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docrockville: Howard University IM, DC
作者:USMedEdu
发表时间:2009-01-10
更新时间:2009-01-10
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现代医学vs“中医”
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发信人: docrockville (docrockville), 信区: MedicalCareer
标 题: Howard University IM, DC
发信站: BBS 未名空间站 (Sat Jan 10 21:25:33 2009)


The morning started with PD Dr. Sealy's presentation, which was very
informative. Among the attendees are 10-15 categorical and 4-5 prelim
applicants. Some of the categorical applicants are Howard or GW students.

He asked everyone's medical school, name, categorical vs prelim, future
interest (fellowship or general practice).

He talked about curriculum and call schedules.

Howard residents rotate in Howard and VA hospitals. But all the calls are in
Howard.


PGY1:

4 month floor (2 attendings + 2 R2 + 3 R1), 1 month ICU ( intensivist plus
intensive care fellows, 2 residents), 1 month CCU (cardiologist, fellow,
senior residents), 1 month non-IM ambulatory rotation (office ortho, ob-gyn,
derm, ENT), 1 month neurology (2 weeks inpatient, 2 weeks outpatient, plus
being part of neurology consult team), 3 weeks vacation (no calls; first
come first serve, in terms of arranging when to take vacation), the rest of
the time in subspecialty rotations.

PGY2: need to have leadership skills.

3 month floor, 1 month ICU, 1 month CCU, 1month ER, 1 month office practice
in a community clinic, 1 month vacation, and the rest of time in
subspecialty (based on choices and availability).

PGY3: leadership, administration (such as controlling call schedules),
research, and teaching.

1 month floor, 1 month ICU, 1 month CCU, 1 month geriatrics (in and out
patient, nursing home, hospice), 1 month in occupational health (treating
work-related injuries) and internal medicine consultation (for non-IM
subspecialties), 1 month ER (working as a consultant for ER attendings), 1
month vacation, and the rest of time in subspecialty (based on choices and
availability).


Away electives are allowed, but no more than 3 months: if it is research,
then you need to have a project that is already designed by self and with
tangible goals such as poster and manuscript; if clinical, then you should
only go outside when it is not offered in Howard)

VA experience: all outpatient experience including rheu, hem/onc, primary
care

Residents work in continuity clinic half a day per week, as a PCP in Howard,
Southeast, or Congressional Heights clinics. Develop your own panel of
patients, under supervision of 2 attendings. case load: 3-5 per patient for
R1, 4-6 for R2, 5-6 for R3. When on night float, ICU, or vacation, you are
exempt from attending clinic.

Night float for 2 weeks or 8 weeks in 2 weeks blocks.

3-4 R1 in night float team

9pm-7am, sign out at 11am. As intern, you are with 2 R2 and 1 R3 (these
people are on their overnight calls)

work from Sun-Thurs

PGy2 and PGy3 do not join night float.

Call schedule

Q4 on floor (5pm-9pm)

2 long calls per month, 7am -7am of the next day, leave at noon the next day
, always on Friday or Saturday, admit 2 transfers from ICU and 5 new
patients

Q4 on ICU

1 day off per week, forecasted by chief resident at the beginning of each
month. During this 1 day you get 24 hours free time, and do not need to
attend conferences.

Interns' life:

7am see patients you carry (usually is 6-8), collecting patient data, check
notes of overnight changes.

7:30am morning report (Monday-Friday): Monday is didactic (case-based),
Tuesday and Wednesday (team report overnight changes, and then case
presentation with EBM support), Thursday (subspecialty case presentation),
and Friday (case presentation with EBM support and weekly quiz with 20
questions).

8:30-9:30 attending rounds (managing round, and teaching round with cases at
bedside)

12 pm: noon conference (Mon: core curriculum, Tues: grand round on advances,
Wed: journal clubs with 2 R2, Thurs: M&M with pathology correlation,
presented by R2, Friday: R2 gives lecture)

5pm: sign out.

Evaluation of residents per month

1. Faculty evaluation: core

meet at the beginning, middle, and the end of each month, to assess
residents' knowledge (based on presentation, rounds), clinical skills,
patient care quality (H&P, DD, and Plan), professionalism (on time),
utilization of system (whether residents know how to use the services of
dietitian, PT), and communication skills.

2. Mini-CEX: OSCE on real patients, 4 cases supervised by 4 different
attendings.

3. Weekly quiz: test reading or not

4. Meet PD every 6 months


Evaluation by residents

1. evaluate faculties including PD

2. evaluate fellow residents

3. evaluate interns

ACP/NBME in-service exam is NOT used for evaluation or promotion

given at 3rd week of October each year, 340 questions in 8 blocks, MCQ
format

Electronic Medical Records: ER and outpatient clinics have EMR, but not in
in-patient department yet (they are building it).

Step3 : must pass by end of PGY-2 year, otherwise cannot go on to PGY3;
given a day off for taking step 3.

1000 dollars allowance for conference or board review course

250 per year for PDA or softwares.

There are some DVDs (UC, mayo, UCSF) on board review in chief residents'
office.

GME office provides modules for teaching how to teach


Then we were taken on hospital tour. The hospital is clean.

No computer in the call room.

Then we sat in a room waiting for faculties to call us out for one-on-one
interview.

The one who interviewed me asked me some general questions for filling out
paper work. Then he told me interview is all about selling yourself. he
asked me what do I want to in next 5 years. He asked me my strengths and
weaknesses, about my research and my work experience. He asked me why I am
interested in Howard. He also told me why he chose to work at Howard post
finishing residency there (to give back to Howard). We also talked about
primary care issues like CMS evaluation of PCPs in terms of following
clinical guidelines.

He suggested that if I want to do second visit, January is most helpful,
since it is close to ranking, but might not help either. he said that I
could just talk to PC.

Then we were taken to grand round, given by a PhD on stress's connection to
breast cancer. Quality was good.

After that we had lunch. Lunch was good (sandwiches, chicken wings.)

During the lunch, two chief residents showed up to answer questions.

We toured ICU, wards, and ER, by a PGY1.

Things are modern and clean. It is well kept, per the resident.

He told me you can have a life outside work there.

Call room clean, with free food, TV, shower, and one computer access to lab
and ECG results in the call room.

200 dollar meal card per month.

PACS system for imaging.

The patient population is 90% black.
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