Guide for Residents

Every clerkship site is different, but various sites have given feedback that an outline of minimum expectations for students and their teachers (including residents) would be helpful. We hope that this will serve as a quick reference to these expectations. Please see the clerkship website for more information.

Student Guidelines

Admissions

  • Med 1 - Students are told to admit one case per call (approximately 2 per week, 8 per block). They have 24 hours to complete a full write-up which they are told should be fairly extensive (background basic text reading evident). They are told not to put these in EMR until a number have been reviewed by you and you have deemed them “fit”.
  • Med 2 - Students are told to admit two cases per call (approximately 4 per week; 14-16 per block). They have until the following morning to complete a full write-up.
  • Students should conduct the interview and physical exam as independently as possible; ideally a portion will be observed periodically and feedback provided to the student on communication and exam skills.
  • Preceptor and student formally review one write-up per week. Students will turn in this corrected/reviewed write-up as part of their portfolio.

Day-to-day patient management

  • Present their patients on work rounds daily; present their new admissions post-call.
  • Write daily progress notes on their patients.
  • Collaborate professionally with other members of the patient’s care team (social work, pharmacy, consultants, primary care physicians).
  • Students should be expected to present 3-5 minute “teaching bullet” on patient-driven question for team to be presented at start of each attending rounds (or work rounds, as appropriate).
  • Students have a didactic schedule- see calendar for site-specific activities.

Resident Expectations

Ward duties

  • Assign new patients to clinical clerks. In making these assignments the resident will:
    1. Select those patients most suitable for advancing the medical education of the student.
    2. Be certain that the student will have an appropriate one hour interval set aside for new admission contact between patient and student.
  • Assign specific reading directly relevant to each patient worked up by the student.
  • Please make every effort to involve the student in the decision-making beforehand (as if they were going to write the orders), or at least keep them informed of orders written on their patients.
  • Review student write-ups along with attending physician. Together with attending determine when write-ups are of sufficient quality to be placed in EMR. Co-sign once in EMR.
  • Closely supervise and improve relationships between clinical clerks and intern.
  • Determine when each clinical clerk is ready to:
    1. Present progress data on work rounds.
    2. Present patients at attending rounds.
    3. Perform procedures under direct supervision.

Feedback

  • Sit-down feedback session with students at least twice: mid-way through and at the end of their time on service. Forms to facilitate mid-way feedback will be given to you by the student clerks. We encourage use of the E*value form attached to the midway feedback from the student knows exactly what your verbal feedback means in a Likert scale.
  • Additional, brief, "on-the-fly" feedback is strongly encouraged.
  • Completion of on-line E*value of the student within two weeks of the end of the rotation. We are under strict LCME deadline to have all evaluations completed in a timely fashion.
  • Structured observations- complete one Mini-CEX per block. Ideally this should be done by resident as a way to increase variety of methods residents gain exposure to and experience with. More frequent observation of history and physical skills is encouraged but students are required to turn in evidence of one structured observation session.

Quick Checklist

  1. Review all H and Ps, progress notes. Co-sign once you and attending deem they can be in EMR.
  2. Assign 5 minute patient-based questions for students to review and report on for rounds.
  3. Meet for formative (midway) feedback – sign and fill out feedback form and the attached preliminary paper E*value.
  4. Complete summative (final) feedback with student- complete final E*value within 14 days of rotation end.
  5. Make attempts to review pertinent physical findings on student patients twice a week.
  6. One Mini CEX completed per block.