GOAL
To provide an opportunity to enhance clinical and procedural skills and to develop a deeper understanding of decisions related to invasive, diagnostic and therapeutic interventions in the Cardiology arena. EDUCATIONAL PURPOSE:
1) Learn skills in physical examination and ability to relate abnormal physical findings to the results obtained from invasive and non-invasive diagnostic studies. 2) Learn clinical and physiologic basis for management of acute cardiac illnesses, including myocardial infarction, arrhythmias, congestive heart failure and their complications. 3) Learn the pharmacological properties and toxic effects of cardiovascular drugs. 4) Learn the indications for thrombolytic therapy and percutaneous interventions in acute coronary syndromes. 5) Demonstrate competence in EKG interpretation. 6) Learn how to function effectively as a member of the multi-disciplinary Cardiology team. 7) Learn ethical aspects of decisions required in the care of critically or terminally ill patients.
PROCEDURES:
Residents will be appropriately supervised for all procedures. Procedures for the rotation include central venous catheter placement, advanced cardiac life support, elective and emergent cardioversion, and appropriate EKG performance.
METHODOLOGY:
Duration: 4 Weeks
Start Time: 8:00 a.m.
End Time: 6:00 p.m.
Call Rotation: PGY1 residents take night call every fourth night. Upper level call is covered by the Night Float resident during the week. The resident on the service will cover one weekend day per month.
Attendings: Cardiology Division Faculty
PRINCIPAL TEACHING METHODS:
Teaching Rounds: These are held daily with discussion of physiology, pathophysiology, differential diagnosis and management of all patients in the CCU or MICU. In the MICU, Pulmonary Division faculty also round on a daily basis with the house staff. Their emphasis is on respiratory failure and management of ventilators.
Reading List: Supplied by faculty as pertinent to patients. Articles: Supplied by faculty and other interested parties including pharmacology doctorate faculty. List: Chapters and standard textbooks of medicine. Conferences: House staff is encouraged to attend each of the daily Cardiology Division conferences, particularly the Thursday Cardiology fellow/Cardiology house staff conference, which emphasizes patient care in a case presentation format.
SUPERVISION:
Residents are directly supervised in their patient care duties by the Cardiology Fellow and the Cardiology Attending Physician. The PGY2 or 3 resident on the service supervises the PGY1 residents and the senior medical student on service.
HOUSE STAFF EVALUATION:
Residents are evaluated by the Attending with the assistance of the Fellow each month using the standard Departmental Evaluation form for each competency. Patient Care is assessed based on direct observation and chart review. Medical Knowledge is assessed through direct questioning on rounds. The resident must demonstrate competent EKG interpretation. Professionalism is assessed based on observation of the resident’s demeanor and behavior on this rotation. Interpersonal and Communication Skills are assessed by observing the resident’s interactions with patients, families and staff. Systems-Based Practice is evaluated based on the resident’s ability to in the team setting, including interactions with the Discharge Planners, nurses, PharmDs and other health care providers. Practice-Based Learning is evaluated based on the resident’s ability to learn and improve his or her skills based on feedback, study and literature review.
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