Rockyview General Hospital Medical Teaching Unit Orientation Document for Residents and Clinical Clerks Revised: 24 February 2015
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Rockyview General Hospital Medical Teaching Unit
Orientation Document for Residents and Clinical Clerks
Revised: 24 February 2015 2
Welcome!
Welcome to the Medical Teaching Unit (MTU) at Rockyview General Hospital (RGH). Whether
you are a resident or clinical clerk, I am very happy to have you as part of the health care team at
our site and look forward to helping you accomplish the educational objectives that are part of
your respective training programs requirements.
This document is meant to provide an overall understanding of the structure of the MTU at RGH
and its operations, which are different in some respects from the other training sites in the
University of Calgary network. It incorporates sections from existing orientation documents for
the MTU rotation, but tries to make them specifically relevant to the RGH site. Thanks to Dr.
Kristen Brown and Dr. Ghazwan Altabbaa for allowing me to adapt from these.
I invite you to read the sections of the document that are relevant to you prior to your MTU
rotation and to continue to consult it during the course of the block to hopefully provide you with
the information that you might need to make your rotation more enjoyable and useful for your
learning.
Please remember that your preceptors are your key resource persons for helping you with any
issues that may arise during your rotation. You should feel comfortable approaching them at any
time with any and all obstacles or problems you might be having with reaching your objectives.
As the MTU director at the RGH site, my job is to ensure that the structure and functioning of the
MTU fulfill its goals for patient care and for trainee education. I am therefore available to support
both you and your preceptors in making your MTU rotation a useful and, ideally, enjoyable
experience.
If I might be so bold as to offer a single piece of advice, it’s that the more you put into any rotation
(including this one), the more you will likely get out of your experience. The MTU rotation may be
difficult at first, and the learning curve steep, but this very challenge can actually be the best part
and allow you to expand your knowledge and garner the experience and independence you will
need for your upcoming careers as practicing physicians.
Best of luck and we’re looking forward to working with you!
Oliver Haw For Chin
RGH MTU Director 3
Important
Contacts
and
RGH
Numbers
Monica Horne, Resident Education Coordinator Tel: 403-943-3491
• MTU call schedules for RGH Fax: 403-943-3408
• Orientation document distribution E-mail: monica.horne@albertahealthservices.ca
• Vacation requests for non Internal Medicine
residents
Dr. Oliver Haw For Chin, RGH MTU Director Pager: 06285
• Responsible for all issues concerning the E-mail: oliver.hawforchin@ucalgary.ca
functioning of the RGH MTU
Dr. Ghazwan Altabbaa, RGH Clinical Teaching Tel: 403-943-3111
Coordinator Pager: 00049
• Responsible for the organization of Fax: 403-943-8535
teaching activities and educational rotations E-mail: ghazwan.altabbaa@albertahealthservices.ca
at RGH
Teresa Thurber, Nursing Manager Tel: 403-943-3107
E-mail: teresa.thurber@albertahealthservices.ca
Casey Jalbert, Unit 93/94 Nursing Manager Tel: 403-943-3127
E-mail: casey.jalbert@albertahealthservices.ca
Catherine O’Nyons, Nurse Clinician, Unit 93 Tel: 403-943-8893
E-mail: catherine.onyons@albertahealthservices.ca
Dawn Stockan, Nurse Clinician, Unit 94 Tel: 403-943-8894
E-mail: dawn.stockan@albertahealthservices.ca
Clerkship Program Coordinator Tel: 403-210-3815
University of Calgary, Undergraduate Medical Fax: 403-270-2681
Education Email: intmed@ucalgary.ca
Useful Internal RGH Numbers
(All internal numbers starting with a “3” can be prefixed with “403-94” and dialed directly from
outside of the hospital)
Unit 93 Nursing Station 38893
Unit 94 Nursing Station 38894
Unit 71 Nursing Station (Cardiac) 33571
Intensive Care Unit Main 33446
Coronary Care Unit Main 33444
Emergency Main 37000
Day Medicine Unit 33797
RGH Inpatient Pharmacy 33461
Other Useful Numbers
Calgary Laboratory Services can be contacted at 403-770-3600. This number is useful for
obtaining information on the result of a test that has been drawn or to add a test to an existing
sample. Please note that CLS will likely only be able to add a test when less than 4 hours has
elapsed from the time of sampling. If a patient is in the ER, please ask the nursing staff to add
the lab test as they have a different process for completing this task. 4
Overview
of
the
MTU
at
RGH
• The division of General Internal Medicine (GIM) provides both inpatient and outpatient
care at the RGH site on a daily basis. In addition to running clinics for pre-operative and
urgent IM assessments, there is an IM consultation service to provide IM care for patients
not admitted to an IM inpatient team.
