Hospital Medicine | Hospital Medicine Observerships & Externships

Hours have been provided by the preceptor. Hours are subject to change at the preceptor’s discretion, but the minimum total hours will remain approximately the same.

What you will do: This is a fully inpatient rotation ideal for a student or graduate seeking to pursue residency training in internal medicine or family medicine, specialties in which 30 to 60% of your time during residency will be spent in the hospital setting. This rotation is also suitable for student pursuing other specialties in which hospital medicine is important, including anesthesiology, neurology, psychiatry, radiology, and other fields where a preliminary year in medicine (or transitional year) is required.

You will be under the supervision of a board-certified family medicine physician. He holds hospital privileges at Advent Health East (formerly Florida Hospital East Orlando). He has had experience teaching international medical students and graduates, and this is part of what gives him joy in his professional life.

You will see patients with the preceptor in the hospital from 7 AM to 7 PM. The typical patient census is 17-25 patients per day. You will see patients in the following areas:

Medical-Surgical Unit
ICU/CCU
Progressive Care Unit (Step-Down Unit)
Medical Telemetry
Emergency Room

Your morning will begin with prerounds during which you will check in with patients to assess how they are feeling and inquire about any new developments or events that have occurred overnight. You will also touch base with the nurse to understanding any nursing perspectives or concerns. After the pertinent data has been gathered, you will present your patients to the attending. You will then visit patients at the bedside with the attending. On a typical day, you will round on approximately 25 patients on different units of the hospital, including the

Following attending rounds, you will accompany the preceptor to multidisciplinary rounds. This is a meeting attended by the attending physician, charge nurse and other registered nurses, case managers, and the pharmacist. During these rounds, every patient, new or old, is discussed as a group. A summary will be provided of the patient's reason for hospitalization, course of treatment, expected length of stay, necessary consults to be placed, plans for discharge, and follow-up care. Barriers to patient care and discharge will be raised and addressed. Your role will be to present your cases, answer questions, and take notes on action items for the patient's plan of care.

After rounds are completed, you will work with the team to implement the day's plans. Periodically, your attending will be on call. With new admissions, you may be able to assist the attending on performing the history and exam in the ED, discuss differential diagnoses, formulate assessments and plans, and complete the admission workup.

After a few days of observation, you will take on an increasing role in patient encounters and learn the following under the preceptor’s supervision:

Taking patient histories under supervision.
Performing exams under the physician's supervision.
Presenting patients.
Access information in the EMR (Epic)
Ordering tests and medications
Requesting specialty consultations
Researching the literature to answer clinical questions at the point of care.
Educating patients under supervision.
Spending time with other healthcare professionals to understand their roles and responsibilities.

You may have opportunities to attend Grand Rounds at the hospital as well as patient safety and ethics committee meetings.

Who should consider this rotation: International medical graduates (IMGs) and students seeking US clinical experience in the hospital.

How to obtain a letter of recommendation: The rotator should ask the preceptor for a LOR near the conclusion of the rotation. Dr. Desai has provided the physician with guidelines about best practices in letter writing that meet residency program requirements. In some cases, the preceptor may ask the rotator to write a letter of recommendation draft.

During the rotation: Our team will be checking in periodically with you to ensure that you are having an optimal experience. We encourage you to contact us if you have any questions during the rotation.

hospitalist rotation #1

TESTIMONIALS

Oliver

"The doctor is an excellent teacher. He is very, kind, and respectful with the patients. He is very knowledgeable and always took great care of me."

hospitalist rotation #2

Hospitalist #2

hospital medicine US clinical Experience
IN orlando

Specialty: Internal Medicine

MD2B Connect Physician ID # 232

Where will this rotation take place: This inpatient US clinical experience will take place in Orlando, Florida.

Hours: Monday - Friday 7 AM to 2-3 PM (day may end at 7 PM when the doctor is on call). Please note this doctor may work for 7-12 days consecutively before having 2 days off. What this means is that you may be rotating in the hospital on some weekend days.

