Medical Resident

The PGY-1 resident physician is expected to develop into a competent internal medicine physician. The following guidelines outline the basic responsibilities of the PGY-1 resident or intern. The senior resident and attending physician on each rotation are the intern’s primary supervisors and educators and may designate any additional guidelines they deem necessary.

Education

Graduate of a medical school in the United States or Canada accredited by LCME or a graduate of an osteopathic medical school accredited by AOA; or a graduate of a medical school outside of the United States and Canada with a currently valid ECFMG certification or full unrestricted license to practice medicine in a US licensing jurisdiction; or graduate of medical schools outside the United States who have completed a Fifth Pathway program provided by an LCME-accredited medical school.

Experience

No prior post graduate training required

Skills

• Substantial interpersonal skills required to effectively interact with staff, physicians, patients, and family members.
• Ability to work under varying degrees of stress and the ability to adjust to changes in the work environment.  Work is of medium to heavy physical demand, walking and standing most of the time.

Licensures, Certifications

Current Basic Life Support and Advanced Cardiac Life Support Certifications

Physical Requirements

• Ability to sit, stand, concentrate and pay close attention to detail

Working Conditions

• Normal patient care environment.
• Frequently exposed to moderately adverse working conditions due to performance of certain patient care activities.  Exposure to communicable diseases.

Conditions of Employment

Possess Citizenship, Green Card, or J-1 Trainee visa sponsorship.

Principal Duties and Responsibilities

Inpatient Medicine (General Medicine Ward Service)

The intern will learn to assume the role of the primary physician by being the primary presenter of the patient, the primary order writer and consult caller, the person to whom all nursing inquiries are referred, and by being the physician who knows the patient best.   The intern will learn to have with them patient vital signs, medicine and doses, labs, x-ray and other test results.

Rounds: The intern will be expected to pre-round on their patients prior to rounds at 8:30 am each day, as well as re-evaluate any patient admitted to them more than two hours previously.  Work rounds with the residents and attending will begin promptly at 8:30 a.m.  Interns will have prepared for work rounds by having reviewed the chart for vitals, notes, nursing medication list, consults and events during the night, and by having examined the patient that morning.  They will practice establishing a care plan for the day during work rounds and follow through with the plan during the day.  Each intern must be present for Work Rounds daily and be prepared to give a thorough, but succinct oral presentation on each new patient admitted to his/her service.  These presentations are not read from the chart.  At the time of the presentation, the results of labs, tests and current medications should be known to the intern.

The intern will have two weeks of night float during the academic year. During his/her call, the intern is responsible for the management of admissions assigned to him/her, as well as the care of urgent problems that develop in patients followed by other ward team members.  The intern must carefully document any diagnostic or therapeutic interventions undertaken on such patients (i.e., cross-coverage note), and verbally inform the appropriate intern the next day.

The intern must accomplish the initial evaluation of all assigned patients as soon as possible following admission.  This evaluation includes:           

• History
• Physical Examination
• Discussion with resident
• Initial Orders/Treatment Plan

The intern is responsible for maintaining the inpatient record in a timely, organized, and complete fashion.

• An up-to-date problem lists
• Laboratory data
• Problem oriented progress note

     -Changes in plan

    -Refinement of differential diagnoses as new info is avail.

     -Acknowledgement of consultant opinion

A procedure note will be written promptly for every invasive procedure.  The note should specify that informed consent was obtained, and possible risks explained to the patient, type of anesthesia, approach used, findings, occurrence, or lack of complications, etc.  The intern will also record this information in his/her personal procedure logbook and have the physician