College of Medicine - University of Illinois Urbana-Champaign

Department of Internal Medicine

Clerkships

Medicine II

ICU Sub-internship Track

Goal
The goal of the rotation are to expand the student’s
knowledge and understanding of internal medicine issues
affecting hospitalized patients, primarily focusing on
appropriate diagnostic and therapeutic interventions and
to provide the opportunity for the student to assume a
more primary role in the responsibility of directing care
of a patient.  Inherent in this experience is an opportunity
for in-depth learning in the areas of professionalism and
systems-based practice as the student will function in many
respects as an intern for his or her patients, albeit with
supervision by an attending physician and a senior resident. 
The elective will encompass the learning of integrative skills,
procedures and how to handle basic clinical scenarios.  By
assuming more direct responsibility for developing the
diagnostic and therapeutic plans for his or her patients, the
student will engage in a formative experience designed to
prepare him/her for the future care of patients. This track is
designed to be rigorous with high performance expectations
of the students, similar to a sub-internship experience on the
general medicine wards.  We expect that this elective will
provide experiences allowing the student to begin an internship
well prepared and comfortable with that role.   
 
Objectives

Patient Care
The student will be expected to demonstrate skill in case
presentation in a logical and succinct manner.  In addition,
longitudinal tracking of patient data and coordinating care
with other health care workers is a requirement of the rotation. 
The student should be able to recognize clinical scenarios and
be in a position to initiate appropriate care with supervision. 
Prioritizing clinical duties/sign out lists, identifying adverse
drug reactions/ interactions, ethics of informed consent
and use of electronic databases will be required. 

Medical Knowledge
During this rotation the student should demonstrate skill
acquisition in the management of commonly encountered
medical issues.  The student’s knowledge will be evaluated
based on how he/she plans to care for the patient.  Scholarly
reference to standard medical textbooks and the literature is
expected during this rotation. 

Practice-Based Learning and Improvement
The student will develop a program of self-guided learning
based on case exposure and resources provided at the start
of the rotation.  The interventions planned for any patient
must be clarified with a senior resident or the attending
physician, before being implemented.  The end of rotation t
est will be used in addition to evaluate the adequacy of
self-directed learning. 

Interpersonal and Communication Skills
The student will present concise, well-organized presentations
to the team and/or attending each morning on rounds.  The
student will be expected to discuss the cases with consultants
to formulate a plan of care for their patient.  The student will be
expected to work alongside other members of the care team in a
manner that will benefit the patient.  Professional behavior and
empathy is expected from the student. 

Professionalism
The student will demonstrate respect for the opinion of team
members caring for the patient.  The student will be punctual
in completing assigned duties and demonstrate positive regard
for the patients, family members and all members of the health
care team.  The student must understand that the needs of a
patient come first and it may be necessary to prioritize differently
based on the specific needs of a patient on the team.  The student
is expected to behave as a team member learning from patients
on the team, even if they are not directly involved in the care of
a specific patient.

Systems-based Practice
The student will demonstrate appropriate interaction with
members of the health care team and recommend appropriate
consultations as needed.    It will be expected that the basic
workup for the patient is undertaken prior to calling for
consultations.  The student should be able to recognize an
emergency and demonstrate the ability to initiate the appropriate
intervention (with supervision).  The student will function as an
integral member of the team. 

Teaching Methods

Experiential and didactic as well as self-directed teaching
methods will be employed throughout the rotation.  Students
will complete the initial evaluation and then present the cases,
with a formulated plan for investigation and care of the patient. 
The student will be expected to communicate treatment goals
and the rationale for a plan of care. 

Students will be expected to attend relevant conferences during
the rotation.  These will include grand rounds, clinical-pathological
conferences (CPC), journal club, research lunch n’ learn, tumor
board and other core conferences. 

A list of common clinical scenarios will be provided to the
student and it is expected that over the course of the 4 weeks
there will be opportunity to discuss most of the scenarios.

Evaluation of the student
The student will be given feedback by the attending physician
midway and at the end of the rotation, and throughout the
rotation as situations and circumstances dictate.  The student
will be evaluated using the RIME form and the evaluation will
be viewed with the student.  Any feedback from other members
of the health care team will also be provided to the student.  

Evaluation of Faculty and Clerkship
The student will evaluate the faculty with whom he or she
worked on the rotation and also evaluate the clerkship experience
on standard survey instruments provided by the Department
of Internal Medicine.

Supervision
The student will be supervised by the Attending physician
and a senior Internal Medicine Resident on the rotation. 

ICU Clinical scenarios that should be reviewed:

• Respiratory distress
• Chest pain
• Altered mental status
• GI bleeding
• Fever in the hospitalized patient
• Acute pulmonary edema
• Hypokalemia/hyperkalemia
• Abdominal pain
• Severe hypertension
• Shock
• Inpatient glycemic control
• Acute renal failure
• Arrhythmias
• Anaphylaxis
• Alcohol withdrawal
• Seizures
• Venipuncture
• Arterial puncture
• Peripheral intravenous line placement

Procedural skills
The student will be expected to maintain a log of the various
procedures performed during the rotation.  The required
procedures are available on the clerkship website.  These
procedures must be done under the supervision of a
credentialed physician.

References:
Harrisons, Cecil, Washington Manual, UpToDate

(Back to Medicine II Description Page)

9/4/08

• Internal Medicine Clerkship
• Goals & Objectives
• Rotation Schedule
• Medicine I
• Medicine II
• Clerkship Manual Medicine I Core
• Electives
• Ambulatory Medicine
• Mandatory Procedure Requirements
• Additional Resources
• Evaluations