Acting Internship in Medicine - VAMC

The Acting Internship on the general medicine wards at the DC Veterans Affairs Medical Center offers students a supportive learning environment to practice advanced clerkship skills. Students are assigned to one of six patient care teams (Teams 1-6) composed of a junior or senior resident, two interns, one supervising attending, and other level students. Students will enter computer orders (must be reviewed and co-signed by the resident) and compose their own electronic medical record documentation (Admission H&Ps, daily progress notes, discharge instructions, etc.). The wards are geographic and patients are admitted on a drip system during the day based on bed assignment and team census. Students assigned to Teams 3-6 rotate with their housestaff teams on to a week (M-F) of overnight call. During that week, there are no daytime responsibilities. On overnights, teams admit patients to the medical service 7pm-7am. Absences for interviewing, etc. will be permitted only under unusual circumstances and must be approved prior to the start of the rotation.

Course Learning Objectives:

By the end of this course, the student should be able to:

1. Perform a comprehensive history and physical exam.
2. Demonstrate the development of a differential diagnosis, work-up and treatment plan for patients admitted to the inpatient medicine service.
3. Demonstrate effective oral and written case presentation skills for new patients, follow up care, and transitions of care.
4. Interpret the rationale and pros and cons of common internal medicine procedures.
5. Demonstrate empathic patient-centered communication when interpreting management plans, risks/benefits, end-of-life care, treatments and behavioral changes with patients and medical personnel.
6. Apply medical standards, clinical practice guidelines and practice algorithms relevant to patients' medical conditions.
7. Demonstrate the ability to navigate through specialty consultations, care management services, discussions with nutrition, psychiatry and psychiatry teams, and other interdisciplinary care requirements to ensure complete co-ordination of care for the patient's well-being.
8. Demonstrate appropriate professional and ethical behaviors related to patients and other health care professionals.