Transcript Intern Orientation- Some Helpful Info

Intern Orientation- Some
Helpful Info
Seth Yandell
Chief Resident
Welcome
Important contacts for questions or
problems:
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Myself
Your residents
Tracie, Sherie, and Julie
In the clinic- Gayle, Nancy, Sonya
Dr Carroll
Dr Quiceno
Dr Feldman
Day to Day Activities On Wards
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Day starts at 7am
On call you are responsible for admissions and
codes from 7am-7am so you must be here
during those times without exception
 We cap at 5 new patients per intern (plus a total
of 2 handoffs) on a call night, or an intern can
cap if he/she has a total of 12 patients at the end
of the day (patients discharged earlier in the day
do not count towards the 12 total)
 On your post call day you round, attend
attending rounds at 10:30 if it is a M/W/F, attend
conferences then leave the hospital by 1pm
cont
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Daily- round on patients and speak with each attending daily
regarding pt assessment/plan (speak with your resident before
calling an attending for the first few months so you know you are
calling the attendings with the pertinent info/plan)
Conferences- mandatory, we have them daily at noon M-F (always
catered), we also have Wed morning conference at 7:30am and
Coffee with Cardiology on Fri at 7:20am. If you fall below 75%
attendance of these you can be subject to disciplinary action (up to
and including non-advancement).
Checkout- list is kept current on Caregate then checkout is
performed prior to leaving hospital (you are listed with your checkout
interns on the calender). Include pertinent information and any work
to be done (it is a good idea to keep meds/allergies updated on
these lists).
Pagers- You have to call the page operator daily to check out your
pager, you are responsible for your pt’s till 5pm daily during the
week and noon on the weekends (and 1pm postcall) so do not
check out your pagers until those times. (i.e. this is Dr Yandell and I
need to check out my pager to Dr Das till 7am tomorrow)
cont
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Attending Rounds- While on wards you have them M/W/F from 10:30amnoon so plan on being done rounding in time for this
 Interns conference- with Dr Feldman every Tues at 11am, one intern will be
scheduled every month to assign the other interns to present during the
month, this is a required conference for interns on wards but everyone is
invited and your attendings will let you leave to attend this conference- you
will not learn more in any conference all year than you will in intern
conference
 Off Days- already scheduled (you have your pre-call T/Th/Sat/Sun off during
the month)
 Clinic- As a categorical you will have a scheduled clinic day throughout your
3 yrs (this day remains the same during your residency), clinic starts at
1:30, you can have anywhere from 3-7 patients a day. There is a special
scheduling twist- if you have a Tues clinic and are post call on tues then you
have to make up your clinic on wed; if you have thurs clinic and are post-call
on that thurs you have to makeup the clinic on the Monday prior to that
thurs. (ex if I usually have clinic on Thursday of the upcoming week but am
going to be postcall on that Thursday then I will have clinic on Monday of
the upcoming week instead). If as a prelim you are interested in
participating in clinic for the year let me know in the next couple of weeks
and you can be set up with myself or another 3rd year resident to work with
in clinic through the year. We had a prelim do this last year and she found it
very educational.
Patient Care
 Forms,
Forms, Forms……
 There is one for everything
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DKA protocols, Stroke protocols, Acute
Coronary Syndrome, Electrolyte Sliding Scale
for K/Mg/Phos repletion, Insulin Sliding Scale,
Restraints etc……
 Samples
Admission
orders
 Insert
sample
Green Stickers
 Insert
picture
Patient Name
MR#
DOB
Discharge Forms
 Insert
sample
Discharge Summaries/Records
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Discharge Summaries- Brief summary of pertinent hospital
course/findings/resolutions with medications and discharge
instructions/f/u- Do not run on forever (hint- figure out what you will
say before you start, use the pause button, and try to do it with the
chart and discharge form in front of you so you can dictate
meds/pertinent labs/dates etc straight from the chart)
Records- Stay up to date with your charts by calling medical records
(on the lower level on the way towards Jackson) once weekly to see
if there are any records they need to pull for you for you to finish
Clinic Records for Categoricals- Our clinic has there own paper
record which has to be kept up regularly. Go to the clinic’s medical
records (across the hall from the ACC) once weekly and sign off on
labs and call patients with follow up when needed.
