Medical
Intensive Care Unit - First Year
Educational Objectives: Demonstrate appropriate knowledge and skills to
evaluate and stabilize the acutely ill medical patient. Demonstrate appropriate
knowledge and skills to manage common acute and life-threatening medical problems.
This would include management of hemodynamic compromise in general and specific
clinical problems, such as acute respiratory failure, alcohol withdrawal syndrome,
acute myocardial infarction, congestive heart failure, disseminated intravascular
coagulation, gastrointestinal bleeding, acute hepatic failure, hepatorenal syndrome,
hyperosmolar coma, hypertensive crisis, ketoacidosis, near-drowning, poisonings,
pancreatitis, pulmonary embolism, pneumonia, acute renal failure, status epilepticus,
and other conditions that may produce hemodynamic compromise. Demonstrate appropriate
knowledge and skills to manage the acutely ill medical patient on an ongoing
basis, including fluid and electrolyte therapy, ventilatory management, nutritional
support, and the treatment of complications. Demonstrate appropriate knowledge
and skills in the procedures necessary for the stabilization and management of
the acutely ill medical patient, including but not limited to, airway management,
hemodynamic monitoring, arterial and central venous catheterization, and use
of thrombolytic agents. Develop an understanding of some of the psychosocial
and ethical problems confronting the medical intensive care unit patient and
their families.
Description of clinical experiences: Residents are assigned to work
as a member of the ICU service for a one month period during their PGY-1 year.
The resident's responsibility will be to perform history and physical examinations
on patients as directed by the senior resident or Attending Staff. Residents
will have the opportunity to participate on the Code Team when assigned by
the senior resident or attending staff. Residents will have the opportunity
to learn some of the basic procedures involved in intensive care medicine such
as insertion of arterial lines, and insertion of central venous catheters.
The resident will take in-house call every fourth night during which time supervision
is provided by the attending staff or senior level resident.
Description of didactic experiences: The medicine conferences include
morning report and noon grand rounds. The residents are expected to attend
the emergency medicine conferences held each Wednesday morning.rotations as
well as the supervising emergency medicine faculty during their clinical shifts
in the emergency department. This is one of the most important ways in which
residents receive direct, immediate feedback. Residents receive written evaluations
after completing rotations to the ICU service. Residents are evaluated on their
knowledge base, facility to perform procedural skills as appropriate for their
level of training. Residents are required to keep a logbook of all procedures
they perform. In addition to the rotation evaluations, residents are evaluated
on the oral examinations administered to all residents annually, the national
in-service examination, and case presentations at conferences.
Evaluation process: Residents are informally evaluated by the attending
staff on the various medicine faculty in the ED and the attending staff on
the other rotations. Such feedback is considered most important in the resident's
education. Several times during the year, the preceptor meets with the resident.
In addition, the Program Director meets with each resident at least twice each
year to formally review the department's evaluation of the resident.
Feedback mechanisms: Residents receive
immediate feedback from the supervising residents and staff.
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