University of Illinois
College of Medicine at Urbana-Champaign
Internal Medicine Residency Program

Program Policy

PURPOSE:     To assure progressive primary patient responsibility and clear communication in patient care.

POLICY:         Residents must write all orders for patients admitted to teaching services with two exceptions: 1. emergencies which immediately threaten patient welfare; 2. orders for subspecialty procedures (e.g. chemotherapy research protocol; bronchoscopy).

PROCEDURES:

Appropriate communication must exist between the resident team and the attending of record to assure that all orders are written by residents.  During regular hours, the attending of record should round with a member of the resident team during the attending’s daily management rounds.  If this cannot occur the resident should be paged to discuss needed orders.  A recommendation in a progress note is least desirable.  When the attending of record is contacted by nursing staff for orders on a teaching service patient, that nurse should be referred to the assigned resident.

Residents who fail to order timely and appropriate care will be counseled by the attending of record and then, if necessary, by the chief resident and or the responsible site coordinator.

Attendings who fail to comply with the program requirements will be counseled by the responsible site coordinator or chief resident.  Repeated violations occurring after adequate counseling will subject the admitting physician to a period of observation and additional counseling, followed if necessary by suspension of privileges for admitting to teaching services.

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