Hours have been provided by the preceptor. Hours are subject to change at the preceptor’s discretion, but the minimum total hours will remain approximately the same.

What you will do: You will be under the supervision of a physician who is board-certified in Internal Medicine. Over 15 years practicing hospital medicine, he has enjoyed teaching international medical graduates. He holds hospital appointments at hospitals within the AdventHealth System. On average, you will round on approximately 18 patients per day with the attending physician.

Two to three patients will be assigned to you and you will be expected to follow these patients from admission to discharge. You will arrive in the morning to complete prerounds with a focus on gathering patient information from the overnight period which you will then present to the attending during attending rounds. This preceptor strongly believes in collegiality and cooperation with nursing staff in the delivery of patient care. Therefore, part of your prerounds will involve discussions with nurses about the events that have occurred overnight, including their perspectives and concerns. This will be an excellent way to build your skills in interprofessional communication. Since residency programs value students who have these skills, this will enhance your strength as a residency candidate.

Following this, you will continue prerounds by interviewing your 2-3 assigned patients. You will inquire about the symptoms that brought them to the hospital and any new symptoms or concerns they have. You will then present this information in a structured manner during attending rounds. This will help you hone essential skills in presenting cases. After you discuss your proposed assessment and plan, you will see the patient together to finalize the day's plan. During these discussions, the attending will share important teaching pearls. You will also be asked to interpret patient information and answer the question, "What would you like to do next for this patient?" Following the patient encounter, the attending will update the EMR with the patient's progress note and enter orders.

When the doctor is on call, you can participate in the evaluation of new patient admissions through the Emergency Department. Please note that in the ED you will spend time with the nurse practitioner who is heavily involved in the admissions process. Please note that while AdventHealth has an internal medicine residency program, this opportunity does not involve patient care with resident physicians. You will be working directly with the attending physician.

After a few days of observation, you will take on an increasing role in patient encounters and learn the following under the preceptor’s supervision:

Taking patient histories.
Presenting patients.
Researching the literature to answer clinical questions at the point of care.
Educating patients.
Delivering talks about important topics.
Teaching other team members.

Who should consider this rotation: International medical graduates (IMGs) and students seeking US clinical experience in internal medicine.

See Where Our Students Applying to Internal Medicine Have Received Interviews or Matched

Read Dr. Desai's Interview with Dr. Roy Ziegelstein (Vice Dean for Education at Johns Hopkins University School of Medicine and Former Program Director of the Internal Medicine Residency Program at Johns Hopkins Bayview Medical Center) about How to Match Successfully in Internal Medicine

TESTIMONIALS

Monique

"He is a very impressive preceptor in many ways. He has a very broad, in-depth knowledge base of all aspects of Internal Medicine. He exhibits excellent bedside manner and ensures to educate and listen to his patients on every ward round, no matter how busy. He is an excellent teacher, with a special ability to explain the most complex conditions in the simplest terms. He was also very patient and caring and took interest in my general well-being and even gave advice as it relates to plans to match. He even shared stories of his journey to matching as an IMG. He is truly an example of all the wonderful things MD2B connect has to offer and in general, an inspiration."

hospitalist rotation #3

Hospitalist # 3

hospital medicine US clinical experience
in Houston

Specialty: Internal Medicine

MD2B Connect Physician ID # 124

Where will the rotation take place: This inpatient US clinical experience will take place 25 miles north of downtown Houston.

Hours: Monday - Friday 7 AM to 6 PM

Hours have been provided by the preceptor. Hours are subject to change at the preceptor’s discretion, but the minimum total hours will remain approximately the same.

During this inpatient experience, you will be under the supervision of a board-certified internal medicine physician. He has hospital appointments at multiple hospitals, including HCA Houston Healthcare Conroe Hospital, HCA Houston Healthcare Kingwood Hospital, Tomball Regional Medical Center, Huntsville Memorial Hospital, Houston Methodist Hospital, and CHI St. Luke's Hospital.

