First Aid for Third Year Clerkships at JMC
Internal Medicine Clerkship at Einstein
How did you get there? What is the IDEAL way to get there (if different)? If you took public transportation how much did it cost?
- Car - 20-25 minutes in the morning, sometimes up to an hour in the evening depending on traffic. Free Garage Parking is available.
- Subway - There are 2 subways you can take: either the Broad Street Line or the Broad Ridge-Spur Line that picks up at 8th and Market. Both are also known as the Orange Line. Buy tokens from bookstore and then take the Orange Line north and get off at Olney. The subway stop is across the street from the hospital. The subway is reliable but not always safe in the evening if traveling alone.
If you lived away from campus, how was the housing?
Food: Was it paid for? Were there free lunches? Did you get meal vouchers when you were on-call?
- There is no housing. However, they do give you a locker so you can leave behind your white coat and books.
- Lunch is not provided. Additionally, as call ends by 9 p.m. (and usually by 7 p.m.), there are no food vouchers.
How were the 4 weeks divided up? What are the teams or the options for the rotations?
Are you able to request what you want?
- You will remain on the same team for 4 weeks. There are only general medicine teams so you will see a variety of patients. The teams are made up of a PGY3, PGY2, PGY1 (intern), a sub-intern and one or two MS3s.
Did you have lectures/didactic sessions at your rotation site? How often? How long? Do you feel like they were as well organized as the lectures at Jeff?
Did you give a presentation? Were you required to do so?
- "Lunchtime lectures were held four days a week and were just for the medical students. There were also "teaching rounds" every morning for 1 hour with the attendings. During teaching rounds (case presentations in a classroom, not bedside rounds) your team and another team present a case to the attending. The presentation is "very informal and a great learning experience." The teaching rounds were described by several students as; "The best part of Einstein."
Did you have any other assignments given to you?
- Yes, but the presentations were very informal. Attendings or residents will ask the students to discuss a topic briefly during teaching rounds. Students reported, "The presentations are a good opportunity to gain some face time with and impress the attending."
- H&Ps - the course coordinator suggested that you write up 2 each week. Most students wrote 1-3 over 4 weeks - this was attending dependent. However, when required, these H&Ps were time consuming. Some attendings required 5-10 pages with an extensive differential diagnosis. The best advice was to save the template from your first H&P so the process will take less time in the future.
What were your hours (roughly)?
Did you get off on major holidays, or were you expected to be there (i.e. Labor Day, Thanksgiving & Friday after Thanksgiving)?
- 6:30 a.m. to no later than 5:30 p.m. (sometimes you can leave earlier depending on the day).
- Students were not required to work on holidays.
What was the call schedule? Were you able to pick your nights or trade with peers?
- Unless on call, you were not required to work weekends.
Describe your typical day (i.e. who you rounded with, etc.).
- Call schedule is q5 with your intern. Einstein uses a night float system, so your team is on call until 9 p.m. If you take the subway home, you will usually leave around 7 p.m. You are unable to switch with your peers.
In the Hospital, did you feel a part of the ‘team’? Did residents/attendings appreciate you?
- 06:45-07:00 - Receive sign out from the night residents.
- 07:00-08:30 - See patients (2-3) and write notes preparing for rounds.
- 08:30-10:30 - Rounds with team. During this time we went to each floor, did "bedside rounds," ordered anything we needed and discussed interesting patients.
- 10:30-12:00 - Teaching rounds with one attending and another team. In teaching rounds, we alternated days with the other team in presenting one case. The presentation included a differential diagnosis and any key learning/teaching points that were relevant. After teaching rounds we would complete any outstanding work from the morning. Roughly one day per week, this hours was spent doing bedside rounds with the attending.
- 12:30-13:30 - Medical student lectures/Grand Rounds.
- 13:30-16:30 - Admissions/follow-up with patients.
- 16:30 - Sign out to the night team.
How was the teaching by attendings?
- Many students described Einstein as "A great place to learn," but admit to feeling less involved in their patients' care than at other sites. The best approach is to expect to spend a lot of time rounding with/following your team and use that time to ask questions about patient care.
- As attendings do not often take part in bedside rounds, most interaction is limited to the classroom teaching rounds. Lack of attending exposure was the major complaint made by students, so be sure have an active voice during the case presentations of teaching rounds. Teaching during the medical student lectures was great, with several students citing Dr. Morris (Cardiology) as a great attending and teacher.
HOW TO BE A ROCK STAR
As always -- Work hard.
Last revised: 01/12