Inpatient/Outpatient US Clinical Experience in Cardiology in Raleigh-Durham

Information about this clinical experience:

You will be under the supervision of a physician who is board-certified in cardiology. The doctor is on staff at Moses Cone Memorial Hospital and Wesley Long Hospital.  The preceptor is actively involved in the education of family medicine residents at Moses Cone Memorial Hospital. Residents rotate with the physician during their cardiology elective, and the doctor lectures to them regularly.

This rotation will take place in the doctor's cardiac center. You will also accompany the preceptor for rounds in the hospital and be able to observe procedures in the inpatient setting. Please note that at times you will work with one of the doctor's colleagues. This will enrich your experience because of the varying perspectives you will receive from the different attendings. 

Because of the high volume of patients seen in the practice, you will encounter patients with a wide range of cardiac problems. As you accompany the preceptor from one room to another, you will see how a physician with an excellent bedside manner can make a strong impact on patients even during shorter encounters. 

In the patient's room, you will be integrated into the clinical encounter and be able to refine important skills under supervision. For example, many of our rotators have been able to hone their skills in the cardiovascular exam under this preceptor's tutelage. As a future trainee, being comfortable and confident with cardiac auscultation is an essential skill. The evidence, however, indicates that many internal medicine residents in the U.S. lacks these skills with one study showing that the correct assessment on auscultation was made in only 22% of patients. 

The preceptor is also an expert in EKG interpretation and will guide you in strengthening your skills in this area. This will be crucial for your development into a competent resident. According to one study, first-year internal medicine residents were only able to correctly interpret EKGs half of the time. Of note, 10% missed acute MIs, 40% missed ventricular tachycardia, and 87% missed complete heart block. 

During your experience, you will learn the following U.S. medical practices under the preceptor’s supervision:

• Taking patient histories.

• Performing physical exams under the physician's supervision.

• Presenting patients.

• Writing or entering clinic progress notes.

• Researching the literature to answer clinical questions at the point of care.

• Educating patients.

• Spending time with other healthcare professionals in the office to understand their roles and responsibilities.

The activities above will mostly take place in the outpatient setting. As a result of hospital policies, inpatient activities will be more observational.