Medical
Intensive Care Unit - Second 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 6 week period during
their PGY-2 year. The resident will function as the senior resident on one
of the combined MICU/CCU teams. Residents will have the opportunity to direct
cardiac resuscitations. They will also have the opportunity to initiate medical
resuscitations (including the use of various procedural skills) and participate
in decisions regarding definitive care under the supervision of the pulmonary
fellow, or attending staff. The resident will take in-house call every fourth
night during which time supervision is provided by the attending staff or
pulmonary fellow.
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.
Evaluation process: Residents are informally evaluated by the attending staff on the
various 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 conference.
Feedback mechanisms: Residents receive
immediate feedback from the supervising emergency 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.
|