• In its current structure, there are three IM inpatient services: one General Medical Unit
(GMU), which is staffed by clinical assistants and two MTUs, to which four junior
residents and two clinical clerks are typically assigned, respectively named Amber and
Purple. A preceptor is responsible for the patients on each of these teams and is on-
service for a two-week period.
• The main difference regarding the daytime structure of the MTU at RGH as compared to
the two other sites is that there is currently no senior IM resident during the day on the
MTU. The interaction for patient care decisions and for learning is therefore directly with
the preceptor. However, a senior internal medicine is on night float shift every night from
2000 to 0800 to assist the junior housestaff with support and provide teaching and
valuable clinical experience.
th
• The two principal medical units at RGH are Units 93 and 94, located on the 9 floor of the
Highwood building. A Nurse Clinician leads each unit, each of whom is your nursing
resource person for the unit in question. Their contact information is listed on Page 3.
Due to unit capacity issues or particular needs, some of your patients may be located on
other unit such as Unit 71.
• Most patients who are admitted to the MTU come through the ER, although they may be
transferred from other services, including the ICU or admitted from outpatient clinics.
During the day, the IM consultation team is generally responsible for the admission of
these patients to the MTU. However, in the afternoon, members of the admitting team
may be asked to see patients in the ER deemed as requiring admission to the MTU.
During the night, the on-call team is responsible for ER admissions.
• Although the MTU is medical-based, it is also a multidisciplinary team effort. You will
be expected to know the roles of other allied health professionals such as nurses,
pharmacists, physical/occupational/speech language therapists and social workers and
interact with these individuals on a daily basis to help your patients get the care they
need. Knowing who to talk to will make life that much easier. 5
RGH
Unit
93/94
General
Information
Unit Staffing Structure
The nursing staff is shared between 2 Units (93&94) and includes RN/LPN and Students
practicing at varied levels of nursing education. Each Unit has a nurse clinician (NC) that is in
charge of that Unit. When the NC is not there, a charge nurse will be assigned for the shift. It is
of utmost importance that you communicate very closely with this person, especially regarding
admissions and discharges. The NC or charge RN is also your resource for unit policies and
protocols.
Each patient has a nurse assigned for his/her care. Occasionally the nurse may be partnered with
a student or Undergraduate Nursing employee. Please inform the nurse if you are entering new
orders that will require immediate attention. Verbal orders are discouraged and cannot be
accepted by all Nursing staff. Please make it your practice to enter ALL orders in SCM. DO NOT
enter an order as a clinical communication to nursing staff.
There are no dedicated respiratory therapists (RT) assigned to our Units but they are readily
available to assist with managing our patients with pulmonary compromise.
There is a unit clerk (UC) on each unit from 0700-2315. They can assist you with some questions
and phone calls. Please ensure that you let the UC know when you have paged someone and
what patient the call refers to. Please do not request the unit clerk or Clinician to inform
consultants of a new consult. They will be happy to call them for you to speak to. If your patient
requires consultation, it is common courtesy to speak directly with the consultant, to ensure that
any immediate questions that they have can be answered appropriately.
You will find all patient charts located at the Nursing desk in the labeled chart racks. Please DO
NOT remove patient charts from the desk area without informing the Unit Clerk or
Clinician/Charge Nurse. Please ensure that you return charts when you have finished with them.
