Hennepin County Medical Center Internal Medicine Residency PGY3 Emergency Medicine Rotation Educational Goals and Lines of Responsibility

Educational Goals:

1. Internal medicine PGY3 residents (IM PGY3s) rotating in the emergency department must have direct meaningful patient responsibility in a supervisory role.  This includes but is not limited to participation in diagnosis, management, and admission decisions across the broad spectrum of medical, surgical, and psychiatric illnesses. The residents should learn how to determine which patients require hospitalization.
2. IM PGY3s should learn and model collegial interactions with their emergency department colleagues.

To optimize the likelihood of attainment of these educational goals, the leadership of both in Internal Medicine Residency Program and the Emergency Department Residency Program have outlined the following lines of responsibility:

• The IM PGY3 will function in a supervisory role with primary medical providers [PMPs] (PGY1s, physician assistants, medical students, eg)
• They should sign up for the number of patients for whom they feel able to act as a supervising physician.  While this number will vary based on resident ability and patient acuity, the expected number is 3-7.
• If the PMP approaches the emergency medicine EM PGY3 about a patient for whom the IM PGY3 has already registered, the EM PGY3 should redirect that PMP to the internal medicine resident.
• The IM PGY3 will present patients directly to EM staff physicians.
• The IM PGY3 will actively participate in all patient rounds with the EM staff and EM PGY3 that occur during their shift.
• It is expected that the IM PGY3, in conjunction with the PMP will enter most/all orders for the care of their patients.
• In the unusual circumstance in which an EM PGY3 enters orders on a patient cared for by the IM PGY3, they should inform that resident ASAP to ensure those orders fit in with the overall therapeutic plan
• The IM PGY3 will keep the EM PGY3 informed about the patients for whom they are the supervising physician.  This is to ensure that the EM PGY3s maintain the educational opportunities afforded by each patient coming into the department and is not to imply that the EM PGY3 has a supervisory role with the IM PGY3.  The EM PGY3 will provide support for the IM PGY3, particularly in situations in which the internal medicine resident has less experience (gynecologic, orthopedic cases, eg).  This is expected to be in a consulting role.
• IM PGY3s are expected to act as medicine consultants in medicine stabilization cases.
• If there are any questions, concerns, or scheduling issues do not hestitate to contact one of the E.D. chief residents at 336-0040.