Introduction to Clinical Medicine ICM

1. Introduction to Clinical Medicine (ICM) Joyce Pickering, MD Oct 29, 2007

3. Topics Schedule and Logistics Important Principles in ICM Marks in ICM Summer 2008 Intro to Clerkship/Clerkship Info re Family Med clinics � Dr. Graves

4. Nicole Guedon, ICM and Clerkships Coordinator

5. Schedule and Logistics for ICM

6. Schedule and Logistics Sign up on line for your sequence of choice, giving reasons (such as life events)if applicable. http://www.medicine.mcgill.ca/ugme/curriculum/icm_general_form_en.htm Opens Oct. 29th, closed Nov. 12th, midnight. You should hear result by Nov. 20th. BCLS plus defibrillator training must be done during the following dates Jan 12 OR 13 OR 20 (half day) http://www.medicine.mcgill.ca/ugme/curriculum/bcls_form_en.htm Opens Jan 3rd, closes Jan 6th.

7. Schedule and Logistics . . You may already have �Textbook of Physical Diagnosis�, Swartz, MH Will be used early in Introduction to Clinical Sciences (January) Bates Textbook of Physical Diagnosis is another alternative. Note: Bates physical exam videos now available as an e-resource through the Life Sciences Library. http://mediasite.campus.mcgill.ca/bates/disc1/index.htm For many courses, material is available on-line

8. Books/Preparation You will need to buy or borrow: Bates or Swartz- for Professional Skills Blueprints in Medicine � for Internal Medicine Lawrence (Essential of General Surgery, Essentials of Surgical Specialties)- for surgery Other reading material as recommended by course directors Looking through Swartz or Bates, or watching the Bates videos online during your holidays is a good preparation for Professional Skills. Your history taking skills should be well on their way, thanks to Physicianship 2.

9. Transportation We recommend the BMW � Bus, Metro, Walk Parking is not always available to students and can be expensive. Lakeshore hospital may be used for some rotations

10. Important Principles in ICM This is the transition period between BOM and clerkship. You will be in the hospitals, but will not have responsibilities for direct patient care. Some rotations do not include direct patient contact (peds, radiology) Teaching will be more individualized, but you will also have to take more personal responsibility to ensure you have met the objectives. A solid ICM experience makes for good clinical clerks!

11. Introduction to Clinical Medicine

12. Professional Issues Dress Behaviour Punctuality Responsibility to patients, to colleagues, to the profession.

13. Dress Wear your white coat and name tag NB: hospital ID card also required MUHC card day Mon. Nov. 26, 13:00 � 15:00, Osler Amphitheatre, 6th floor, MGH Bring McGill ID � for libraries No jeans/shorts Men: shirts should have collars No exposed abdomens Shoes Avoid perfumes/colognes etc.

14. Behaviour Be courteous � even if people aren�t courteous to you. You have to behave BETTER than others Everyone has a right to be treated politely - patients, cleaning staff, secretaries, your peers (and of course your teachers/attending staff)

15. Punctuality Punctuality is considered part of professionalism. Students have failed rotations and been asked to leave the program because of being repeatedly late Medicine is an �early� profession � check the start times for your rotations. In general, you will be finished by 5:00 p.m. But if the clinic is still working, the operation is ongoing etc. stay until the end. If you have an appointment and have to leave by 5:00, let them know ahead of time that you will have to leave. Always notify both the teaching office at the hospital (usually where you will be oriented, phone number will also be in manual) and your tutor if you are ill and cannot attend a session. Bring a medical note.

16. Shadowing Some rotations include a �shadowing� experience � you will �shadow� a clerk (3rd year student) or resident for an evening. Surgery, psychiatry Possibly: internal medicine, radiology, anesthesia On these days you may be asked to stay until about 11:00 p.m.