IMPORTANT: Patient confidentiality and protection of information and privacy
The unit space is shared with the general public, families, other patients, and AHS staff that may
not have direct relationship with your patient. It is your responsibility to make sure that you adhere
to regulations that pertain to confidentiality of patient information. You should be aware that
teaching and conference rooms are audited and screened routinely for any unattended patient
lists, patient results and reports, copies of charts/discharge summaries and/or medication lists
with patient information. The unit management will reserve the right of following the privacy
breach procedure that does include notifying the IT security department and attending preceptor
which may impact the rotation evaluation of your professionalism.
Conference/Teaching Rooms
ROOMS 9333 & 9340 are available for our IM teaching teams to use. If you use one of these
rooms please:
• Do not leave any personal belongings or bags in these rooms – day use lockers and coat
hooks are available in the service corridor for your use. Please bring a lock and remove it
at the end of your shift.
• If you use one of these rooms for a break or lunch please remove your containers and
garbage.
• Remember to log on and off the computers and ensure that you are using AHS
equipment in accordance with the IT security appropriate use policy. 6
Procedure Room
Room 9320 is a shared procedure room equipped to support the completion of a variety of
invasive procedures on the IP unit. We have provided a supply cart and stock of the most often
required items for many of the procedures that IM and Pulmonary physicians perform.
• Notify the Clinician on Unit 93 that you will be using the room, when your procedure is
complete and if the patient is not from Unit 93/94.
• If the patient will require conscious sedation, there is a protocol that needs to be
followed. Advise the Clinician who will involve one of the clinical nurse educators. The
latter will provide valuable support to ensure the patient’s safety.
• Unit nursing staff can not be responsible for monitoring, recovering and returning any
patients who are not admitted on Unit 93/94.
• Ensure that you clean up after your procedure with particular attention to sharps and
biohazard waste.
• Do not remove supplies from this room for use on another Unit. These are provided for
the 93/94 service patients.
• A portable ultrasound machine for use in procedures is available in this room. It must be
returned immediately after use cleaned with Virox wipes (not Cavi-Wipes), locked and
plugged in.
Schedules/Assignments
Please ensure that your assigned patients are clearly identified to the Clinician/Charge Nurse.
Use the assignment board or provide your patient list to ensure that all Unit staff is aware of
whom to call for each patient.
Discharge Planning
Please communicate clearly the intended care path for your patients including an anticipated date
for discharge. This is very important to facilitate the planning required for all other services
involved in the patient’s care and successful discharge.
Diagnostic Imaging
All routine DI tests are to be done in the DI department. Orders for chest X-rays should not be
requested as portable or ‘STAT’ unless the patient is significantly unstable.
Pages
• Please ensure that the Unit staff (Unit clerk or Charge) has your correct pager and is
aware of your patient assignment and the patients/teams that you are covering overnight.
This will help to avoid a delay in care when Unit staff is trying to contact a physician.
• Please call the Unit ASAP after you are paged as they are instructed by the Nursing
Manager to page the attending if they are unable to reach a Resident in a timely manner.
• It is a good practice to check in with the Unit Charge Nurse for any outstanding
housekeeping items and address them before retiring/ leaving.
Families
Our support teams often arrange family meetings and multidisciplinary care conferences that you
are welcome and encouraged to participate in as part of your learning. 7
Information
for
the
First
Day
of
the
MTU
Rotation
Block
Clinical Clerks:
At the start of each 3-month Medicine/ER block, clinical clerks are required to attend the
mandatory orientation that is held at the University of Calgary. As soon as possible
following this, the clinical clerks are to report to the Unit 93 nursing station to find out their
team and preceptor assignment.
All Trainees:
At the start of each block, clinical clerks (at other times than the situation above) and
residents are to report to the Unit 93 conference room to find out their team and
preceptor assignments at 0800. Handover of patients from the on-call team will occur at
that time with patient lists being printed by the on-call team.
At 0830, there will be a mandatory orientation session led by a pharmacist and charge
nurse to provide useful tips on the functioning of the MTU. Trainees are to meet with
their preceptors after this for introductions and determination of how the day will proceed.
