Welcome to your Clinical Clerkship in Medicine. The members of the Department of Medicine and I want this to be an outstanding educational experience for you. Internal Medicine is a most fascinating medical discipline as it encompasses both the diagnostic work of a medical detective, and the interventional work of an engineer, as we try to rebuild patients’ health.
Our Department is founded on the twin principles of caring and investigation. We strive to care for not only our patients, but each other as well. We also seek to not just be medical technicians, but medical investigators, with every patient and every situation, continually striving to find a better way of doing things. It is these two principles we want to convey first and foremost. But we also want to systematically impart medical knowledge, and we have set up the rotations to maximize this, both with inductive and didactic learning.
During the clerkship, you will be an important member of the Medical Ward Team which is comprised of the attending physician, resident, interns and medical students on the service. The website details our objectives for your Clinical Clerkship, plus the schedules and materials which we feel will help you in your orientation to the Medical Service.
During your clerkship in Medicine you will learn to perform a careful and complete history and physical examination, identify the patients’ problems, develop a differential diagnosis and impression, define that diagnosis in an investigative manner, and then plan for treatment, also in an investigative manner. You will become sensitive and responsive to the needs of your patients, which must come first with you. This is foundational to our culture of caring. By virtue of becoming physicians, we have made a promise to our patients that we will always care for them, with our hearts as well as our minds, and part of that caring is never accepting the status quo, but always investigating how we can do even little things better.
Your attendance is required at rounds. You are expected to attend teaching sessions unless a patient care matter takes precedence. For this reason, we do not take attendance but trust you to be adult learners. Sometimes these conferences will convey information that seems complex, but feel free to ask questions to clarify any of the concepts, as you are an important part of these conferences. First Exposure INTERNAL MEDICINE: Hospital Medicine, Symptom to Diagnosis or IM Essentials are recommended for day to day reading on your patient’s problems and to prepare for your final exam. Harrison’s Principles of Internal Medicine or UpToDate is recommended for the in-depth reading on specific subjects, usually triggered by a patient in your care. You may spend up to one half day a week in a subspecialty clinic. You may arrange this with a faculty member in internal medicine. The clerkship directors are happy to give suggestions. On the last Friday of the Clerkship, you will take a standardized national board examination covering the general field of Internal Medicine. You are expected to pass this test in order to receive a passing grade in the Clerkship. Remember, gaining medical knowledge should be driven not by the motivation to pass this test, but by the goal of taking great care of sick patients, and very soon you are going to need this information to do that.
Finally, it is very important to us that we create an environment that fosters the development of life-long learning skills, reflection, and exemplary professional behavior. These are examples of what our culture of caring and investigation looks like. To promote this, we will assign you an Internal Medicine Coach. These coaches are trained educators who love students and love to teach. Each coach will work with a “teamlet” of 3-4 students. The goal is to support each other both interpersonally and in your professional development. The coach will help you develop goals and a plan for implementation. They will be available for feedback and even direct observation if you need that. We encourage teamlets to work together on projects that will improve patient care and your own learning.
We are determined to make this an outstanding educational experience for you. If there are problems or questions, you should contact the Clerkship Directors, Dr. Heather Harrell and Dr. Ryan Nall at 265-0230 and in Jacksonville, Dr. Carlos Palacio at (904) 244-3093. Also please feel free to contact me or Dr. Richard Schofield, Chief of Medical Services at the Veterans Administration, or the chief medical resident at the Veterans Administration or Shands Hospital for assistance.
Should you wish to convey concerns to someone outside the Department of Medicine, you will have the opportunity to meet with Dr. Vidaurreta in small groups and you may contact her individually. You may also contact one of the deans of student affairs or use the new online, anonymous reporting system. We take your concerns very seriously as it is hard to be caring in an uncaring culture.
Welcome again, you have my best wishes for a great learning experience.
Jamie Conti, MD, FACP
Interim Chair, Department of Medicine