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First Aid for Third Year Clerkships at JMC

Internal Medicine Clerkship at Jefferson Hospital

TRANSPORTATION

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?
  • Because this is at Jefferson, most students walk from home.

LIVING

If you lived away from campus, how was the housing?
  • Because this campus is considered as "local," housing is not provided.
Food: Was it paid for? Were there free lunches? Did you get meal vouchers when you were on-call?
  • Rarely lunch is provided at noon lectures. Thus, students are responsible for their own food. There are no on-call food vouchers.

SITE STRUCTURE

How were the 4 weeks divided up? What are the teams or the options for the rotations?
  • There are 4 teams at Jefferson. Green (General), Yellow (GI/Liver), Red (Cardiology), and Blue (eme/Onc). Students assigned to Green or Yellow are on that particular team for one month. Students can also be assigned to a combination month of Red and Blue, spending two weeks on both teams.
  • Each service is further subdivided into 4 teams (i.e. Green 1, Green 2, Green 3, Green 4). Each team is composed of one attending, one upper year resident (PGY-2 or -3), one intern (PGY-1), one sub-intern (4th year med student), and one or two medical students.
Are you able to request what you want?
  • There are no requests permitted unless the student spent their affiliate month on a specialized team (i.e. a request for a general team can be requested if a student spent one month on a hem/onc team at an affiliate and are then assigned to Blue/Red at Jefferson).

FORMAL LEARNING

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?
  • There is resident case report every day at 11 a.m., and intern lectures at 12, which you are expected to attend if you were done with your work (rounds, notes, consults, etc.). There is also Medicine Grand Rounds once a week, which you are required to attend. About once or twice a week there are lectures specifically targeted for the med students that you are required to attend. Every other Thursday afternoon there is a physical diagnosis sessions with Dr. Mangione in the clinical skills center. You are required to attend two patient-centered physical diagnosis sessions with Dr. Majdan. There is also a weekly Student Report session.
Did you give a presentation? Were you required to do so?
  • There is a Pharmaceutical-ad analysis group assignment. Students are assigned to teams based on their team number (i.e. Green 1, Red/Blue 1, and Yellow 1 students are all assigned to the same group). Each group is given an ad and are required to research the basic pharmacology info of their assigned drug, vet the ad for inaccuracies, and perform a cost analysis. Some teams require you to give a 10-15 minute presentation during rounds on a topic pertinent to one of your current patients. While not required on other teams, it can be a good way to show interest and initiative, and is often noted later on your evaluations.

WORK SCHEDULE

What were your hours (roughly)?
  • I would get in around 6:30 a.m. to pre-round on my patients and write my notes; I would usually leave around 5-5:30 p.m. on non-call days, and anywhere from 8-10 p.m. on call days [Please note that other teams rounded earlier, so some students would come in at 5:30 or 6 a.m.]
Did you get off on major holidays, or were you expected to be there (i.e. Labor Day, Thanksgiving & Friday after Thanksgiving)?
  • Labor Day, Thanksgiving weekend, and Memorial Day are all off.
Weekends?
  • Yes, you will work weekends. Exactly how many will vary. The call schedule is Q4, which means that you and your team will take call every 4th night. This also means that: one weekend each month will be your "golden" weekend: no work either Saturday or Sunday; one weekend is your "black" weekend: work both Saturday and Sunday; and two weekends you work one day (one Saturday, one Sunday).
What was the call schedule? Were you able to pick your nights or trade with peers?
  • Call is Q4. You take call with your team, so when you admit a patient, they are admitted to your team, and you will be responsible for following them in the hospital. Thus, you are not allowed to switch days with your colleagues. As you don't get to pick your team, you also don't get to pick your call schedule. However, you do get to wear scrubs.
In the Hospital, did you feel a part of the ‘team’? Did residents/attendings appreciate you?
  • Yes, very much so. The Attendings and residents listened to, considered, and often acted on my suggestions. You are often responsible for the day-to-day care for your patients, which is awesome preparation for your intern year.
How was the teaching by attendings?
  • Teaching was fantastic, and always high yield. Teaching styles are different for each attending, but generally the covered material is pertinent to your patients. Some attendings teach less than others, but during my month at Jefferson I had two attendings and they both taught a substantial amount.

HOW TO BE A ROCK STAR

  • Know your patients thoroughly. This means knowing information outside of their current hospital meds and daily physical. Although those items are extremely important, it is advantageous to also know home meds, pertinent social info, drug MOAs, drug-drug interaction. If you want to impress your attendings and residents be prepared to talk about your patients current ailment (i.e. if you have a CHF exacerbation make sure you know the NYHA CHF classifications) to a point that is a bit further than just typical reporting info. Knowing Evidence Based Medicine is always helpful for both your patient and your team. Attendings like nothing more than a well-informed student who is willing to teach the team something new.

CANDID COMMENTS FROM STUDENTS

Pros:
  • "Great teaching from residents and attendings; really felt like a part of the team"
  • "I loved being at Jeff. The attendings were outstanding."
  • "Lectures were excellent, residents and interns were excellent and helpful and overall a pleasure to work with and clear about expectations. Hands-on learning was encouraged and teamwork was emphasized. The only thing really lacking is teaching and time with attendings compared with affiliate sites. It was great during cardiology to write the patients' notes and have then cosigned by the interns/ residents, which gave us the chance to get daily feedback and feel like our considerations were taken seriously."
Cons:
  • "Excellent doctors but not enough interaction with attendings."
  • "Less patients to see on my own and less interactions with attendings."

Last revised: 01/12


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