Please note that while this attending physician is a core faculty member of the internal medicine residency program at the HCA Houston Healthcare Kingwood Hospital, the rotation will take place at a different hospital. Although the hospital where you will be based has a family medicine residency program, you will be working directly with the attending physician.

This preceptor is well regarded for his teaching. He is known to ask his students lots and lots of questions in a gentle way to promote learning. Through his style of teaching, you will be able to refine your skills in developing differential diagnoses and formulating assessment and management plans. You will learn how to synthesize data gathered from patients to make diagnoses and defend your clinical reasoning. When clinical questions arise at the point of care, you will be asked to prepare and deliver short presentations to the attending. Giving feedback is important to this preceptor; the frequent feedback you receive will help you grow through the course of the rotation.

This preceptor is also known for his compassionate bedside manner. You will be able to observe how an experienced clinician communicates efficiently and caringly with a culturally diverse patient population. Empathy, respect, and sensitivity are hallmarks of this attending's bedside manner.

The typical census is 18-20 patients per day. After a few days of observation, you will take on an increasing role in patient encounters and learn the following under the preceptor’s supervision:

Taking patient histories.
Performing physical exams under the physician's supervision.
Presenting patients.
Have opportunities to research the literature to answer clinical questions at the point of care.
Being involved in patient education.
Giving talks.

There may be opportunities to participate in scholarly projects. Learners should let the physician preceptor know as early as possible of their interest in participating in a project.

Who should consider this rotation: International medical graduates (IMGs) and students seeking hands-on patient care experience in hospital medicine.

TESTIMONIALS

Xiaolei

"The doctor is very good at teaching and educating. He asked questions during the rounds, elicited critical thinking about the medical cases and encouraged further learning on medical topics. He provided opportunities for me to get more interaction with patients and other team players. He is very knowledgeable. He explained in detail about the pathogenesis of the disease, the rationale of different drug uses and tests ordered for diagnosis differentiation. He always reviews the imaging results by himself and I have learned a lot on imaging reading including X-ray, CT and MRI. His bedside manner is most impressive. He takes time with his patients, listens to their stories and explains complex medical situation in plain language. As it is said, a good physician treats the disease; the great physician treats the patient who has the disease. There is no doubt he is the latter one. The doctor is so nice and friendly, to his patients, to the nurses, to his coworkers and to everyone. I never feel stressed working around him. He cared about my career development and would like to offer help."

hospitalist rotation #4

Hospitalist # 5

hospital medicine US clinical experience
in Philadelphia

Specialty: Internal Medicine

MD2B Connect Physician ID # 209

Where will this rotation take place: This inpatient US clinical experience will take place in Philadelphia, Pennsylvania (approximately 20 miles from downtown).

Hours: Monday - Friday 5:45 AM to 2-4 PM

Hours have been provided by the preceptor. Hours are subject to change at the preceptor’s discretion, but the minimum total hours will remain approximately the same.

You will be under the supervision of a physician who is board-certified in Internal Medicine. The physician is on staff at Lower Bucks Hospital, and serves as Associate Program Director of an internal medicine residency program. He is also Director of the Hospitalist Program. He works closely with the internal medicine residents.

As a core faculty member in an internal medicine residency program in Philadelphia, the attending physician is actively involved in resident education, and enjoys teaching and mentoring trainees.

The typical day will begin at approximately 5:45 AM when you will meet the residents on your team at the hospital for patient handover from the night team. At this point, the patients will be divided among the residents on the team. Following this handover and assignment of patients, you will preround with the residents. The focus of prerounds will be to gather relevant information to assess patients and formulate the assessment and the day's plan. This information will be communicated to the team during teaching rounds and documented in the EMR.

Prerounds will last until approximately 8 AM at which point there will be a one-hour morning report. At morning report, the residents will convene to discuss interesting cases as "unknowns." Typically, cases are presented by PGY-1 residents and attendees work through the case to determine the diagnosis under the guidance of an attending physician.

