Internal Medicine — Rotation Detail
MTU at Adan
Tutors
MTU Rotation Guide in Adan Hospital
First of all, Welcome to MTU Rotation In Adan Hospital You will be assigned to a side from the beginning of the rotation.
Daily rounds:
• Daily rounds will be assigned to Consultant/Specialist/Senior/R5 from the beginning of the month.
• The daily round schedule is done by Dr. Mohammed Husny and will be available first of the month.
• Daily round will start at 9:30 am sharp.
• Patient’s list and distribution of cases to the juniors will be done by Registrar level or R2 level if Registrar is not available.
• The distribution of cases will be based on the complexity of the case itself.
• Maximum active cases assigned to an Assistants level is 5 + 1 chronic case.
• Maximum active cases assigned to a trainee is 3.
• In case of each junior reached maximum number of cases, extra cases should be seen by registrar level.
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The Daily work and responsibilities:
A) R1/R2:• R1/R2 residents, must assess patient clinically and examine them daily. They also should check on the most recent investigations as well as review their files prior to the round. They are also responsible of reviewing medication lists daily.
• R1/R2 residents are responsible for writing daily progress notes as well as documenting the notes in our electronic system sapphire.
• They are also required to check on the previous care plan in order to make sure the plan has been completed.
• At this level R1/R2 resident should be able to formulate an initial management plan for their patients in order to discuss the plan during the round with their seniors.
• They are also responsible of writing Handover Notes or SBAR notes of their patients if required.
B) R3/R4:
• R3/R4 residents are responsible of distributing and assigning cases to the juniors according to the complexity of the case.
• R3/R4 residents are responsible of tracking and reviewing the junior progress notes as well as adding addendum notes if required.
• They are expected to review the cases with the juniors prior to round, in order to provide initial management plans as well as teaching materials to the juniors.
• They are expected to lead the round daily
• R3/R4 residents are responsible of reviewing discharge summary prepared by the juniors as well as discharge medication, discharge instructions, and follow up plan
• They are also responsible of reviewing handover/ sbar sheet or transfer of service notes written by juniors.
C) R5:
• R5 are expected to do all the tasks of R3/R4 residents in addition to being responsible of the round and being able to formulate proper management plans to the patients. -
Oncall Duties and Responsibilities:a) General Rules:
• On call starts from 8:00 am until next morning 7:59 am.
• On call are divided into two shifts however residents expected to be available throughout the 24 hour period in case of emergency.
• Residents are expected to always respond professionally to any calls from nurses, emergency physicians and other colleagues throughout their entire official on call coverage hours.
• Assistant registrars (R1/R2):
● They are expected to cover ward calls and supervise trainees during on calls.
● They are expected to clerk all new admissions to the medical wards by documenting admissions notes, reviewing investigations and carrying out plans written by admitting doctors.
● They are allowed to assess cases in ER (observation room only) under direct supervision of registrars (R3/R4)
● R2 residents in core stage are expected to perform duties as acting registrar with supervision of his senior.
• Registrars (R3/R4):
● R3/R4 residents are responsible for receiving and evaluating consults from the casualty.
● They are responsible of admissions, formulating and completing the management plan their patients (e.g., ordering investigations and medications).
● They are expected to supervise assistant registrars and trainees and if needed, attend sick patients in the ward.
● R3/R4 must lead the code blue in medical ward in case of arrest.
• Senior registrar (R5):
● R5 residents should attend to all new admissions, especially patients who are deemed to be critically ill.
● They are responsible of seeing all consults during on call (urgent and non urgent)
● They are expected to lead the evening round held by the consultant/specialist on-call.
4) PostCall Round and Weekend Round:
• PostCall round and weekend round schedule will be available by the beginning of rotation.
.5)Sick/emergency/vacation:• All sickleaves and excuses should be uploaded to the KBIM website.• Permission should be taken from your seniors prior.
• For 1 month rotation, 7 days leave is permitted.• For 2 months rotation, 14 days leave is permitted.• Holidays and sick leaves are included within your maximum days of leave
.6) Morning meetings:
• Attendance is mandatory in the morning meeting. Participation in active discussion is expected from all levels of residents.
• Attendance is signed through our electronic system starts at 7:30 until 8:00
• Morning meetings are held at IM building 5th floor opposite to ward entrance. • Regular attendance and participation in the discussion will be reflected in your end-of rotation evaluation.
• Expected attendance of at least 80%
• During morning meetings all cases admitted during on call will be presented by assistant registrar (R1/R2) and trainees.
7) Educational activities:
• All Educational activities schedules will be available in the beginning of the rotation on the WhatsApp group. Please make sure you save the schedule in order not to miss any activity.
8) Sapphire system
● It is electronic system used to write your progress notes and request investigation and orders to the nursing staff.
● Contact Dr.Fatmah Boland (94450600) to get your account and training on using the system