in internal medicine
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.
What you will do: 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.
May give topic presentations or talks to the team.
Spending time with other healthcare professionals to understand their roles and responsibilities.
You will receive regular feedback on your performance.
Please note that, at times, you will round with one of his hospitalist colleagues.
This is an audition rotation and previous rotators have been invited for residency interviews at this program. However, your chances of securing an interview depend upon your clinical performance. An interview is not guaranteed. Since most of your day will be spent with the residents on the service, it will be important to develop strong relationships with these residents as they will provide input regarding your performance to the attending physician. Students who demonstrate a strong work ethic, excellent teamwork skills, high degree of professionalism, the willingness to help out whereever it is needed, and put the needs of patients first will be well received. This rotation is best suited for students who have experience in other rotations and are not afraid to appropriately assert themselves to maximize their learning. Since the residents on this service often switch every 1-2 weeks, students who are comfortable adapting to new situations and teammates wil find it easier to meet the needs of the rotation and residents.
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.
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. Please note that the attending physician will write the letter based on his interactions with you during attending rounds and feedback provided by the residents you work with.
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.
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
"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."