At approximately 9 AM, teaching rounds will begin during which patients on the service will be presented. The day's plan for the patients will be finalized during these rounds. Your interaction with the attending will take place during attending or teaching rounds. This is typically 1-1.5 hours in duration. Students interested in presenting cases to the attending should indicate that interest to the residents.

Following teaching rounds, the team will work to implement the diagnostic and treatment plans. This may include completing notes, ordering labs, and arranging for patient discharge among other tasks.

At Noon, there will be a one-hour confererence. This will be an educational session covering topics essential to the practice of internal medicine.

In the afternoons, you will work with residents to work up patients and complete patient care related tasks. This may include visits to the Emergency Department to evaluate patients who are newly admitted.

After a few days of observation, you will take on an increasing role in patient encounters and learn the following under the preceptor’s supervision:

Taking patient histories (no physical exams) under supervision.
Presenting patients to the residents and attending physician.
Researching the literature to answer clinical questions at the point of care.
Giving topic presentations or talks to the team.
Spending time with other healthcare professionals to understand their roles and responsibilities.

Please note that, at times, you will round with one of his hospitalist colleagues.

Please note that this experience requires a criminal background check or police report from your native country within the past year.

Who should consider this rotation: International medical graduates (IMGs) and students seeking US clinical experience in internal medicine.

TESTIMONIALS

David

"The doctor is a knowledgeable, down-to-earth, and easily approachable mentor. He encourages active participation and welcomes initiative in his hospital team. Perhaps his biggest strength is how closely the resident team identifies with him and his demeanor, making him easily one of the favorite attendings among the residents."

Hospitalist # 5

hospitalist rotation #5

hospital medicine US Clinical experience
in Houston

Specialty: Internal Medicine

MD2B Connect Physician ID # 225

Where will the rotation take place: This is an inpatient US clinical experience which will take place 70 miles north of downtown Houston.

Hours: Monday - Friday 8 AM to 5 PM

Hours have been provided by the preceptor. Hours are subject to change at the preceptor’s discretion, but the minimum total hours will remain approximately the same.

During this clinical experience, you will be under the supervision of a board-certified internal medicine physician. The attending holds a hospital appointment at Huntsville Memorial Hospital. As a hospitalist and team leader of a group of hospitalist physicians, this physician has extensive experience in leadership and teamwork and is excited to share with students how collaborative care in the inpatient setting can lead to better outcomes for acutely ill patients.

In this clinical experience, you will meet with the preceptor and the team upon arrival to receive an update and signout of patients from overnight. The updates will include a list of new and established patients. At this point, the list will be divided among the hospitalists and nurse practitioners. After a period of observation during which time you will become comfortable in your new environment, your preceptor will assign you several patients to follow. Your responsibilities will be to take their histories, gather all relevant information, and present these cases to the preceptor during attending rounds. At that time, you will discuss your thoughts with the preceptor and work together to formulate the day's plan of of care. New admissions will be accepted by the preceptor usually until Noon at which point admissions will be worked up by the nurse practitioners. After the plan of care is established, you will help the team execute the plan during the remainder of the day.

This preceptor enjoys serving the diverse patient population of the community in which the hospital is located. Approximately 40% of the population is Black or Hispanic. The median household income of the community is lower than other parts of Texas and the percentage of residents with college degrees is approximately 20%. The community is in the bottom fifth of health rankings in a number of areas, including health behaviors and socioeconomic factors. What this means is you will be working with a largely underserved patient population offering you rich opportunities to impact the lives of these patients.

Mortality rates in the community are higher in the community than other communities in Texas. The leading causes of mortality in this population are cancer, heart disease, chronic respiratory disease, cerebrovascular disease, diabetes, sepsis, dementia, and chronic kidney disease. From a preventive medicine standpoint, rates of screening for such diseases as breast cancer and colorectal cancer are low. This will present you with significant opportunities to educate patients about preventive measures that can save lives.

