Expectations for Residents on the Inpatient Service

  1. Answer your pages promptly. All else fails if this does not occur.

 

  1. Intake rounds begin in the Medicine library promptly @ 7:15 AM on weekdays and @ 8AM on weekends.  Be concise yet thorough. Goal is to present each new case in a few minutes.  

 

  1. Work rounds begin @ 8AM. You are expected to physically ‘walk round’ with the entire team. Some attendings will join you at 8am. These are still your rounds. If attendings cut you out of decision making, let us know.

 

  1. Resident Report (11AM – 12PM) is mandatory. Please be on time and prepared.

 

  1. Noon Conference (12:30-1:30 PM) is mandatory. Please be on time.

 

  1. If you are admitting with either your team intern or an orphan intern, you must verbally review every admission with the intern before leaving the hospital. COMMUNICATION is key!!!! Know their pager numbers.

 

  1. You are expected to physically be in the hospital until at least 5PM on weekdays, 3pm on non call weekends. You are the back up for the interns, for their questions and concerns. If you have no notes to write, nothing to look up and no families or consultants to talk with, let us know.

 

  1. On Clinic days, if your work is not completed or if your team needs help, you are expected to return to the wards after Clinic. Check in with your team before you go home.

 

  1. Please communicate with your co-residents. Sign out any potential ‘disasters’ to the PGY-2’s and 3’s. Think ahead of time. “Who could get worse?” Then give some hints as to next steps. Do not leave the building without speaking with (preferably face to face) with your coverage. This is basic professional behavior.

 

  1. Cutting, copying, and pasting of notes is illegal and unethical. Notes found to be written this way will have to be re-written. Notes can be brief. The key is not to regurgitate labs or data that can be obtained on the computer, but to lay out in a clear problem list, your diagnostic and/or therapeutic plan for each of your patient’s problems. Do not simply list a dx and a list of tests and meds. Let the reader know your thoughts and “show your math”.  Cutting/Pasting will be treated as a serious breach of professionalism by the Residency Training Program.

 

  1. Communicate with your team. Educate, guide, and supervise.  Leadership skills are essential!!! Think back on a “great” and “not so great” resident you had during your internship. Be one of the great ones. There are no stupid questions, and its OK to hold your team (including yourself) to high standards.

 

  1. If something is not going well with your team, discuss early and often with your attending. If the attending is the issue discuss with Dr. Rifkin

 

  1. The residents are expected to be the primary person calling in consults

 

  1. If the medical students are not making more work for you, you are not doing right by them.

 

  1. What to do with clinical questions?
    1. Ignore
    2. Do whatever attending says
    3. Do the same thing you did last time
    4. Ask a specialist ‘curb side’
    5. Call a formal consult
    6. Look it up

                                                              i.      UpToDate

                                                            ii.      Harrison’s etc

                                                          iii.      Cochrane

                                                          iv.      ACP JC

                                                            v.      PubMed Quries, OVID, smart searches