17. Responsibility Clearly identify yourself Take the initiative to contact your tutors about OR times, clinics etc. Report issues that you are concerned about To your tutor Rotation director Dr. Tellier, Dr. Pickering

18. A story . . . An ICM student was doing anesthesia, and in the operating room with the anesthetist. Shortly after the case began, the surgeon was notified that his car was parked in an illegal zone, and he was asked to move it immediately. As the case had already begun, and it would have been difficult for the surgeon to leave, the anesthetist volunteered to go and move the car. She invited the student to come with her. She left the OR and not only moved the car, but as it was a particularly nice car, went for a 5 or 10 minute drive before coming back to the OR. The student felt obliged to follow her, and so was a passenger in the car during the drive.

19. On returning to the OR, the anesthetist was quite open about the incident, including joking with the surgeon that she �almost got him a ticket�. The student was very uncomfortable with this incident. He noted that �someone much less critical than the anesthetist could have moved the car�. The student did say that in other ways the anesthetist was an excellent teacher � in fact, she probably gave the best teaching that week. The student came to see Dr. Pickering about this incident. Dr. Pickering contacted the Director of Professional Services (DPS) at the hospital. The DPS was aware of other issues with this physician and arranged for the �Programme d�aide aux medecins� of the College des medecins du Quebec to get involved, as well as appropriate disciplinary action. 

20. If it feels wrong to you, it probably is. Talk to your peers, a teacher you feel comfortable with, or Dr. Tellier or Dr. Pickering

21. Topics Schedule and Logistics Important Principles in ICM Marks in ICM Summer 2008 Intro to POM/Clerkship - Clerkship

22. Marks in ICM Most courses are pass/fail Exceptions Intro to Internal Medicine � 5 categories Intro to surgery � 5 categories Family medicine, ethics � pass/fail/honors Details of marking scheme for each course are in your package � also available on line. Comments are transcribed onto the Medical Student Performance Record (aka Dean�s Letter)

23. Marks in ICM Please ask for feedback at the end of a rotation. Final evaluations are often not ready by the end of the rotation.

24. Anna Lee sends out e-mails when the evaluation is received in the Dean�s office, and you are encouraged to come in and review it if it is not available on line.

25. ICM marks If you feel your ICM mark has been unfair Speak to your tutor/rotation supervisor first You may appeal an evaluation within 8 weeks of the Dean�s office receipt of it Suggestion: discuss with Dr. Pickering before requesting a formal appeal. Dr. Pickering will ask to meet with anyone who receives a fail or below expectations in any rotation.

26. It�s all in the Red Book!

27. He�s not even in medicine, and he finds it a fascinating read . . .

29. MSPR The Medical Student Performance Record (MSPR), a.k.a. Dean�s letter, compiles your evaluations (among other things) and is sent out when you apply for a residency position. A sample Dean�s letter can be viewed on the McGill Faculty of medicine home page (www.medicine.mcgill.ca) - go to medical education, undergraduate education, student affairs, career planning office, documents

32. Introduction to Clinical Sciences (ICS) hospital orientation and tutor sessions start January 3rd. Missing these session could result in comments about attendance, reliability or professionalism on your MSPR.

33. Options: Take a vacation Do a clinical elective Do a research elective (8 weeks) Write the USMLE Step 1 Essential if you will be applying to the US for residency Useful to yourself as review and consolidation of material learned in BOM and ICM.

34. We will permit electives � however Unless you take an extra month of vacation later, you will be charged for the credits You must attend the one week (July 21 to 25th) Intro to Clerkship course. If you wish to do an 8 week summer research project, you can do so by doing 4 weeks research in the summer, attending the Intro to clerkship course (1 week), then returning to spend your first 4 weeks of clerkship as a research elective.

35. Topics Schedule and Logistics Important Principles in ICM Marks in ICM Summer 2008 Intro to POM/Clerkship

37. Core Clerkship �starts July 28st, 2008 In February I will meet with you again about clerkship issues. Assignment to sequences will be at random, although again we will ask for life events. Dr. Tellier and Tamara Lutz will also talk about career planning at that time.