Ideally, trainees should determine their personal educational objectives, which will vary,
based on their home program. You are encouraged to discuss these objectives with your
preceptor. Your preceptor is there to help you to achieve these objectives, while
ensuring that proper patient care is delivered. Please do not hesitate to open discussions
with your preceptor should you feel that your educational objectives are not being met. It
is always better to deal with a problem earlier rather than later. 8
Daily
Weekday
Housestaff
Responsibilities
on
the
MTU
• Patient handover: MTU team members are asked to be present at 0800 in the U93
conference room for patient handover from the overnight on-call team.
Overnight issues are the first to be handed over to each respective team.
When presenting the newly admitted patients, please try to be succinct (i.e. try not
reading your entire admission note verbatim). Briefly describe how the patient came to be
admitted and outline diagnosis/problem list along with what treatment or investigation
plan was started. Be sure to underline any particular immediate concerns that you may
have that require immediate attention.
The handover period should last no more than 30 minutes to allow for morning
report to start on-time.
• Patient assignments: Following patient handover, patients are to be divided among
team members for the day. Whenever possible, patients should be followed by the same
team member to provide continuity of care.
After designating a team member responsible for each patient, please report these
patient assignments to the respective Nurse Clinicians on Units 93 and 94. They will
transcribe these assignments onto the patient board.
For patients admitted overnight and are still in the ED, the attending staff will be called
with issues until they come up to the ward.
• See your patients effectively: Always try to see the newly admitted patients or any
patients who have become unstable overnight FIRST.
It is better practice to see your patients immediately without dwelling excessively on the
laboratory results (unless critical), or on the charts. Save writing notes for until you have
made sure that all your patients are stable.
Do not hesitate to page your attending staff immediately if you have ANY concerns
about a patient appearing or becoming sick.
• Review lab work: Address critical values immediately. Ensure tomorrow’s labs are
ordered and are necessary.
Laboratory test for patients with central lines or PICC lines are ordered as “Unit to Collect”
on SCM. Most provincial laboratory results such as TB smear and Respiratory Viral
Panel for influenza are now available on SCM and on Netcare.
• Review medications:
a. Know what is ordered and why.
b. Cancel old PRNs that aren’t needed.
c. Ensure medications such as antibiotics have appropriate stop dates.
d. Mark medications as “reviewed” and renew appropriately.
e. Consider DVT and GI Prophylaxis when appropriate.
• Discharge planning:
a. Preventative Health – Ensure your patient has received all eligible vaccinations
b. Patient Education – Ensure your patient knows what to do if their condition recurs
or worsens and has a plan that can try to avoid coming to the ED. 9
c. Transition Services and Social Work – If these valuable allied health
professionals can help in your patient’s discharge, consult them early and when
appropriate. Keep them aware of discharge plans so they can arrange for the
services to start in a timely manner (i.e. home care services, emergency
medication assistance).
d. Medication Review – The MTU pharmacist can provide counseling and a
medication schedule for your patient prior to discharge. These are especially
helpful when there are many medications with complex scheduling.
e. Discharge Prescriptions – These can be printed directly off of SCM. Try to
remove all unnecessary PRNs and suspended orders first.
Patients on the Med-Assist program through home care (making sure
patients take their medications properly) or who need blister packing of
their medication need their final prescription faxed to their pharmacy 24
hours before discharge. The MTU pharmacist can assist with this.
f. Follow-up Appointments – whenever possible, ask the Unit Clerk to book
appointments before the patient is discharged. Record appointment dates,
locations, and contact numbers in the chart AND in the discharge summary
provided to the patient.
Two clinics are available to patients being discharged from the MTU as part of
efforts to reduce hospital readmissions. MTU patients can be referred to the RGH
MTU follow-up clinic if it is for one or two clinical issues that will likely not need
ongoing care. They can also be referred to the Complex Internal Medicine
clinic if they have two or more medical issues that fit the criteria of the clinic for
longer-term follow-up by internal medicine. Referral forms need to be filled and
faxed along with the discharge summary.
