Course information
From Iusmicm
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[edit] Course expectations
1. Clinical evaluation of the patient. You will be expected to (a) hone the interviewing skills learned last year and merge the "patient's story" into a medical history format, (b) perform a complete physical examination and differentiate normal from abnormal findings, (c) record your findings in a concise and understandable way, and (d) present this information to your peers and your preceptor.
2. Fund of medical knowledge. You will be expected to acquire sufficient didactic medical knowledge to successfully make the transition to the junior year. This knowledge will be primarily about paradigm problems in the various disciplines. We will focus on fundamentals of disease processes with emphasis on common conditions. You will be expected to integrate basic science information into your growing clinical knowledge base. You will be expected to understand how to gain access to medical information both from reading and electronically. You will also be introduced to basic and fundamental aspects of medical therapy in some sections of the course. You will also develop a rudimentary appreciation of the radiographic findings in health and disease.
3. Clinical problem solving. You will be able to (a) use the hypothetico-deductive approach to clinical problem solving and arrive at a reasonable, albeit abbreviated, list of the patient's problems, and (b) develop a preliminary plan for the further evaluation of this (these) problem(s).
4. Patient education. Patient education will be stressed in lecture and in afternoon tutorials. You will be expected to consider patient education as you develop the assessments and plans for your patients.
5. Other skills. In afternoon sessions in the second semester, you will be taught and given an opportunity to practice the following skills:
- suturing,
- venipuncture,
- arterial puncture (on a mannequin),
- endotracheal intubation.
[edit] Grading
- "Basic concepts of disease will be stressed in all clinical sections. You may also be asked to know basics of therapy as well."
- Honors: Score of 90.0% and higher, High Pass: Score of 84.0% to 89.9%, Pass: Score less than 84.0% and within two standard deviations of the mean score overall at the end of the course.
- In addition students must satisfy their preceptor on the head to toe physical exam and must score above the 11th percentile on the NBME Introduction to Clinical Diagnosis exam.
- Every section exam must be passed or remediated in order to pass the class; pass will be considered "above 2 SDs of the class mean).
- "Preceptor Ratings: Your preceptor will give you a satisfactory or unsatisfactory grade for your performance in afternoon sessions. Regardless of your examination grades, you cannot pass ICM II with an unsatisfactory grade from your preceptor."
[edit] Competencies
•Level 1 Competency: There are six (6) competencies you will be evaluated on. You will either receive a “Satisfactory” or “Unsatisfactory.” The competencies are as follows:
- 1) Effective Communication, #2) Basic Clinical Skills, #3) Using Science to Guide Diagnosis, Management, Therapeutics and Prevention, #4) Lifelong Learning, #5) Self-Awareness, Self-Care and Personal Growth, #7) Moral Reasoning and Ethical Judgment, #9) Professionalism and Role Recognition.
[edit] Peer and self assessment
- Peer and Self Assessment (PSA) is a curricular program for MS1s, MS2s, & MS3s designed to attain Level 1 and Level 2 achievement in Competency 5 and Competency 9.
- Since the 2003-04 school year PSA has become a part of the IUSM
curriculum to help students recognize strengths, areas of potential improvement, and learning goals during medical school.
[edit] Course material: ANGEL
- Angel website (https://angel.medicine.iu.edu) – ICM II course material will be placed on the website.
- For ANGEL website difficulty, please e-mail angel@iupui.edu to report problems.
[edit] Syllabus
- ICM II Syllabus will be posted on the ANGEL – ICM II site (https://angel.medicine.iu.edu) beginning August 2, 2011. You will not receive hard copy of the syllabus.
- Exams are in Emerson auditorium
[edit] Section evaluations
- You will have on-line “section” evaluations to complete for ICM II; please complete these evaluations in a timely manner.
- We are looking for constructive feedback; please don’t feel that you have to wait until the end of a section to discuss questions or make suggestions.
- Your evaluations are reviewed by the ICM II Course Director, as well as the ICM II “Section Leaders” to help improve the course.
- The evaluation information will be distributed via e-mail at a later time.
[edit] Afternoon session attendance
- ATTENDANCE IS MANDATORY AT THE AFTERNOON SESSIONS. If you find it absolutely necessary to miss, please make advance arrangements with your preceptor. We have asked the preceptors to notify us of any unplanned absences and more than one excused absence during the year.
- Please notify @656-4274 if you cannot attend an afternoon session so she can arrange for the (diminished) appropriate number of patients.
[edit] Specialty Physical Diagnosis
One afternoon a week on designated weeks of the year will be devoted to the specific physical examination skills necessary in various specialties. Here you will receive specific instruction in the examinations necessary in the fields of rheumatology, neurology, pediatrics, obstetrics and gynecology, ophthalmology, otorhinolaryngology and urology. The scheduling of these sessions will be made available to you early in each semester.
