Inpatient US Clinical Experience in Internal Medicine in Orlando

Information about this clinical experience:

You will be working with a board-certified hospitalist who has been practicing hospital medicine for over 15 years. This preceptor is on staff at hospitals within the Orlando Health and AdventHealth Systems and is a dedicated teacher, having taught many medical, nurse practitioner, and physician assistant students.

On the first day of the experience, this preceptor will meet with you to understand your goals for the experience. An understanding of your background and interests will help the preceptor tailor the experience to meet your needs, ensuring that you maximize your learning and professional growth.

You will see patients with the preceptor in the hospital from 6 AM to 3 PM. The typical patient census averages approximately 18 patients per day. Patients will be seen in the following areas:

• Medicine Ward

• ICU

• Step Down Unit

Your morning will begin a review of the patient list with the attending physician. After you receive your patient assignments, you will start with prerounds. During prerounds, you will learn how to gather relevant information needed to assess patients and establish the day’s plan of care. After the pertinent data has been gathered, you will meet with the preceptor to begin hospital rounds. As you move from one patient to another, you will have the opportunity to present your findings to the attending. Being able to organize and communicate relevant information to teammates will a crucial part of your role as a future resident; therefore, this will be excellent practice for what’s to come. Discussions during rounds will also provide a means for you to hone your skills in developing differential diagnoses, synthesizing data, and formulating assessments and plans.

Following attending rounds, you will accompany the preceptor to multidisciplinary rounds. This is a meeting attended by your preceptor, nurses, case manager, physical therapists, and pharmacists. During these rounds, patients are discussed as a group. Barriers to patient care and discharge will be raised and addressed.

After multidisciplinary rounds are completed, you will accompany the preceptor to see postoperative patients as well as any new admissions from overnight. You will also spend some time writing a simulated progress note on one of your patients. You will review this note with your preceptor and receive feedback.

Every day, you will be asked to read up on a topic related to patients on the service. On the following day, you will have a chance to discuss the topic with the attending.

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

• Taking patient histories.

• Presenting patients.

• Writing simulated notes (no independent access to EMR)

• Have opportunities to research the literature to answer clinical questions at the point of care.

• Teaching other team members (you will give 2-3-minute topic presentations).

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