• Write a note every day: – Patient ID and date and time always! Every patient gets a
daily note. Use SOAP format. Clerks must review their patients/notes with a Junior
resident on a daily basis.
a. ID – one or two line summary of patient (ie: 73yo M admitted 5 days ago with
AECOPD)
b. Subjective – descriptive summary of clinical status, overnight issues (ie: O2
requirements decreasing. Afebrile overnight. Feels “Well.)
c. Objective – record vitals, physical exam and relevant lab work
d. Assessment/Plan – issues based, numbered ie:
i. AECOPD – day 4/5 prednisone 50mg (then stop), 4/5 Levoflox
ii. DM2 – diabetic diet (tolerating), Metformin restarted
iii. Disposition – OT/PT to assess safety to discharge home
• Discharge summaries: A typewritten discharge summary on SCM is to be completed
on the day of discharge. Under the “Documents” tab, press Ctrl+E and type Discharge
Summary – Medical to start. Ensure the diagnosis list is complete. You will not be able to
finalize the document as this role belongs to your attending.
A copy can be printed for the patients either for their records or such that they can give it
to their primary care physician if it is within the next few days. A paper copy will be sent to
their physician if this is indicated on the “CC list”.
• New daytime admissions: The IM consultation service will usually admit patients to the
MTU/GMU teams during the day with a view to balance the numbers as much as
possible. Should the consultation service be very busy in the afternoon, MTU team
members may be asked to see patients once the major part of the day’s work is done
with the patients already admitted.
• Teaching sessions: Housestaff are required attend all teaching sessions on on-time.
They are priority unless your patient is unstable and please try not to be late out of 10
respect for the teacher. Kindly remind your preceptor of the necessity of attending
rounds if they have lost track of time. See schedule on the next page.
• Update the electronic sign-over record: This is a mandatory part of the end of the day
for each team member and the patients for which they were responsible that day. This
document allows the on-call team to know the active issues for each patient and
streamlines the handover process. In SCM click on the ‘Patient Info’ tab, then click
‘Health Issues’ on the top left-hand side, double click an issue to edit, or click the bottom
left ‘Health Issues’ to create a new issue. To print the report, go to Reports (printer
button) and select “Medicine/Pediatrics Handover Document”.
• Call for help right away! Assess all patients personally with any change in status and
document. If your patient is unstable or you are worried, call/page your preceptor right
away. Your preceptor is there to help you, so don’t risk patient safety because you are
unsure or don’t want to appear “dumb”.
• Leaving early (ie: for FM call back): If you must leave before 1700H on any given day,
please notify your preceptor. Sign out to your team members on-call and ensure that
your patients are discussed in sign-out rounds. If you must leave early and there are no
other residents available that day, it is your responsibility to contact the on call resident
for that day and provide a sign over.
• Evening Sign Out Rounds: Housestaff from each team must meet with the junior
resident and clinical clerk on-call at 1645 each weekday (conference room on unit 93), to
provide a list of their patients and to relay potential problems. Present your patients
succinctly, giving an Identification, relevant Past Medical Issues, Reason for Admission,
Present Active Issues, and Anticipated Overnight Problems. Outstanding lab or other
reports which require follow-up should also be handed over. Most medical errors
affecting patients occur during the “handover” process. It is essential that problems and
potential problems are clearly outlined to the individual on call who will be taking
responsibility for these patients. Please ensure the SCM handover document is
accurate (instructions above).
• Clinical clerks to ensure orders are verified: To help in increasing experience, clerks
are encouraged to enter orders in SCM for their patients. However, in doing so, they are
also solely responsible to ensure that these orders are indeed verified by either a resident
or preceptor. It can be dangerous when an order that was believed to have been put in,
ended up not being executed due to it not being verified. 11
RGH
Teaching
Rounds
Schedule
Monday Tuesday Wednesday Thursday Friday
On-call On-call On-call On-call On-call
8:00-8:30am handover (Unit handover (Unit handover (Unit handover (Unit handover (Unit
93 Conf Rm) 93 Conf Rm) 93 Conf Rm) 93 Conf Rm) 93 Conf Rm)
Preceptor
Morning Report Morning Report Nephrology
8:30-9:00am Rounds (MTU
by IM senior by IM senior Rounds
attending)
9am-12pm
MTU Mock
ID/Nephro
Simulation Code Rounds/
(Room 4A187)
Teaching CPC Rounds JAMA Rational
OR Academic Half-
12pm-1pm (Simulation (Rm 10331/30), Clinical
Simulation Day
Lab) Examination
(Simulation lab)
*lunch provided Rounds (Unit
*lunch provided
93 Conf Rm)
Medical Grand
1pm-2pm Rounds (Rm
10331)
3pm-4pm
4:45-5pm Evening sign-out (Unit 93 Conference Room)
Please see “Room Information” below for location of above rounds
Up-to-date information about teaching rounds including location and dates are announced on the
following websites hosted by the Department of Medicine:
RGH IM teaching events: http://www.departmentofmedicine.com/rounds/rounds.htm
RGH IM clinical simulation teaching events:
http://departmentofmedicine.com/education/rgh_simulation_centre/calendar.html
All trainees are expected to attend all offered teaching opportunities. Please arrive on-time
for these sessions.
