2024-2025 M3/M4 Course Syllabi
Internal Medicine
COURSE NUMBER:
07 07 35
TITLE:
Night ICU -IM -ICE
This unique rotation is an advanced senior student rotation with nocturnal Pulmonary and Critical Care faculty and one senior resident who is covering the MICU and the Medical Step Down Unit (MSDU) over night. Students will be involved in the care of patients transferred for ICU level of care with severe medical illness, respiratory failure, multisystem failure and post-procedural monitoring. This rotation is best for students who are strong independent learners able to actively seek out learning opportunities.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26931373 (INTERNAL MEDICINE CORE CLKSP), 26931472 (ACTING INTERNSHP-INT MEDICINE), 26931472 (ACTING INTERNSHP-INT MEDICINE)

Must have successfully completed the required Acting Internship in Internal Medicine
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
NO
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
COURSE LENGTH:
4 weeks
DIRECTOR:
Leann Coberly, MD
leann.coberly@uc.edu
558-5295
MSB, 6055
ADMINISTRATIVE SUPPORT PERSON:
Gabriela Ionascu
ionascgi@ucmail.uc.edu
513-558-2592
MSB, 6055A
SITE(S):
UCMC - University of Cincinnati Medical Center
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 05/06/2024 - 05/31/2024 0
2 06/03/2024 - 06/28/2024 1
3 07/01/2024 - 07/26/2024 1
4 07/29/2024 - 08/23/2024 1
5 08/26/2024 - 09/20/2024 1
6 09/23/2024 - 10/18/2024 1
7 10/21/2024 - 11/15/2024 1
8 11/18/2024 - 12/13/2024 1
9 12/16/2024 - 01/10/2025 0
10 01/13/2025 - 02/07/2025 1
11 02/10/2025 - 03/07/2025 1
12 03/10/2025 - 04/04/2025 1
13 04/07/2025 - 05/02/2025 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:
7:30PM - 9AM; 4 nights per week of student’s choosing, total of 16 shifts across 4 weeks
REPORT 1ST DAY:
Will get an email prior to first day with directions.

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Lecture
  • Patient Presentation--Learner
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
FEEDBACK:
ASSESSMENT:
 Evaluation by Faculty

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Narrative Assessment
FINAL GRADE:
GRADE ASSIGNED BY: Principle instructor

OBJECTIVES

Curricular Resources :
Critical Care Medicine: Principles of Diagnosis and Management in the Adult, 5 Ed, 2019 by Joseph E. Parrillo MD FCCM (Author), R. Phillip Dellinger MD MS (Author)

Internal Medicine On Call Lange Medical Book, 4th Ed.  Available on Amazon.
Instructional Methods:
  • Clinical Experience - Inpatient
  • Independent Learning Patient Presentation—Learner
  • Self-Directed Learning
Knowledge/Skills:
Content Goals and Objectives

  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
Procedures:
N/A
Remediation Plan:
 N/A

SAMPLE WEEK

SCHEDULE NOTE:
Hours are: 7:30PM - 9AM; 4 nights per week of student’s choosing, total of 16 shifts.
Working days must include the entire 4 week block.

AI in Internal Medicine is a prerequisite.

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.




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