After a few days of observation, you will take on an increasing role in patient encounters and learn the following under the preceptor’s supervision:

Taking patient histories.
Presenting patients.
Writing notes (please note that these will be simulated notes for the doctor's review and will not be part of the medical chart)
Have opportunities to research the literature to answer clinical questions at the point of care.
Be involved in patient education.
Working with other healthcare professionals to understand their roles and responsibilities.

Who should consider this rotation: International medical graduates (IMGs) and students seeking US clinical experience in Internal Medicine.

See Where Our Students Applying to Internal Medicine Have Received Interviews or Matched

TESTIMONIALS

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Hospitalist Rotation #6

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Hospital Medicine US clinical Experience in San Francisco

Specialty: Intensive Care Unit (ICU)

MD2B Connect Physician ID # 219

Where will this rotation take place: This observership will take place in San Jose, California.

Hours: Monday - Friday 9 AM to 3 PM (please note that the start time may be adjusted every day due to the preceptor's other commitments as a leader in the hospital which include mandatory meetings)

Hours have been provided by the preceptor. Hours are subject to change at the preceptor’s discretion, but the minimum total hours will remain approximately the same.

What you will do: You will be under the supervision of a physician who is board-certified in pulmonary medicine and critical care medicine. The physician is on staff at multiple hospitals, including Regional Medical Center, O'Connor Hospital, and Good Samaritan Hospital, and holds multiple leadership roles, including Vice Chair of the Department. As a leader, this physician has been instrumental in organizing, overseeing, and coordinating the hospital's teaching program for both U.S. and international medical students.

Under supervision, you will have the opportunity to refine your skills in history taking. This attending will emphasize the importance of the history in making diagnoses. This attending will also urge you to take ownership of your patients and to care for patients on the team as you would want your loved ones to be treated.

Your day will begin with prerounds during which you will gather the essential information needed for rounds with other students. Following this, you will organize the information for case presentations that you will then deliver during attending or teaching rounds. During these rounds, the team will visit the patients in the ICU together with each student presenting his or her patients. The attending will ask you questions during and after your presentation, pushing you to develop your critical thinking skills with such questions as "What else whould we be thinking about?" and "Why are you recommending this?" Because of the severity of illness encountered in ICU patients and the rapid changes that can occur in each patient's course, rounds may take place twice a day.

Although notes in this hospital are entered in the EMR, this attending feels strongly that student's documentation skills are best developed by writing notes by hand. Notes that you will learn how to write effectively include admit notes, progress notes, transfer notes, and discharge notes. These will be simulated notes that you will submit to the attending for review and feedback.

Although you will dive deep into pathophysiology, mechanisms of disease, and evidence-based medicine, this attending will also teach you about patient-centered care and family-centered care. You will learn how to provide care that meets not only the medical needs of patients but also needs in other domains. For example, psychosocial aspects of care will be an important part of each patient's discussion. End-of-life issues and palliative care will be discussed during the course of the clinical experience.

The care of inpatients is team-based and the ICU is no exception. Therefore, you will be interacting with non-physician personnel in the ICU, including nurses, respiratory therapists, and pharmacists among other professionals. This will allow you to gain a stronger understanding of the roles and responsibilities of other healthcare professionals.

Beyond the daily teaching that occurs during rounds, you may have the opportunity to participate in a weekly didactic and CME conference. You may also be asked to research topics related to issues that arise in patient care and present what you learn to the larger team.

Please note that the attending typically has 5-6 students at a time.

You will receive regular feedback on your performance.

Who should consider this rotation: International medical graduates (IMGs) and students seeking US clinical experience in the ICU. Since many specialties will have their residents rotate through the ICU, this experience will help you develop the skills needed to be more effective in such environments.

See Where Our Students Applying to Internal Medicine Have Received Interviews or Matched

Hospitalist 6

TESTIMONIALS

Swati

"I highly recommend this rotation. It was a great learning experience and prepared me to be able to work in the US health system. I would be more confident in my interviews thanks to this rotation and will be at ease from day one of my residency. I had done more than one outpatient rotation before this, but the kind of exposure and understanding an inpatient rotation provides is unparalleled. More because it has a residency program, and the preceptor has years of teaching and mentoring experience."