Room Information
th
Unit 93 Conference Room: Located on the 9 floor of the Highwood building, first door on the
right upon entering Unit 93.
th
Room 10331/30: Telehealth meeting room located on the 10 floor of the Highwood building, all
the way to the end of the meeting rooms.
Simulation Lab: Located in the basement of the Highwood building adjacent to the Rehabilitation
Medicine department at the end of the building opposite from the cafeteria. Follow signs to
Simulation Lab.
Room 4A187: Located on the main floor of the Holy Cross Ambulatory Care Center, through and
behind the Internal Medicine Clinic. 12
RGH
MTU
On-‐Call
Structure
and
Expectations
• The on-call team is responsible for attending to the medical needs of patients admitted to
the two MTUs and for patients that are admitted from the ER after work hours.
• On weekdays, call begins at 1700 and ends at 0800 the next morning. On weekend and
statutory holidays, call starts at 0800 and also ends at 0800 the next morning.
• The on-call team generally consists of one junior resident from one of the MTU teams
and one clinical clerk from the other team such that no two members of the same team
are post-call the next day.
• The on-call team must receive handover for overnight issues for patients prior to the start
of call.
• An IM night float senior resident is on call every evening from 2000 to 0800 the next
morning. The senior is responsible for fielding calls from the ER and deciding if a patient
is appropriate for admission to the MTU. They also assist the junior resident and clinical
clerk on call with the overnight care of the patients admitted to the two MTUs by providing
supervision and advice. The clinical clerk and junior resident must review their cases with
the senior resident during this period.
• Between 1700 and 2000 on weekdays and 0800 and 2000 on weekends, the attending
staff on-call will receive calls from the ER for requests of admission of patients to MTU.
During these periods, the clinical clerk and junior resident will review their cases with the
preceptor directly.
• Patients are to be admitted to the service of the preceptor on call for that night, which, on
some nights, may be the GMU.
• To provide the clinical clerks with more on-call experience, they will be first call for ward
issues for BOTH teams unless it is for a medication issue. The junior resident is second
call and clinical clerks should discuss their assessments and plans for all ward issues
with them. Again, any sick/unstable patients should also be reviewed with the Senior
Resident (2000 to 0800) or staff (1700 to 2000). RGH IM preceptors are always willing to
come back to the hospital to help.
• The patients on the GMU team will be covered by the on-call Clinical Assistant. If you
receive calls about patients on the GMU team overnight, please direct the caller to call
the Clinical Assistant on-call, listed in ROCA under Internal Medicine – General Medical
Unit.
• Housestaff on the MTU are NOT responsible for covering patients under the care of
other services (including the GMU). If you receive a call or page for a patient admitted
to another service, please explain to the caller that they must direct their request to the
attending physician (Surgeon, Hospitalist etc - listed under the ‘Patient Info’ tab in SCM).
If this is a new consultation for internal medicine for a patient admitted to another service,
the attending physician on-call for IM Consults should be contacted directly by the
consulting service.
• Over the weekend, you will be asked to round on the patients on your own MTU team.
After receiving hand-over for overnight issues and new admissions, please start rounding
on your own team’s patients, preferably starting with any new and unstable patients.
