1. Intern Orientation 2015

2. Welcome Dr. Robert Salata Dr. Robert Bonomo
Interim Chair, Department of Medicine
Dr. Robert Bonomo
Vice Chair for VA
Chief of Medicine, VA

3. Program Leaders Ronda Mourad, MD Keith Armitage, MD Carla Harwell, MD
Program Director
Carla Harwell, MD
Associate Program Director
Primary Care, Health Care Disparities, Woman’s Health
Simran Singh, MD
Ambulatory Programs, Woman’s Health
Charles Lopresti, MD
Procedures, Inpatient Medicine
Ronda Mourad, MD
Associate Program Director
Ambulatory Block curriculum
Hiloni Bhavsar, MD
Patient Safety and Quality
Amanda Clark, MD
Starting July 1
Clinical Skills Block
Crystal Lantz-DeGeorge, MD
Starting August 1

4. Administration Dr. Salata Dr. Bonomo Dr. Sarah Augustine
‘runs the VA’
Dr. Raj Chandra
Gen Med
Teaching and nonteaching
Deena Segal
Administrative Coordination for Educational Programs
Carol Bennett
VA Housestaff Office
Barbara Bonfiglio
UH Housestaff Office
Notary
Historian
Copy machine queen
Amateur psychiatrist
Provider of batteries

5. Most Importantly: Chief Residents
Cassandra Kovach UH
Brian Hambley
Ambulatory
Dhruti Chen VA
Jason Tuckerman
Pt Safety
Nathan Stehouwer
Med Peds

6. Chiefs….. Q 3 month rotation UH 31250 VA 31533 Ambulatory 31529
Med-Peds 36672
Patient Safety and Quality 36644

7. Who are you? 34 Categorical IM 4 Med-Peds 8 IM Prelims
12 Neurology Prelims
14 Anesthesia Interns

8. The goals of internship
Learn Patient Care
Supervised clinical experience
reflection
36,000,000 admissions/year
You will do about 200
Fund of Knowledge
Career Goals
Subspecialty training
Primary care
Research
Other

9. The ‘curriculum’ of Internship
The goal- gain clinical competence in the care of adult patients (ACGME Competencies)
“the patient is the curriculum”
General medicine and specialty wards; ICU and ambulatory rotations, clinical skills block, neurology
Noon conference
Other conferences
Attending rounds; walk rounds
Morning report
Grand Rounds
Reading
ACP curriculum

10. ACGME Competencies Patient Care Medical Knowledge Communication
Practice Based Learning and Improvement
Communication
Professionalism
Systems Based Practice
And then there are the Milestones….

11. Research and Elective Time
No “assigned” elective
Be available 8-5, M-F; let the Chief Resident know about other time away
Dr. Salata, Dr. Bonomo, Program Directors and Chief Residents can assist in picking elective and research mentors
GI Elective/Jeopardy
Required to go to all conferences

13. Annual Events Intern Mini-retreat- October/November Bronson Day
Getting feedback on the program
Professional Development
Bronson Day
Holiday Party
Morale Week
Spring Dinner – May 26, 2016
Intern Retreat- June, 2016
End of the Year Picnic- June 2016
End of Internship- June 23, 2016
Last week of June = 5th week vacation

14. Evaluation and Feedback: Getting and giving
“Self feedback”
Electronic-
Attending feedback!
Rotation and program feedback
On-going feedback about the way things are going
Semi-annual review
Doors of Program Directors are always open (honestly)

15. Faculty Mentors
Meet December or January with one of the program directors
Dr. Salata, Dr. Bonomo,
Chief Residents
Meeting with subspecialty directors, fellows and peers
New Fellowship time line….
Picking a faculty advisor

16. Duty Hours Icompare! 80 hour work week 1 in 7- averaged over 28 days
Averaged over rotation
16 hours
Work flow, efficiency
There will be a ‘system learning curve’
8-10 hours out of the hospital- between periods of duty
Should leave at 9; must leave by 11
1 in 7- averaged over 28 days
Schedule complexity…..

17. Duty Hours Monitoring Rotation evaluations
Web based surveys (program and ACGME)
Signout rounds with Chief Residents and Program Directors
Each Block- one week audit via

18. Duty Hours- Icompare http://www.jhcct.org/icompare/default.asp
One year randomized trial looking at flexibility in duty hours on patient outcomes
+ 80 hours, 1/7
No 16 hours rule for PGY1s

19. Duty Hours Days off- You may need to be proactive if you miss a day
Please let me know if you feel you are not in compliance

20. Misc. Stuff
all communication from the residency, hospital GME office, etc. will be to uhhs.com or UHhospitals.org
mail.uhhs.com; outlook
Patient related s- UH or VA only!! HIPPA
Social Media…
PHI
Switch dates/block schedule
Clinic
Maternity/Paternity leave
Vacations

21. Misc. stuff, cont Meal tickets/swipe card
Jeopardy schedule (“safety net” for urgencies)
call offs….
Step III- must be done by end of PGY2 year
Discharge summaries- must be done the day of discharge

22. Misc.,
Medical records
Typical daily schedule
7: Preround-
8-10:30 Work Rounds
10:30-11:30 Morning Report (residents M,W,F; interns Tu, Th at 11) (10-11 VA)
Attending Rounds*
12-1 Noon Conference (M&M- Fri. UH, Wd VA)
Grand Rounds- Tuesday starting Sept.
1-2 Attending Rounds*
What are “pre-rounds”
Leave/Sickness-

23. Intern Orientation Handbook
Misc.
Computer resources
Core Library
Dress Code
Intern Orientation Handbook

24. Lakeside Hospital
Federal government appropriated $20,000 for a Marine Hospital on Lakeside Avenue.
City Hospital on Wilson Street.
Lakeside Hospital opened.
Cost $2.33/day.
Average daily census 212.
Medical staff from WR Faculty.
1992 Lerner Tower
2012 Seidman
UHHS system……

25. Flexner Report 1910
AMA and Carnegie Foundation commissioned survey by Abraham Flexner.
Visited all 155 medical schools then operating in US & Canada.
Only two medical schools considered as excellent in both clinical and laboratory facilities: Johns Hopkins and Western Reserve.
“Excellent laboratories, in which teaching and research are both vigorously prosecuted…. Lakeside Hospital, an endowed institution of 215 available beds, [is] thoroughly modern in construction and equipment.”
Abraham Flexner
“ The Medical Department of Western Reserve University is next to Johns Hopkins University which, for various reasons, occupies an exceptional position, the best in the country.”
Letter from Flexner to WRU President Thwing following his visit.

26. University Hospitals Move to University Circle
MacDonald House.
B&C.
Institute of Pathology.
Lakeside Hospital
Hanna House
Medical School moved to University Circle.
Lakeside Hospital & ward circa 1932

27. My advice…….. Develop Effective Time Management and Teamwork Skills
Ask questions………………
Know Your Limitations; Ask for Help
You NEVER have to be Alone
Learn to say “I don’t know” (don’t make it up)
Ask for feedback
Have fun
Always take a patient centered approach
Develop Effective Time Management and Teamwork Skills

28. More Take Home Points *Yes, the Schedule may (will) change *Focus on:
Attentive Patient Follow-up
[nightfloat admissions!]
Knowing Where Your Limits Are
Asking “Why?”
Support each other!
*As I said………….Expect to Work Hard ... AND HAVE FUN!

29. Intern orientation…