[edit] Clinical encounter tracking
- Complete the on-line “Clinical Encounter” form located on the ANGEL website (https://angel.medicine.iu.edu). Please complete one form for each encounter you have in the hospitals, clinics, etc. This will be explained during ICM II – Orientation.
- We want you to document all of the patients that you came into contact during your precepting session. We also want you to document your clinical encounter in your SPD sessions as well (patients and/or standardized patients).
- This year, I have defined the minimum clinical encounters that are expected in ICM II. They are listed below. I expect that the students will exceed these numbers (number of clinical encounters during ICM II – 44).
- Pediatrics Exam: 1 performed or observed.
- HEENT Exam: 4
- Musculoskeletal Exam: 2
- Abdominal Exam: 4
- Cardiovascular Exam: 4
- Pulmonary/Chest Exam: 4
- Neurological Exam: 3
- GYN and Breast Exam: 1
- Male GU Exam: 1
- Complete Exam: 4
- Complete History: 8
- Focused History: 3
- Focused Exam: 3
- Complete Physical Examination: 2
[edit] Basic clinical skills
[edit] DATA COLLECTION
At a beginning level of proficiency, you should be able to:
1) Communicate with the patient in understandable language, so that you have dealt with all the issues raised in a "complete history."
2) Perform the components of a "complete physical examination," differentiating normal from abnormal physical findings (or recognizing when further consultation is necessary to determine this).
3) Integrate and arrange in a coherent fashion (prioritizing where possible) the information from the patient interview, the physical examination, and the patient's "old" or hospital record (where this is recommended by your preceptor). You should try to construct a logical framework for the information.
4) Record legibly the comprehensive history and physical in a reasonable length of time
[edit] Clinical Problem Solving
At a beginning level of proficiency you should be able to:
1) Identify from the currently available data a list of problems at their present level of resolution (e.g. an established medical diagnosis, a symptom and/or abnormal physical finding for which diagnoses have not yet been established, an abnormal laboratory test result, or a socioeconomic or emotional problem).
2) Generate a differential diagnosis for each of these problems.
3) Generate an appropriate initial management plan for each of these problems (including plans for establishing or clarifying a differential diagnosis when that has not been done, a plan for treatment, and a plan for patient education).
4) Describe or diagram any possible pathophysiologic interrelationships among the patient's problems.
5) Discuss possible ways, if any, that the patient's current problems might have been prevented; and by what means, if any, the chances of recurrence or exacerbation can be minimized in the future.
[edit] Dressing for ICM
- "Please dress appropriately and wear your white coat/identification badge on your first day of ICM II physical diagnosis (note that "physical diagnosis" sessions are different than "special physical diagnosis" sessions). You are required to wear your white coat and identification badge at all times throughout the year when entering a hospital/clinical setting while participating in ICM II sessions."
- Best not to bring materials other than what you need as there is not always a secure place to store them.
[edit] Textbooks
[edit] Required Textbooks
- I.U. faculty corebooks will be utilized for several of the clinical sections. These will be provided at no charge this year. Other sections will use Harrison’s On-line (Harrison’s Principles of Internal Medicine, 17th Edition), Introductory Textbook of Psychiatry (5th Ed.) or handouts.
- Textbook of Physical Diagnosis: History and Examination, 6th Edition, Mark H. Swartz, W.B. Saunders and Company Publisher.
- Essential Radiology, 2nd Edition, Richard Gunderman, M.D., Thieme Publisher.
- Introductory Textbook of Psychiatry, 5th Edition, Nancy C. Andreasen, M.D., Ph.D., Donald W. Black, M.D., American Psychiatric Publishing, Inc.
- Symptom to Diagnosis: Evidence-Based Guide, 2nd Edition, Stern, Altkorn, Cifu, Lange Medical Books, McGraw-Hill.
- Harrison’s On-line (Harrison’s Principles of Internal Medicine), 17th Edition. Follow this link, then click on AccessMedicine.
[edit] Group 18 info
- GROUP 18 – MEET AT COMMUNITY EAST HOSPITAL FOR ICM II PHYSICAL DIAGNOSIS.
- Physical Diagnosis Preceptors: Drs. Brian Foley, Justin Magid and Michael Nader.
- Students/Preceptors meet on Wednesdays for ICM II physical diagnosis.
- Students meet on Mondays for ICM II specialty physical diagnosis and teaching skills sessions.
- These specific schedules will be posted on ANGEL and the MS II bulletin board outside of Medical Science Bldg., Room B26.
- Initial Meeting Location for Physical Diagnosis:
- Community Hospital East, 1500 N. Ritter, Indianapolis, IN 46219.
- Please meet at Community Hospital East in the Main Lobby, 1500 N. Ritter.
