Internal Medicine
TITLE:
Medical Intensive Care Unit - Jewish Hospital -ICE
The student will be part of an interdisciplinary team and supervised by internal medicine residents and faculty in the care of patients transferred for ICU level of care with severe medical illness, respiratory failure, multisystem failure and post-procedural monitoring.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26931472 (ACTING INTERNSHP-INT MEDICINE)
Must
have passed the Internal Medicine Clerkship. Must be a 4th year student.
expand all
GENERAL INFORMATION
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
STATUS:
Full-Time
OFFERED AS FULL-TIME AND PART-TIME:
NO
ALLOWS OVERLAP:
NO
DIRECTOR:
Greg Kennebeck, MD
Greg.Kennebeck@uc.edu
558-7581
MSB, 6603
ADMINISTRATIVE SUPPORT PERSON:
Jessica Bailey
baileyj7@uc.edu
558-2592
MSB, 6055
ROTATIONS:
Rotation |
Dates |
Max |
1 |
07/06/2020 - 07/31/2020 |
0 |
2 |
08/03/2020 - 08/28/2020 |
0 |
3 |
08/31/2020 - 09/25/2020 |
1 |
4 |
09/28/2020 - 10/23/2020 |
0 |
5 |
10/26/2020 - 11/20/2020 |
1 |
6 |
11/23/2020 - 12/18/2020 |
1 |
7 |
01/04/2021 - 01/29/2021 |
1 |
8 |
02/01/2021 - 02/26/2021 |
1 |
9 |
03/01/2021 - 03/26/2021 |
1 |
10 |
03/29/2021 - 04/23/2021 |
1 |
11 |
04/26/2021 - 05/21/2021 |
1 |
12 |
06/01/2021 - 06/25/2021 |
1 |
NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
Variable shift work (includes weekend call shifts and overnight)
REPORT 1ST DAY:
4777 E. Galbraith Road, 3rd Floor, Medical Education at 8:00 am
INSTRUCTION
LEARNING ACTIVITIES:
- Case-Based Instruction/Learning
- Clinical Experience - Inpatient
- Clinical Experience - Inpatient (Nights)
- Conference
- Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
- Patient Presentation--Learner
- Research
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.
The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
50% |
Attending Physician |
50% |
Senior Resident |
FINAL GRADE:
GRADE ASSIGNED BY:
Course director
OBJECTIVES
Curricular Resources :
Critical Care Medicine: Principles of Diagnosis and Management in the Adult, 4e 4th Edition, 2016
by Joseph E. Parrillo MD FCCM (Author), R. Phillip Dellinger MD MS (Author)
Knowledge/Skills:
1. Identify appropriate circumstances to use non-invasive positive pressure ventilation (NIPPV) such as CPAP or BiPAP for acute respiratory failure