HoSpitalist Rotation #6

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Hospital medicine US clinical experience in Newark

Specialty: Anesthesiology

MD2B Connect Physician ID # 221

Where will this rotation take place: This inpatient US clinical experience will take place in Newark, New Jersey (approximately 10 miles north of downtown Newark).

Hours: Monday - Friday 6:30 AM to 3 PM

Hours have been provided by the preceptor. Hours are subject to change at the preceptor’s discretion, but the minimum total hours will remain approximately the same.

What you will do: You will be under the supervision of a team of board-certified anesthesiologists who hold hospital appointments at multiple institutions, including Garnet Health Medical Center, Bon Secours Community Hospital, Good Samaritan Regional Medical Center, Chilton Medical Center, Saint Barnabas Medical Center, and Hudson Regional Hospital.

In this fully inpatient rotation, you will gain a stronger understanding of how the practice of anesthesia is delivered to patients in the operating room. You will encounter patients undergoing surgery in such areas as cardiac surgery, orthopedic surgery, general surgery, and plastic surgery among other specialties.

In the late afternoon, you will learn which cases you will be assigned to the following day. Using the EMR, you will be able to review the patient's chart and preoperative anesthesia assessment. As you read this information, you will think about the patient's medical conditions and how they impact the anesthetic plan. Consider the patient's medication list carefully as many medications interact with anesthetic agents. This assessment provides valuable information about the type of challenges the anesthesiologist may encounter during the case and influences medication choice and decision-making.

In the operating room, you will spend time with the anesthesiologist and certified registered nurse anesthetists (CRNAs). Please note that you will be working with different anesthesiologists throughout the course of the rotation. After introducing yourself before the case to the anesthesiologist and the operating room staff, you will appreciate the different aspects of anesthetic care, including induction and airway management, maintainance, emergence, and extubation.

During the case, you will observe how patients are monitored using the pulse oximeter, blood pressure monitor, and electrocardiogram. In some cases, more invasive monitoring, including arterial or central venous lines, will be used. You will also learn how aanesthesiologists detect and manage intraoperative complications. A major focus will be on understanding anesthetic agents and their mechanisms of action, including induction agents, sedation/analgesia drugs, and reversal agents. You will be expected to ask questions to advance your learning and therefore should not hesitate to do so. However, you must select the appropriate time to ask your questions.

Please note that this is not a shadowing observership. After a few days of observation, you will take on an increasing role in patient encounters and learn the following under the preceptor’s supervision:

Interacting with the patients and members of the healthcare team
Helping to set up the operating room
Working with the anesthesiologist to position the patient properly on the table
Assisting the anesthesiologist through different aspects of the case
Transitioning the patient to the post-anesthesia care unit (PACU).

Who should consider this rotation: International medical graduates (IMGs) and students seeking US clinical experience in anesthesiology.

Listen to Dr. Desai's Advice on How to Match into Anesthesiology:

Matching into Anesthesiology

Hospitalist 6

TESTIMONIALS

Testimonials Coming Soon!

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hospitalist rotations

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HOSPITAL MEDICINE US clinical Experience in orlando

hospitalist rotation #1

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hospitalist rotation #2

hospital medicine US clinical Experience IN orlando

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hospitalist rotation #3

hospital medicine US clinical experience in Houston

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hospital medicine US clinical experience in Philadelphia

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hospitalist rotation #5

hospital medicine US Clinical experience in Houston

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Hospitalist Rotation #6

Hospital Medicine US clinical Experience in San Francisco

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HoSpitalist Rotation #6

Hospital medicine US clinical experience in Newark

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HOSPITAL MEDICINE US clinical Experience
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hospital medicine US clinical Experience
IN orlando

hospital medicine US clinical experience
in Houston

hospital medicine US clinical experience
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hospital medicine US Clinical experience
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