Each of the attending staff will be responsible and present for rounding on their own
teams over the weekend. You will not be alone rounding on your team. Whenever 13
possible, an extra resident may be assigned for a day assignment only. This resident’s
main role is to help with rounding but may also be asked to see an admission in the ED if
it gets busy. Although this resident’s official duties end at 1700, they may be dismissed
earlier.
• As per PARA, those residents who have been on call overnight will be allowed to leave
the hospital by 1000 and will not be assigned any new clinical duties between 0800-1000.
Housekeeping duties (chart notes, following up labs and discussing any issues with your
preceptor) are acceptable duties during this time. We are committed to ensuring that
timely departure of post-call residents is strictly enforced. Please let the MTU
director know if this is not happening.
• Junior and senior residents are asked to enter an “Admit to RGH” order as soon as it
becomes apparent that a patient will need admission to hospital, even if the rest of the
admission orders are not yet entered. This will allow the ER to begin the admission
process and improve flow through the department.
Call Room Information
Senior and Junior IM residents:
The designated call rooms for you are located in Medical Education, near the ICU/CCU and ER
entrance. The senior resident is assigned room 4594 and the junior resident is assigned 4596.
The keypad code to gain access to all rooms is 1234* (one-two-three-four-star).
Clinical Clerks:
Although there are unfortunately no designated call rooms for clinical clerks on IM services at this
time, they usually will have access to the sleep rooms located in the Rehabilitation Medicine
department in the basement, in the direction opposite to the cafeteria (next to the Simulation Lab).
We hope that when there is more hospital “real estate” available, we can provide better
accomodations.
The sleep rooms are intended to provide on-call physicians a place to sleep. They are not
reserved on-call rooms and should not be occupied “just in case”. Use your keycard to access
these rooms. They can only be locked from the inside.
On very infrequent occasions, there may be instances when there are no sleep rooms available.
The recommendation from the IM Clerkship Committee is that clinical clerks should then advise
their resident of this fact and leave by 2300. They will be expected to be present for their duties
the next morning as usual.14 MTU Bootcamp The MTU Bootcamp is a simulation-based activity that is designed to help residents in their approach to frequently encountered clinical scenarios while on-call on the MTU. Rationale: This is a unique experiential learning opportunity designed to address residents’ concerns to deal with acute issues while on call for MTU. This is NOT an assessment or evaluation tool of residents. Completion of one 4-hour MTU bootcamp session is not mandatory or a prerequisite for passing the MTU block. That being said, it is strongly recommended, especially for learners who have not been on-call for an acute medical service for more than 3 months. Organization: Each individual resident would have to complete one full 4 hours block, preferably on same day. This is a one-on-one learning opportunity so it can accommodate up to 2 residents maximum per time block. You need to bring with you your own stethoscope. You can bring any electronic or pocket resources in case you may need to use it for consultation. Scheduling: Residents would receive an email with an attached list of availabilities of the simulation lab and team. The dates are usually on Thursday afternoons or Friday mornings. Residents can sign up by replying back with preferred dates. Confirmation is on a first-come, first-served basis. Dates will be circulated very early during the academic year to allow you early planning. Please note that your choice to time block should not be in exchange for time on a clinical rotation. It is an educational activity that should come from personal education time as an adult learner. We will send your program director a letter with details of your participation, along with a certificate of achievement describing your dedication to your own learning and commitment to patient safety and quality of care that can be added to your resident's file of home program. While it is preferable to complete the 4-hour MTU block prior to start of MTU rotation, many residents still found it useful, even when they completed the MTU bootcamp session after MTU rotation since we cover several medical presentations that are common in any other rotation. Structure of MTU bootcamp session: 10 minutes: introductions and orientation. 5 minutes signing simulation and confidentiality agreements. 100 minutes: high fidelity simulation of 4-5 acute medical presentations including feedback. 10 minutes: break 100 minutes: high fidelity simulation of 4-5 acute medical presentations including feedback. 10 minutes: feedback and evaluation of training session. Contact Information: Dr. Ghazwan Altabbaa, Tel 403 943 8693 ghazwan.altabbaa@albertahealthservices.ca Location: RGH IM Simulation, Rehabilitation Medicine
15
Other
Important
MTU
Related
Information
Vacation and other leave requests:
Please review the PARA agreement: http://www.para-ab.ca/agreement/collective-
agreement/article12-vacation
The RGH MTU follows the policy set forth by the Internal Medicine Training Program. The
complete vacation policy can be found at:
http://www.departmentofmedicine.com/education/policies.html
• Residents in the IM program are to submit their requests through the residency training
program as they would for any rotation at any other site.
