College of Medicine - University of Illinois Urbana-Champaign

Department of Internal Medicine

Clinical Training Sites

Veterans Affairs Medical Center

A. ORIENTATION

Students meet with Medical Service Administrative Officer, Mrs. Calhoun, at 7:45 a.m. for orientation to the VA. Her office is on the third floor of Building 58, Room 350. Orientation will include a short tour and introduction to staff and nursing

B. GENERAL INFORMATION

Pagers
Second and third year residents carry U of I beepers routinely

Meals
No meals are provided for the student. Quarters 35 is available and has facilities for cooking. Refrigerators are on the ward. VA Canteen is located in 104 and has a full menu. Hours of operation are 8:15 a.m. to 3:45 p.m.

Parking
Students will be issued a parking sticker that allows them to park in any space that is not restricted. Most parking is in the huge lot by the greenhouse, across from Building 58 – Lot E.

Mail
Mail should be directed to correspondence symbol (111). Wards have outgoing and incoming mail location.

Holidays
Students are not on call during holidays or holiday weekends. In most cases, students are excused from patient care for approximately one week during the December holiday season.

Call
Students will be assigned to night call approximately once every fourth night. Call is served with the resident that you are assigned to. If you have prior commitments on the day that you are scheduled to be on call, contact Mrs. Bowen who can rearrange the schedule. Students will be called for admissions and interesting cases. It is requested that you make rounds at the different nursing stations on 58-2, 58-3, and ICU during the evening to let the nurses know that you are available and that you will notify them before retiring to the house for the night.

Housing
Quarters 35 has been provided as a sleeping area for students who are on call or who would rather not travel back and forth from Champaign. When staying at the house, cars should not be parked directly behind the house but in the designated parking area. Clean linens are provided along with cooking utensils. Dirty linen should be placed in bags on the back porch for pickup. Repairs needed should be reported to Mrs. Bowen. There is no outside telephone at the student house. Incoming calls can be directed to the student house by dialing 554-4020. In case of emergencies parties should contact Mrs. Bowen who will get in touch with the student.

Telephones
Telephones are not to be used for personal business. When placing calls, the FTS line will be used. Please ask Mrs. Bowen or one of the secretaries to help you place your call until you are familiar with placing FTS calls.

Copying
There is a copy machine on 58-3, Room 311

C. DAILY SCHEDULE

Please see schedule section.

Each student must have a written work up of two to three patients per week. The work up may be obtained from admissions, clinic patients, and/or consultations.

Each student will present at least ten patients at teaching rounds during the rotation. Physician Assistant students will be asked to present to one of the full-time PA's or to Dr. Marshall weekly.

Write-ups are to be reviewed by the recipient of the presentation. Each student is responsible for the history, physical examination, and progress notes. The student is also responsible for writing a set of orders. This may be accomplished by writing orders reviewed by:

• Staff Physician
• Resident
• Health Care Practitioner
• Special Care RN

If orders have been written prior to student finishing his work up, he is to write a suggested set of orders as part of his plan. This is done for a learning experience. Students are also responsible for reviewing the laboratory data including x-rays and EKGs.

It is expected that each student read a minimum of two references for each patient he works up. Students are encouraged to use standard texts and ask staff or residents for suggestions.

D. LIBRARY

The Medical Library is open 24 hours per day, 7 days per week. After hours, the key for entrance to the library is obtained from the senior resident on call.

E. TELEPHONE NUMBERS

F. KEY PERSONEL

G. DICTATING INSTRUCTIONS

All Dictations:

1. Pick up the phone receiver in a quiet area.
   Dial 7 to access the machine.
   Dial 1 to dictate.
   You will hear a steady tone after dialing 7, once you dial 1 to dictate this steady tone will disappear
2. State your name.
   State the type of dictation; i.e., history and physical examination, final discharge summary, transfer summary, progress note, consultation, clinic note (includes clinic follow up progress note).
   State the number of copies desired.
3. State and spell the patient's full name.
   Dictate the entire Social Security number (all 9 digits).

H. DISCHARGE SUMMARY

After STEPS 1 through 3 above, begin dictation with FINAL diagnoses--Diagnosis #1 should be the diagnosis responsible for the major part of the patient's stay; then, remaining diagnoses in order of clinical importance for which treatment was given.

List all operations/procedures performed during current hospital stay, including dental procedures and give dates for each operation/procedure.

Body of summary should include the following:

• Reason for hospitalization
• Significant findings (brief history, pertinent physical findings)
• Course in hospital
• Treatment given
• Condition of patient on discharge
• Specific instructions given to patient and/or family (includes instructions relation to physical activity, medication, diet, and follow up care)
• Date patient is able to return to employment (if applicable)
• Medications furnished upon discharge
• Competency opinion (if applicable--only for those patients with final psychiatric diagnosis)
• Follow up care recommended

History and Physical Examinations
These dictations are automatically given priority transcription but it is up to the dictator to identify the dictation properly for expedition.

Consultations
The original referral consult should be sent to the Transcription Unit after dictation of the consultation with number of copies specified by the dictator.

Stat Transfer Summaries
As above--see Final Summaries.
When completing the transfer summary, DIAL "O" to alert Transcription Unit. WAIT until the operator in the Transcription Unit answers your call. Specify at that time what the dictation consists of; i.e., Transfer to VAMC Indianapolis, date of transfer, patient's name and ward location. The cassette will be retrieved from the machine immediately and transcription will begin

Please Note:

Residents: When dictating final summaries, please indicate the attending physician's name at the beginning of your dictation, as each summary must be co-signed.

Spelling is a very important factor in the quality of the transcription. If unusual dictations, drugs, names, treatments, etc. are dictated without spelling, these items will be left blank to be filled in upon receipt of the dictation. To facilitate our dictation/transcription, please remember to spell.

Please remember you are dictating to a person, not a machine. That person's ears are very precious. Courtesy is appreciated. Speak slowly and distinctly and enunciate for your transcriber.

I. CONFERENCE GUIDELINE

A.M. Conferences
Residents are required to attend and the students are invited to attend when possible. The teaching material will be aimed at the residents.

P.M. Conferences
All students are required to attend and residents are required to attend when they are the presenter. All other residents are invited to attend if possible. The teaching material will be aimed at the M-3, M-4 and PA student.

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