Third Year Medical Student Rotation
Welcome to the Geriatrics Component of Family Medicine! The next two weeks will be an exciting time for you. Your time will be spent as part of the UT Medicine-Nix geriatric inpatient team. You are required to review the information on grading policies shown below. We hope you enjoy your time with us and will join us again in your fourth year.
GETTING STARTED
On the Friday before you start, call the geriatrics office (358-3200) and find out who is on the inpatient service beginning Monday. Call the resident on the service on the first day for details on what time you should show up. If you can not find the resident, show up at 8am on the 19th floor of the NIX and ask them to page the geriatrics resident.
**Prior to your first day:
- Review the Sevocity EMR and Discharge Summary Tutorial listed in the Orientation Info area of this page.
- Familiarize yourself with the various Geriatric Assessment Instruments listed on the Geri Resources Page.
- Review the various articles on geriatric syndromes & inpatient care of the elderly listed on the Geri Resources Page.
- Download the PDA and electronic versions of the "Geriatrics at Your Fingertips" handbook, available online: http://www.geriatricsatyourfingertips.org.
How to Find Us & Parking
The Nix Senior Health Center is located at 414 Navarro, STE. 1111 in downtown San Antonio. Please park at Mid-City Garage across the street from the Nix (see map). Have your parking ticket validated at the Nix garage on the first floor. Let them know that you a physician working with the Nix geriatrics group.
Call Room - Although no call rooms are available the outpatient office (11th floor) has computer access and a place to rest during the night. Coded entry so please take down the code when you get there.
Cafeteria - 6th floor. There is a 25% physician discount with jacket and UHS id. The cafeteria is cash only. SACU ATM available on the first floor in valet parking. Lunch is provided free during the Monday Geriatrics Grand Rounds, but not at any other time.
Further Information on the Nix Hospital can be found on their website, www.nixhealth.com .
Medical Team Support
There are usually six to eight patients on the inpatient service at any one time. You will be assigned to help the attending and the third year family medicine resident care for these patients. Medical students will assist with activities such as writing discharge prescriptions, tracking down lab and imaging results and other assigned duties in a helpful and pleasant manner. If the service has 3 patients or less it is also expected that you will help the attending see patients in the outpatient clinic during your afternoons.
Medical Record Charting
In addition you will be responsible for two key pieces of medical charting on your patients during your rotation. You will be responsible for a written History & Physical and Discharge Summary. The H&P must be available within 18 hours of admission and the discharge summary on the date of discharge. Copies of your drafts may be stored in the outpatient office on the 11th floor. You may work on the discharge note each afternoon to save time on the day of discharge.
Formats and information on completing the written H&P and the discharge summary are available in the Orientation Info area on this page.
EVALUATION
Resident evaluation will be weighed towards three (3) distinct areas: Attitude & Behavior, Medical Records Review, and Didactic Participation.
Attitude & Behavior
Absences - Students will have no unexcused absences. Two or more unexcused absences may result in you needing to repeat a portion of your rotation which usually involves after hours call support. Excused absences due to an illness must be accompanied by an practicing physician (not colleague) note.
Tardiness - Students will have no tardiness. Pre-rounding with the resident usually starts by 7:30am. Ask your resident at what time he/she prefers you in house. Call (358-5600 or the resident beeper) if you anticipate that you are going to be tardy. Tardiness of more than 30 minutes will be treated as an absence.
Dress - Dress appropriately. As our patients represent a unique cohort with preconceived notions of how physicians should interact with them it is requested that students dress respectfully. Men should wear ties and women dress modestly. No open toes sandals. Failure to dress appropriately, in and of itself, is a basis for a sub par evaluation.
Medical Records Review
The student is responsible for the completion of both the written H&P and discharge summary in a responsible and complete manner. It is expected that the student will present the attending with at least three patient charts for review during the two week period for a total of six documents to review (three H&P's and three discharge summaries).
Students who get honors for this content area will have been expected to have all elements of the H&P and the discharge summary on the patient complete on ALL three new patient charts reviewed. Students who fail will either: (1) not have presented the three charts for review to an attending or (2) will have missed basic elements such as the medical problem list or the geriatrics instrumentation list on at least two of the H&Ps or discharge summaries presented.
Didactic Participation
Student participation in both rounds and geriatric didactic portion (Monday geriatrics grand rounds) will count towards the final evaluation. This will done in an honors, pass, fail format with students who participate actively scoring higher than those who are not attentive. Honors students will be expected to contribute new or recent inpatient elder care knowledge to the discussion on a regular basis.