• For residents not in the IM training program, vacation requests must be directed to the
Office of Medical Education (Ms. Monica Horne) at least 56 days before the first day of
the rotation.
• An average of 7 juniors are allocated to RGH. Up to 1 junior resident per site is permitted
vacation or educational leave at any one time. Leave is granted on a first come, first
served basis. When two residents request the same vacation period, the first resident to
submit a request shall prevail.
• Vacation or educational leave is not granted during the CaRMS R-1 interview period.
Feedback and evaluations:
Residents and clinical clerks should ideally be having regular evaluations with their preceptor.
This can generally take the form of a verbal informal evaluation after a week to identify major
issues and weaknesses that could be improved upon by the end of the block.
The resident should send a midterm evaluation through the one45 system to the preceptor two
weeks into the rotation for a 4-week block or four weeks into an 8-week block. For most residents,
the MTU director will be responsible for distributing the responsibility for completing the final ITER
to the appropriate attending staff. Whenever possible, this staff chosen will be the one who has
spent the most time with the resident or clinical clerk at the latest time in the block. Depending on
resident vacation or leaves, this may not be the staff on the last day of the block.
If you are having trouble getting the preceptor to complete your ITER after a reasonable amount
of time, please notify the MTU director who, along with Monica Horne, will endeavor to get it
completed.
Storage of personal items:
Please avoid storing your personal items (jackets, bags) in the Unit 93 conference room. This is
not a secure location and impedes upon the room’s use by other groups.
There are a number of lockers designated for use by residents and clerks that are located on Unit
93 for day use only, and require the user to bring a lock. Please ask at the nursing station for
the location of these lockers.16 General Objectives of the MTU Rotation The main objectives of the Internal Medicine rotation at RGH including MTU, GIM consults and clinics is to development competencies around the Royal College CanMEDS roles: Medical Expert: as applied to illnesses on the inpatient medical service (MTU) when working in direct contact with the admitting internist in addition to the role of the consultant on the GIM consults, GIM outpatient clinics, urgent assessment clinics, and preoperative clinics. Communicator: Learners will be communicating with their patients, attending staff, colleagues allied health services, consultants, families and emergency room physicians. Collaborator: Learners will be working with ancillary health services, other residents, students and consultants whether on the MTU or other GIM services. Manager: Learners will be working in different inpatient and outpatient settings with exposure to managerial skills needed for such practices as discussed with unit managers and attending staff. Health Advocate: Competencies as per GIM but particularly applied to the Urban community hospital setting and patient population. Scholar: Learners will be discussing their patient care with attending staff and consultants with emphasis on providing evidence based care which brings to the surface opportunity for research ideas and gaps in knowledge dissemination. Professional: Learners will be demonstrating a commitment to patients, staff and society through ethical practice.
17 Attending Staff Contact Information The following are the pager numbers and email addresses for the attending staff of the Division of General Internal Medicine at Rockyview General Hospital: Name Pager # E-mail Address Dr. Anna Purdy 05290 purdy04@telus.net Dr. Ghazwan Altabbaa 00049 ghazwan.altabbaa@albertahealthservices.ca Dr. Horacio Groshaus 11594 hgroshaus@shaw.ca Dr. Jan Sporina 03206 sporina@telus.net Dr. Johan Conradie 07222 conradie@shaw.ca Dr. Jonathan Yau 04594 jonathan.yau@albertahealthservices.ca Dr. Khan Ali 02384 khanali@hotmail.com Dr. Michele Burns 04187 michele.burns@shaw.ca Dr. Oliver Haw For Chin 06285 oliver.hawforchin@ucalgary.ca Dr. Sandeep Deol 10755 sandydeol46@hotmail.com Dr. Xiumei Feng 01716 xiumeifeng@shaw.ca
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