inpatient US clinical experience
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.
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.
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
"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."