MEDU-4005 - Cardiology Consultation

MEDU-4005 - Cardiology Consultation

Elective Title: Cardiology Consultation
Course Number: MEDU-4005
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 2
Prerequisites: Successful completion of Year 3
Additional Requirements: N/A
Responsible Faculty Director: Wissam I. Khalife Periods Offered: 1-13 including holiday period 8 
Coordinator: Victoria Garcia & Kiki Baldwin Other Faculty: n/a
Location to Report on First Day:
5.106 John Sealy Hospital at 8:15am

To develop skills in the diagnosis and management of cardiovascular disease.

At the completion of the four week elective, the student should be able to:
1. Obtain the pertinent history and detect major abnormalities on physical examination.
2. Recognize the indications for and limitations of laboratory procedures commonly used in the detection and management of cardiovascular disease.
3. Recognize the normal and commonly encountered abnormalities on the electrocardiogram.
4. Participate in the management of common cardiac problems.
5. Evaluate patient's cardiac risk during non-cardiac surgery.

Description of course activities
Students see daily consults, formulating an assessment and treatment plan for each patient which is then presented to consulting fellows and faculty. Exposure to exercise stress testing is provided, if desired. Students spend time with fellows and faculty. Students will interpret electrocardiograms and other noninvasive and invasive diagnostic tests. Students will see patients on the fourth Wednesday afternoon of each month in TDC Cardiology Clinic under the supervision of Cardiology faculty and fellows.

Type of students who would benefit from the course
This elective should be of value to students interested in internal medicine, family practice and adult cardiology, or to those entering other specialties which frequently encounter patients with cardiovascular problems.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM
Monday 8:00am, Perform AM consults received Perform PM consults received-5:00pm
Tuesday 8:00am, Same as Monday Same as Monday-5:00pm
Wednesday 8:00am, Same as Tuesday Same as Tuesday-5:00pm
Thursday 8:00am, Same as Wednesday Same as Wednesday-5:00pm
Friday 8:00am, Same as Thursday Same as Thursday-5:00pm
Saturday Off Off
Sunday Off Off

 Average number of patients seen per week:
 Call Schedule:

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study
Other Research time will be assigned for those who desire it only.

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty, Fellow, Residents and Interns rotating on the service.
  B. Frequency / Duration of Presentation(s)?
    10 to 14 per week.
  C. Format - What guidelines are set for the student's presentation?
    The standard UTMB Internal Medicine format.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    10 to 14 per week.
  B. Format - What guidelines are set for the student's written work?
    The standard UTMB Internal Medicine format.
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    The student will be assigned patients referred to the service by the Faculty and/or the Fellow.
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    The student will be assigned referral patients as the referrals are received.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.
    Student performance is evaluated by faculty and fellows based upon daily association.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.