Description

Students are assigned to the internal medicine consultation service at Mayo Clinic Hospital — Rochester, Saint Marys Campus. They work as part of a team with two internal medicine residents and a consultant.

Specific goals

1. Learn the principles of effective medical consultation.
2. Learn the process of effective medical consultation. This includes determination of questions asked of the IM Consult Service, review of the medical record, interview and examination of the patient, and formulation of relevant assessments and management plans.
3. Learn the principles of preoperative medical evaluation, including perioperative risk stratification and medical recommendations.
4. Learn the optimal care of geriatric inpatients with orthopedic injuries, including the prevention and management of common perioperative complications such as cardiac complications, venous thromboembolism, pulmonary complications, delirium, renal dysfunction, and gestational complications.

Although much of the work that we do is perioperative, there are some consultations for patients on non-surgical inpatient teams including Neurology, Physical Medicine and Rehabilitation, and Psychiatry.

1. Consistently demonstrates professional and ethical behavior
2. Communicates effectively
3. Demonstrates knowledge of basic human structure
4. Demonstrates knowledge of normal function
5. Demonstrates knowledge of pathophysiology of disease
6. Demonstrates knowledge of pharmaceuticals, therapeutics, and interventions
7. Applies knowledge of basic sciences to patient care
8. Contributes to discovery or translation of new medical knowledge
9. Demonstrates patient-centered approach
10. Gathers and records relevant patient history systematically
11. Conducts complete physical examination or selects appropriate components in a systematic and directed fashion
12. Performs routine clinical procedures and basic lab and diagnostic tests
13. Accurately interprets data from history, exam, and other findings and formulates a differential diagnosis
14. Selects and initiates appropriate investigations for the purpose of health screening and promotion, diagnosis, prognosis, or intervention
15. Makes appropriate clinical decisions and formulates and implements management plans both for treatment of illness, prevention, and relief of symptoms and suffering, and monitors its effectiveness
16. Participates in health promotion and in prevention of disease and disability
17. Manages life threatening conditions
18. Advocates for patients and the community
19. Displays effective teamwork
20. Fosters self-awareness
21. Demonstrates commitment to personal wellness including physical, emotional, chemical, spiritual, and relationship health
22. Displays leadership
23. Promotes patient safety
24. Demonstrates knowledge of medical economics, healthcare finance, and healthcare policy
25. Understands healthcare processes and systems
26. Exhibits behaviors of lifelong learning

Activity outline

Students participate in the daily operations of the general internal medicine consult service. Appropriate consultation opportunities are provided to each student, who determines the questions asked of the GIM consult service, reviews the patient’s medical database, performs an appropriate history and physical examination of the patient, reviews the patient case with one of the medical residents and with the medical consultant, and formulates assessments and management plans. Appropriate discussion and teaching occur after presentation of the case, as well as during team morning rounds. During the course of the rotation, the students present focused, informal reviews of selected patient care topics.

Method of evaluation

The student will be evaluated by the consultant using formal grading sheets, narrative comments, and verbal feedback.

Per Mayo Clinic institutional policy, faculty and residents/fellows will not complete any outside evaluations. You will be provided with an electronic performance evaluation via Mayo Clinic’s MedHub portal. A final summative evaluation will be sent to you and your school official upon completion of your clerkship.