Subinternship in Medicine

(The following is adopted from the Clerkship Directors of Internal Medicine)

GOALS AND OBJECTIVES:

The general goal of a sub-internship is to provide an educational experience for clinical clerks by offering graduated supervised responsibility for patient care in the area of a general specialty. The sub-intern will assume increasing responsibility for patient care and function as a fully integrated member of a medical team on the inpatient floors. Under attending supervision sub-interns render direct patient care and assume the responsibilities of an intern with a reduced load.

The sub-internship is designed to be a supervised educational experience that will serve to improve and build upon those cognitive and technical clinical skills already attained during the a 3rd year clerkship. The experience will hone the skills of data gathering and interpretation and further the student’s knowledge of the illnesses that effect adult patients, and the basic management of these illnesses. Through the sub-internship, the student will have the proper environment in which to learn the clinical skills and behavior essential to the practice of the specialty and the delivery of the highest quality patient care.

SUBINTERN CLINICAL COMPETENCIES:

I. Communication Skills

  • Communicate effectively with patients and family members with humanism and professionalism.
  • Recognize verbal and non-verbal clues of a patient’s mental and physical health.
  • Consider cultural sensitivities and patient wishes when providing information.
  • Learn to effectively communicate with physician and non-physician members of the health care team and consultants.
  • Demonstrate the ability to clearly and concisely present oral and written summaries of patients to members of the health care team.

II. Coordination of Care

  • Learn to prioritize tasks for daily patient care in order to effectively utilize time.
  • Learn how to contact members of the health care team, consultants, and other hospital personnel. Learn to identify appropriate issues for the consultant referral and how to appropriately utilize consultants.
  • Effectively coordinate with physician and non-physician members of the health care team learn how to properly transfer care throughout a patient’s hospitalization, including end of the day and end of service coverage.
  • Be able to arrange appropriate care and follow-up for the patient after discharge from the hospital coordinate care plan utilizing community resources when necessary.

III. Information Management

  • Be able to document the patient’s admission information, daily progress, on-call emergencies, transfer notes, and discharge summaries and instructions accurately and in a timely manner. Understand the ethical and legal guidelines governing patient confidentiality.
  • Learn how to access clinical information at the hospital including clinical, laboratory and radiologic data.
  • Understand how panic values are communicated from the hospital laboratory to the responsible team member.
  • Understand the importance of precision and clarity when prescribing medications.
  • Use electronic or paper reference to access evidence based medicine to solve clinical problems.

IV. Procedures

  • Understand the risks and benefits of common invasive procedures, and how to obtain informed consent.
  • Effectively explain the rational, risks and benefits for the procedure in language that is understandable by the patient and/or his/her family.
  • Gain experience with procedures that are commonly performed by interns and residents.
  • Recognize potential procedure related risks for the operator and the need for universal precautions.
  • Write a procedure note.
  • Ensure that samples obtained are properly prepared for laboratory processing.