Course Description
This clinical rotation focuses on internal medicine problems of dogs and cats.
Athena Title
Small Animal Internal Medicine
Non-Traditional Format
This course is a senior clinical rotation where 2 hours in the clinic equals 1 contact (40 hours per week divided by 2 equals 20 contacts per week or 1.3 credit hours per week).
Prerequisite
Must be fourth year veterinary student
Semester Course Offered
Offered fall, spring and summer
Grading System
S/U (Satisfactory/Unsatisfactory)
Course Objectives
The objective of this block is to develop problem-solving skills in small animal internal medicine and cardiology. This is done through daily discussions in rounds and keeping problem-oriented medical records that will be evaluated daily. This rotation is designed to help you make the transition from student to doctor and to assist you in dealing with internal medicine problems if you choose to enter a private practice that sees small animal patients. Even if you do not enter clinical practice, this block will assist you in developing general problem-solving skills that can be applied across species and disciplines.
Topical Outline
1. Assume a responsible role in the management of the patients you see, some of which will be critically ill. 2. After taking a history and performing a physical examination, you will be expected to formulate your own R/O lists, and diagnostic and therapeutic plans in writing prior to approaching the clinician (unless the case is critical) and to carry the plans out once approved by the supervising clinician on the case. You will be sure to search for the results of your plan each day (e.g., laboratory reports, radiographs, ultrasound, surgery, etc.) so that you can include these in your SOAP and your plan for the following day. 3. You will strive to manage your cases as efficiently as possible (for example, you will remember not to feed animals that are scheduled for sedation or radiographic studies, or blood tests that require fasting). 4. You will be present for patient discharges and will be well-prepared with instructions and medications ready at the time the client is expected. 5. You will not schedule patient discharges during your receiving or rounds times. 6. You will arrive early enough in the mornings to examine and care for all your patients prior to 8:00am on weekdays and 9:00am on weekends. 7. You should plan 30 minutes per ICU case and 15 minutes per ward case. Your ICU orders will be completed prior to 8:00am every day. Your treatments will be completed by 9:00am on weekends, at which time clinicians will review each case and distribute new emergency cases. Weekend emergency receiving will be scheduled and you will pick up new emergency cases if you are assigned to a specific weekend. 8. You will be a "team player" by working well with the nurses, caretakers, and your classmates. You will help your classmates as needed, knowing that many procedures require more than one person. You will keep the number of cases assigned to you up to date on the dry-erase board in the medicine ward so that the case distribution will be as equitable as possible. If you know you have the fewest cases, you will volunteer to take the next emergency case. 9. You will be professional in appearance with clean, clinically appropriate smocks, slacks or skirts (no jeans) and shoes. You will strive to keep the hospital professional in appearance by cleaning up after yourself and your patients in the ward, examination rooms, conference room and exercise areas. Your patients will be well cared for and will go home clean and groomed. 10. You will be on time for receiving your cases and will be willing to take emergency cases any time on this block. 11. You will be sure your patients have identification collars and that their cages are appropriately labeled with a completely filled out cage card. 12. You will SOAP each inpatient's record each day. SOAPs and TPRs are due by 8:00am on weekdays and 9:00am on weekends. Each active problem will be SOAPed. You will begin with a large number of problems and gradually see which ones can be combined so that you will work down to one or two major problems. Remember that problems can be historical, physical, or laboratory in origin. Read textbooks for assistance in assessments, but do not copy information from textbooks. The content of your record should be applicable to your specific case. Be sure to include a diagnostic and therapeutic plan for each problem for each day. Tests and treatments you are doing should be boxed and checked off when done. Tests you may want to do should be listed but not boxed. When administering drugs, be sure to include the dose (mg/kg and total dosage), route, and frequency of administration. 13. You will contact in-patient clients once daily or as instructed by your supervising clinician. You will be prepared to convey general updating information, such as which diagnostic or therapeutic procedures were completed that day or how the patient is doing. You maintain good communication with your supervising clinician regarding information conveyed to clients. You will record a summary of all client communications in the patient's medical record. 14. You will be prepared to present your patients during case rounds in an organized and time-efficient manner. When you have a case, you will bring the record, radiographs and any other pertinent information. On the first day of presentation, give the signalment, chief complaint of the owner, summary of the history, pertinent physical examination findings and any pertinent diagnostic test results. Summarize the major problem, your major rule-outs, and your diagnostic and therapeutic plans for that day. On subsequent days, give the signalment, major problems, and current status of the diagnostic and therapeutic plans. 15. You will utilize nursing staff effectively. The medicine ward nurses can perform most diagnostic tests for you if you communicate the need for these tests with them. They will perform daytime treatments as long as these are listed on the treatment sheets hanging on each cage door. Learn to make nurses part of your animal health care team. Our nurses are a valuable resource. 16. Evaluation will be done as written comments in your patient records and verbally as appropriate. Evaluation is based on subject knowledge, patient care, the utilization, organization, and content of the problem-oriented medical record, ability to identify and solve problems, participation in rounds, organization and clarity of case presentations in rounds, efficiency in carrying out diagnostic and therapeutic plans, ability to relate well to people even in stressful situations, professional appearance, initiative, enthusiasm, communication skills, and technical abilities. A verbal and written evaluation will be provided after the first 1.5 weeksw. A final written evaluation will be completed on the last day of the block and submitted to the Dean's Office. 17. Students canot expect to miss any weekdays without making the days up to receive a grade for the course. 18. Regarding weekends, all students having cases are expected to come to the hospital and take care of their patients prior to 9am. The current status of the patient and plans for the next 24 hours will be reviewed with the clinician in charge of the case at approximately 9am on Saturday and Sunday. In addition, students assigned to pick up emergency cases must come into the hospital at 9am on Saturday and Sunday to assume care of these emergency transfers. All other students must be available by phone or pager in case the number of emergency transfers requires additional students. If a student needs to be away for a weekend day, that student must seek permission for such from the supervising faculty member well in advance of the weekend day in question. Students should assume that they will have responsibilities to this rotation 7 days a week. 19. Medical records must never be falsified in any manner. All information recorded must be accurate. Once written, no page of a record may be destroyed or discarded. All pages in the record must be dated and clearly and completely identified as belonging to a specific patient. all changes must be initialed and dated. Information deleted should be marked through with a single line. Records always have to be completed. Names of the primary clinician and supervising faculty member responsible for the case should be listed on the case summary.
Syllabus
Public CV