If you don’t stay up to date with this you will get a nasty letter from
Dr. Rinner about how you are a failure and are fired (Ok I made the
failure/fired part up, but you will get a derrogoratory letter telling you
to update your records or you will lose your privileges)
Do you need help?
 Social
Workers- your best friends
 PT/OT/ST
 Pharmacists
 Nurses
 Nurse Psychiatry Liason
 PCT’s
Non wards months
 Hours
and responsibilities vary depending
on the rotation and attending
 Call the attending at least the week prior to
starting the rotation to get details on their
expectations
 Ask your fellow residents about their prior
experiences
Resident Conferences/Journal
Club/Potpourri/CPC/M&M
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Everyone gives one 1hr resident conference on
a internal medicine topic of your choice (please
run your idea past me before you start so I can
let you know whether it has been covered in the
last year so we aren’t bored with redundancy)try to be somewhat narrow in your topic
selection so you don’t get overwhelmed
 3 journal club presentations through the yearapprox 15 minutes for each one, pick large
journals or groundbreaking studies
 Might have to present or help prepare a case for
Potpourri, CPC, or M&M conferences
Vacation- Now we’re talking
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You are allowed to take up to 5 days of vacation on non-wards
months
These days should be taken consecutively (barring emergency) and
preferrably either the first or last week of the month (to limit breaks
in pt care)
If you miss more than five days in a month due to some dire
unforseen circumstance (you or someone you love dearly better be
real sick or dead!) then the extra days will have to be made up
If you have left over vacation days at the end of the year you will be
paid for the left over hours (you should have at least 5 days worth
the first year since you can only take 25 of the 30)
Only one intern/resident can be taking vacation on a rotation at a
time
After verifying that no one else on the same rotation is taking
vacation at the same time, then fill out the vacation request form and
turn it in to Sherie >30 days prior to the start of the vacation (and
really the earlier the better)
If you are a catagorical let Sonia in the clinic know as soon as you
know when you are going to take vacation so she can block out your
schedule and not schedule patients- this should be done 5-6 weeks
ahead of time at least to limit inconvenience to your patients and the
clinic staff
ICU (I Can’t Understand!!!)
 7am
to 7pm daily
 Intense rotation
 Procedures, procedures, procedures- tons
of fun
 Work one weekend during the month
Speaking of Weekends/Holidays
 Depends
on which rotation you are on
whether you will have to work a weekend
 Holidays are also dependent on the
rotation and attending (if you are on ICU
and are scheduled to work Christmas then
you might as well buy a Santa hat and
beard)
Important Codes/Numbers
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Physician dining lounge on 1st floor: 214
Physician lounge on 9th floor: 997722
Call Rooms: B 231, C 214, D 451
Sherie: 6176
Page Operator: 8480
Chief: 8810 office and pager 214-786-2942, if I
am off then call my cell phone 972-890-2107 or
my home phone 972-617-0414 and if I don’t
answer leave a message and I will reply
Computer Programs
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Caregate- used daily with web powerchart,
crosscover, and links to resources like MD
consult (full access) and Ovid-pubmed (login to
caregate is network login and password)
 Synapse- for accessing radiology
images/reports (login name is
texas\networkloginname, password is same as
network password)
 Welford- for the categoricals this is your new
nemesis (I will schedule a time with you upstairs
and walk you through some tricks that I have
learned to speed up the process)
More programs
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Citrix Program Neighborhood- Can be found in
programs or on desktop of computers at work,
login is same as network login/password. Use
this program to access copath. To access from
home go to elink.texashealth.org and download
the citrix program, after that you can access
copath or welford from home (I will show you
how to do the welford access after the first few
months in clinic)
 Copath- sign on and password set up as
employee ID#, this is a nice asset to see path
reports which don’t show up on caregate
Couple of finishing points…
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Be involved
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Do abstracts/posters- if you need a case just ask and
I can find you one
Research- most of our attendings are interested in
research so just ask them or if you need an idea talk
to myself/Dr Quiceno/Dr Carroll/ or Dr Feldman
Go to talks (free good meals, you can network, and if
you pay attention you can sometimes learn
something)
When we have get togethers with the housestaff show
up and enjoy your coworkers company outside of
work.
Let’s have some fun this year