Department of Internal Medicine: Acting Internships

The required Acting Internships in Internal Medicine extend the student's Internal Medicine experience with added clinical exposure and responsibility.  Students can select, if available, experiences in critical care, hospital-based internal medicine, non-urban internal medicine or, if not accomplished during the third-year clerkship, an ambulatory experience.  The objective of these rotations is mastery of reporter clinical skills, with additional practice of interpretive, manager, procedural and self-education skills.

Objectives

Refinement of reporter skills
Method of achieving objective: histories, physicals, progress notes, bedside presentations, and patient presentations at conferences

Development of interpreter skills
Method of achieving objective: problem lists, differential diagnosis, discussions with residents, discussions with attendings, completion didactic case, application of principles of evidence-based medicine, laboratory interpretations, X-ray interpretation, special study interpretations

Development of manager skills
Method of achieving objective: writing countersigned orders on patients, discussions with residents, discussions with attendings, completion of didactic cases, application of evidence-based medicine.

Development of procedural skills
Method of achieving objective: Students will have first opportunity to perform procedures on her/his patients for which the student is felt qualified.  The attending physician’s judgment and institutional policy will apply in determining student qualification to perform a procedure.

Development of educator skills
Method of achieving objective: presentation at conferences

Instructional Activities

Provision of patient primary provider responsibility including: admission H&Ps, countersigned orders, progress notes, discharge summaries, and longitudinal follow-up on at least 3 but no more than 8 patients per week.

Participation in all scheduled didactic activities including: morning report, work rounds, attending rounds and conferences.Other didactic activities as assigned by attendings.

Preparation for conference presentation of an evidence based medicine project involving analysis and presentation of either a clinical trial or meta-analysis relevant to a patient on their service.

Completion of computer cases

Call – nights and weekends – as assigned by the institution sponsoring sub-internship

Other clinical activities assigned by the preceptor (such as ER, nursing home, hospice, etc.)

Observation of, and/or participation in, all procedures, autopsies, or special events occurring on student’s panel of patient

Documentation of clinical skills and professional demeanor by a form to be completed at the end of the subinternship by senior resident (R2 or above), if present and the attending

Completion of computer cases

Completion of a portfolio which will contain summary cards of all patients following, written documentation of the evidence-based medicine project, and completion of the exit interview form

 

Department of Surgery: Acting Internships

Introduction Surgery is a broad discipline encompassing many subspecialties but exposure to general surgery and these specialties is limited in the third year of medical school.  Further experience in the fourth year of training is designed to enhance the students' knowledge of surgery and also expose the student to an environment that will prepare them to enter and successfully complete resident training following graduation.  Acting internships in general surgery and orthopedic surgery are available. Students will participate in both inpatient and outpatient settings with the emphasis on outpatient experience, particularly in the orthopedic AI.  Night and weekend call will be expected as part of the AI as it would be for any residency.

Objectives 

A. General Surgery 

1. To expose the student to a learning environment that will prepare the student for residency training. 

2. To gain a perspective of general surgery at it relates to other disciplines, particularly primary care. 

3.  Gain experience in the recognition of surgical diseases and their management. 

4.  Expose the student to the technical aspects of surgery and improve their basic surgical skills. 

5.  Expose students to the management aspects of a surgical practice. 

B. Orthopedic Surgery 

1. Provide the student an experience in orthopedic surgery that will help to understand the relationships of orthopedics with other areas of medical practice. 

2. Familiarize the student with the recognition, diagnosis and management of common orthopedic problems. 

3. Participate in the care of orthopedic problems in the outpatient, inpatient and emergency room. 

4. Enhance the technical skills of students, particularly as it applies to the management of orthopedic trauma. 

C. Criteria for Grading – Criteria are similar for both general surgery and orthopedic surgery and will include the following: 

1. Assessment of history and physical exam skills. 

2. Preparation for clinical encounters with the preceptors including the operating room. 

3. Demonstration of skills relating to the diagnosis and management of patients. 

4. Professional conduct including interactions with other medical personnel such as nursing, physical therapy, etc. 

5. Availability for and participation in clinical activities as determined by the preceptor. 

6. Demonstration of sensitive patient interaction skills and ethical behavior.

Grading will follow recommendations of the School of Medicine and Health Sciences.