Family Medicine at Mount Sinai Chicago
Weeks 1-3: Outpatient Clinic (9am to 3 or 6pm)
Weeks 4-6: Inpatient (6:30am-5pm)
Every Friday: Lectures at Mt. Sinai, no clinic/inpatient, 8am-11am
GENERAL: Your schedule may vary as they continue to improve the program. You may start with inpatient or begin at one of the many outpatient locations. The duration of each segment has also varied between some students (example: 2 weeks at one clinic, 2 weeks inpatient, 2 weeks at another clinic). This program boasts some of the happiest residents in the hospital!
HEADS UP: This is technically an elective for AUC students, so you’ll be expected to work until your last registered day. Ross students are required to take the shelf exam and will be granted at least Thursday off to study.
DAY 1: Orientation. You’ll meet on the 10th floor of the Frankel tower. Typically orientation is conducted by whichever resident is in charge of the medical students. They walk you through the day-to-day and will give you a tour of their areas of the hospital for inpatient and talk you through expectations. This is also when you’ll receive your schedule for the full rotation.
OUTPATIENT CLINIC: Each attending has their own style. I was at the Archer Clinic with a fairly new (and awesome) attending. Each day we arrived by 8:45am. The schedule was fairly light, and that translated to me being able to practice a lot of counseling skills with patients. It was incredibly fulfilling to make an obvious impact in these patients’ lives. I would interview the patient, get an HPI, and perform a focused physical exam. I’d then go to my attending present the patient with my findings. Then she and I would go into the room together to see the patient.
At other clinics, some of the differences may be that the attending has a large patient roster, so you may find it is a faster pace. It will all depend on where you’re placed.
INPATIENT: This was a very different pace and lines up a bit more with what you can expect in Internal Medicine. You may be either placed at Mt Sinai or Holy Cross which both vary slightly in their responsibilities. Most patients are of lower acuity (COPD, CHF exacerbations, stable NSTEMI, viral illnesses, substance withdrawal, etc.) that require 24-48 hour observation. So, you’ll get opportunities to see and interview a lot of different patients.
Mount Sinai -- On your first day (and each day following a day off) you’ll arrive at the residents’ lounge by 7am ready to get started. On any other day, you should aim to arrive early enough to get overnight updates on your patients to present at 7am rounds. If that’s 6:30am, then do that, but if you need more time then make the time. You’ll meet your senior and intern resident at 7am in the lounge to divide up and discuss any new patients. Take notes on everything your senior/intern is signing out to you for your patients (some talk fast). Typically students will pick up newly admitted patients from the night before and not follow existing patients, but that’ll be your senior’s decision. Your senior may give you additional tasks to follow up on (labs, special tests ordered, confirming information) in addition to reviewing the patient. You’ll then be adjourned to review your patients and interview them. Once you’ve followed up on all your tasks, take some time to organize your notes and get ready to present. The students will create a group chat with the residents and they will let you know what time the attending would like to round. During rounds, the student’s role is to present the patient and parts of the plan. PRACTICE WITH EACH OTHER. There’s a heavy emphasis on presentation skills during this rotation. Each attending rounds differently (one likes to meet in the resident lounge and do table rounds then bedside rounds alone; another likes to meet on one of the floors for computer rounds then does bedside rounds with only the senior; another likes to do combined oral with bedside rounds; and yet another likes to do computer rounds followed by bedside rounds with everyone). Once rounding has ended, you’ll be cut loose to follow up on tasks the attending asks for, help residents with scheduling appointments, update the sign-out sheet. Your day usually ends by 3pm. Each student is responsible for taking “call.” That student will remain and work until 6 or 7. S/he is responsible for seeing new patients being admitted to the service. Each student will also take a weekend call day. For Sinai those days are Friday-Sunday. On Fridays you’ll begin your call after lectures at 11am and on Saturday/Sundays you’ll be working 7am until around 6pm.
LECTURES: Every Friday 8am-11am at Mount Sinai, 10th floor of Frankel tower
Residents and students attend weekly lectures every Friday. Each hour has a dedicated topic that will include 1 or 2 guest lecturers from different departments, a journal club discussion, and a board review hour with AAFP questions. After lectures students are typically released unless they’re on call for Sinai.
HOW TO SUCCEED
You’re not required to take a shelf exam, but the real trouble with that is it’s VERY tempting to avoid study. You always have something you need to be doing, so create a schedule for yourself to keep up with studying. These 6 weeks serve as a great opportunity to do things like study for IM or Comp, write your personal statement/CV, and schedule electives, so try to capitalize on that extra time.
Good luck on your rotation!