Internal Medicine
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
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:
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
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 |
ASSESSMENT:
Evaluation by Faculty
ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Narrative Assessment
FINAL GRADE:
GRADE ASSIGNED BY:
Principle instructor
OBJECTIVES
Instructional Methods:
- Clinical Experience - Inpatient
- Independent Learning
Patient Presentation—Learner
- Self-Directed Learning
Knowledge/Skills:
Content Goals and Objectives
- Identify
appropriate circumstances to use non-invasive positive pressure ventilation (NIPPV) such as CPAP or BiPAP for
acute respiratory failure
- Manage ventilator changes.
- Identify how to change a ventilator
to improve ventilation and oxygenation in acute respiratory failure
- Identify when it is appropriate to
intubate a patient in acute respiratory failure
- Deliver appropriate goal-directed
therapy for severe sepsis.
- Interpret chest x-rays for common
lung disorders.
- Perform basic procedures including
arterial lines, intubation, central lines, thoracentesis, paracentesis under
supervision
Process-Based Goals and Objectives
- Acquire accurate and relevant
history
- Perform an accurate physical exam
- Develop prioritized differential
diagnoses
- Develop an evidence-based
diagnostic and therapeutic plan
- Demonstrate accurate medication
reconciliation
- Provide accurate, complete, and
timely documentation
- Identify the appropriate clinical
question for consultative services
- Identify clinical questions as they
emerge in patient care activities and access medical information resources
- Perform bedside presentations that
engage the patient and focus the discussion around the patient’s central concerns
- Minimize unfamiliar terms during
patient encounters
- Demonstrate shared decision-making
with the patient
- Use teach-back method with
patients regarding medications and plan
- Communicate with primary care
physicians
- Recognize the scope of his/her
abilities and ask for supervision and assistance appropriately
- Minimize unnecessary care
including tests
- Use feedback to improve
performance
- 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
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.