must be sealed in an envelope Have an index card with the ff: Your name Name of the resident/fellow Rotation - have each resident / fellow / consultant sign once you have given them your evaluation sheet

30. EVALUATION Submit procedure and patient log on the last day of the pre-residency. All procedures performed must be countersigned by the resident who supervised him.

31. ORAL EXAM At the end of the pre-residency, the pre- residents will take a 2-hour move-system type oral examination (OSCE) to be given by the senior residents of the department. 2 cases; 3 stations each 1 st station – differentials 2 nd station – diagnostics 3 rd station - therapeutics

32. INCOMING NOTES At the end of his ward rotation, each pre- resident must submit 2 copies of his best incoming notes, handwritten, on short bond paper, 3 pages maximum. These shall be evaluated by the Chief Resident and 2 nd year residents and will be part of his ward performance grade.

33. CRITICALLY APPRAISED TOPICS (CAT)  All pre-residents are required to make at least 1 CAT during his pre-residency.  At the end of his pre-residency, the pre- resident must submit 1 completed CAT (prescribed format) with a photocopy of the full text journal article to ma’am Gina at the Chairman’s office.

34. CHECKLIST OF REQUIREMENTS Rotation Grades. Ward – at least 4 evaluations (1 service consultant, 1 service senior, 2 first year residents) OPD – at least 6 evaluations (4 if with holiday) ER – at least 2 evaluations (ER) Pay – at least 2 evaluations (MROD) CAT – 1 CAT sheet with full text journal article Patient and Procedure Census Incoming Notes – 2 copies, handwritten

35. OTHERS

36. Elect a batch head for each pre-res batch

37. General Reminders Wear proper attire White blazer No maong pants No slippers/sandals

38. Callroom: Stay in the Patient Education Room (PER) There’s a comfort room near the PER Bring your sleeping bags and pillows Proper garbage disposal Don’t bring valuables Always lock your room

39. Be courteous to patients and hospital staff. Introduce yourself as a doctor; part of the managing staff

40. When in doubt, REFER!

41. You have 3 weeks to learn… to shine… to have a great time… to know if IM is for you.

42. There is no perfect residency program… It’s what you make of it.