Department of Family & Community Medicine

Enhanced Skills Program: Hospital Medicine Goals and Objectives Family Inpatient Service (FIS)

1. Medical Expert

By the end of the rotation the resident will:

  • Independently assess patients and determine fitness for transfer to the FIS service.
  • Demonstrate an approach to common general medical conditions requiring hospitalization (the following is a guideline and is not exhaustive):
    • Cardiovasuclar: angina, heart failure, acute coronary syndrome, arrhythmias, hypertension, hyperlipidemia, syncope
    • Dermatology: common inpatient problems, drug reactions
    • Endocrinology: diabetes, thyroid disorders, lipid disorders, osteoporosis
    • Gastrointestinal: GI bleeding, diarrhea, constipation, acute/chronic liver disease, abdominal pain
    • Geriatric: dementia, delirium, recurrent falls, weight loss, polypharmacy, urinary incontinence, chronic pain, decubitus ulcers
    • Hematology: anemia, coagulation disorders, cytopenias, lymphadenopathy
    • Infectious Disease: acute infectious illness (sepsis, meningitis, encephalitis, pneumonia, endocarditis, gastroenteritis, cellulitis, urinary tract infection, pyelonephritis), tuberculosis
    • Neurology: headache, seizure, stroke, vertigo, syncope, movement disorders
    • Nephrology: acute kidney insufficiency, chronic renal insufficiency, electrolyte disorders, acid-base disorders
    • Oncology: mass NYD, appropriate screening tests
    • Palliative: end of life care, symptoms control
    • Respiratory: obstructive airway disease, pleural effusion, infections, interstitial lung disease, malignant disease, thromboembolic disease
    • Rheumatologic: acute/chronic monoarthritis and polyarthritis, vasculitis
  • Make appropriate use of antibiotics/antibiotic stewardship
  • Recognize disease presentations that deviate from common patterns and require complex decision making
  • Modify differential diagnosis and care plan based on the patient’s clinical course and available investigations, in the context of patient centered care
  • Correctly interpret laboratory tests, chest radiographs and ECGs
  • Demonstrate familiarity and intermediate competence in procedures including but not limited to arterial puncture for blood gas, joint aspiration/injection, nasogastric tube insertion, paracentesis, thoracentesis
  • Demonstrate an understanding of the potential and appropriate use of bedside ultrasound
  • Manage, with minimal supervision, general medical patients with a broad spectrum of clinical disorders

2. Communicator

By the end of the rotation the resident will:

  • Demonstrate a targeted and organized approach of gathering historical information from patients and their family to allow appropriate triaging and transfer of patients to the Family Inpatient Service
  • Work with junior residents and medical students to ensure effective, patient centered communication regarding diagnosis, prognosis, medical status and treatment options occur with patients and their families
  • Effectively communicate consultation requests to specialty services and allied health care personnel and judiciously put into practice their recommendations
  • Participate in patient handover to on-call staff/residents outlining patient status and potential areas of medical concern

3.Collaborator

By the end of the rotation the resident will:

  • Develop strong and effective working relationships with senior medical residents and Team A fellows to recruit appropriate patients to the Family Inpatient Service
  • Utilize consultation with other services appropriately and effectively
  • Demonstrate effective collaboration with medical and allied health team members to ensure comprehensive, efficient and safe discharge planning occurs

4.Manager/Leader

By the end of the rotation the resident will:

  • Provide leadership to the Family Inpatient Service, mentoring junior trainees
  • Delegate patient care issues to junior trainees, ensuring patient care requirements and educational objectives are met
  • Supervise and provide teaching to junior trainees in the assessment and management of complex medical inpatients
  • Provide informal and formal feedback to junior trainees at appropriate intervals
  • Demonstrate time management skills to reflect and balance priorities of patient care, outpatient practices, academic demands and sustainable practice/personal life.
  • Demonstrate familiarity with inpatient billing practice

5. Health Advocate

By the end of the rotation the resident will:

  • Assess, individualize and respond to inpatients health concerns using a biopyschosocial model
  • Mentor advocacy to team members throughout inpatient admission and through planning outpatient discharge plans

6.Scholar

By the end of the rotation the resident will:

  • Maintain and enhance professional activities through ongoing learning
  • Participate in point of care resources/evidence based medicine seminars and mentor acquired knowledge to junior trainees throughout the rotation
  • Use medical literature in a variety of sources to complement team discussions and teaching
  • Understands the principles of adult learning and helps others learn by providing guidance, teaching and by giving constructive feedback.

7. Professional

By the end of the rotation the resident will:

  • Recognize the scope of his/her abilities and asks for supervision and assistance appropriately
  • Maintain appropriate professional relationships with patients and families