2. Manage ventilator changes.
3. Identify how to change a ventilator to improve ventilation and oxygenation in acute respiratory failure
4. Identify when it is appropriate to intubate a patient in acute respiratory failure
5. Deliver appropriate goal-directed therapy for severe sepsis.
6. Interpret chest x-rays for common lung disorders.
7. Perform basic procedures including arterial lines, intubation, central lines, thoracentesis, paracentesis under supervision
Process - Based Goals and Objectives
1. Acquire accurate and relevant history
2. Perform an accurate physical exam
3. Develop prioritized differential diagnoses
4. Develop an evidence-based diagnostic and therapeutic plan
5. Demonstrate accurate medication reconciliation
6. Provide accurate, complete, and timely documentation
7. Identify the appropriate clinical question for consultative services
8. Identify clinical questions as they emerge in patient care activities and access medical information resources
9. Perform bedside presentations that engage the patient and focus the discussion around the patient's central concerns
10. Minimize unfamiliar terms during patient encounters
11. Demonstrate shared decision-making with the patient
12. Use teach-back method with patients regarding medications and plan
13. Communicate with primary care physicians
14. Recognize the scope of his/her abilities and ask for supervision and assistance appropriately
15. Minimize unnecessary care including tests
16. Use feedback to improve performance
17. Demonstrate empathy, compassion, and a commitment to relieve pain and suffering
Main Course Topics :
Cardiovascular Disorders
Pathophysiology of Circulation in Critical Illness
Shock
Pulmonary Embolic Disorders
Pulmonary Disorders
Pathophysiology and Differential Diagnosis of Acute Respiratory Failure
Noninvasive Ventilation
Management of Ventilated Patient
Acute Hypoxemic Respiratory Failure
Acute-On-Chronic Resp Failure
Status Asthmaticus
Restrictive Disease
Ventilatory-Associated Pneumonia
Liberation for Mechanical Ventilation
Infectious Diseases
Principles of Antimicrobial Therapy and the Clinical Pharmacology of Drugs Septic Shock
AIDS
Pneumonia
Bacterial Infections of CNS
Infectious Complications of Intravascular Devices
Neurological Disorders
Cerebrovascular Disease
Neuropsych Disorders
Status Epilepticus
Coma, Persistent Vegetative State, and Brain Death
Hematological/Onc Disorders
Blood Products and Plasmaphoresis
Bleeding Disorders
Renal/Metabolic
Acute Renal Failure
Rhabdomyolysis and Myoglobinuria
Dialysis in in the Critical Care Patient
Acid/Base Disorders
DKA, Hyperglycemic Coma
Adrenalcortical Insufficiency/Thyroid Disease
Gastrointestinal Disorders
Gastrointestinal Hemorrhage
Acute and Chronic Hepatitis
General Management
ICU Emergencies
Pain Control, Sedation, and Use of Muscle Relaxants
Airway Management
Ventilator-Induced Lung Injury
Monitoring Respiratory System
Pulmonary Artery Catheter
Prevention and Early Detection of Complications of Critical Care
Multiple Organ System Failure: Clinical Expression, Pathogenesis, and Therapy
Withholding and Withdrawal of Life-Sustaining Therapy
SAMPLE WEEK
Monday:
8:00AM |
9:00AM |
Pre-rounds |
9:00AM |
12:00PM |
ICU Rounds |
12:00PM |
1:00PM |
Noon Conference |
1:00PM |
4:00PM |
ICU Work/Procedures/ Family Discussions |
Tuesday:
8:00AM |
9:00AM |
Pre-rounds |
9:00AM |
12:00PM |
ICU Rounds |
12:00PM |
1:00PM |
Noon Conference |
1:00PM |
4:00PM |
ICU Work/Procedures/ Family Discussions |
Wednesday:
8:00AM |
9:00AM |
Pre-rounds |
9:00AM |
12:00PM |
ICU Rounds |
12:00PM |
1:00PM |
Noon Conference |
1:00PM |
4:00PM |
ICU Work/Procedures/ Family Discussions |
Thursday:
8:00AM |
9:00AM |
Pre-rounds |
9:00AM |
12:00PM |
ICU Rounds |
12:00PM |
1:00PM |
Noon Conference |
1:00PM |
4:00PM |
ICU Work/Procedures/ Family Discussions |
Friday:
8:00AM |
9:00AM |
Pre-rounds |
9:00AM |
12:00PM |
ICU Rounds |
12:00PM |
1:00PM |
Noon Conference |
1:00PM |
4:00PM |
ICU Work/Procedures/ Family Discussions |
SCHEDULE NOTE:
May include shift work that is overnight on the weekend/week day. Also late night shifts.
ATTENDANCE AND ABSENCE POLICY
Session Attendance for M4 Students
- Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
- Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
- AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
- Excused Absences - The following will be considered excused absences:
- Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
- Personal illness, accident or a major catastrophic event
- Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
- Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
- The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
- The following items are explained in detail in the Medical Student Handbook:
- Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work
See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.