The inpatient internal medicine acting internship at Maine Medical Center is a combination of experiential learning and structured learning activities. Essential to your education is the daily care of patients as a member of the ward team. In accord with the collaborative work of the Society for General Internal Medicine and the Clerkship Directors in Internal Medicine, our acting internships focus on basic competencies, intended to meet focused needs of a medical degree.
The overall goals of the Acting Internship in Medicine are:
- Consolidate and expand on the fundamental skills in history and physical examinations and case presentation.
- Expose you to the variety and complexity of Internal Medicine in hospitalized and/or ambulatory patients.
- Develop the fundamental behaviors of thoroughness, reliability, and efficiency that will aid you as an intern in internal medicine.
- Develop a knowledge base from patient care experiences, independent study, defined readings and didactic sessions that will enhance your ability as an acting intern.
- Develop skills in the identification and analysis of patient medical problems sufficient to enter an internship in medicine.
- Develop those technical/procedural skills needed to be an intern in medicine.
- Have fun and learn!!
The department emphasizes the development of sound fundamental skills in collecting information from patients and in developing an approach to identifying and addressing the problems patients present. The inpatient internal medicine acting internships provide opportunities for the exhaustive study of illness and disease at advanced stages.
During the acting internship, students will strive for excellence in acquiring the skills needed to be competent, caring physicians. At the end of the month, each student will have advanced their ability to guide data collection and problem solving of a broad spectrum of problems and will demonstrate the skills, attitudes, and behaviors needed to function effectively in the clinical setting.
The department has developed an extensive program to assist you in achieving these objectives. Nevertheless, we stress that your greatest learning comes from reading about your patients' problems and in your individual efforts to improve fundamental clinical skills.
Medical knowledge is not static and must be constantly renewed through reading, lectures, and other forms of self-learning. For this reason, we emphasize the development of sound fundamental skills in collecting information from patients and in developing an approach to identifying and addressing the problems patients present to us as physicians.
While performing an acting internship at Maine Medical Center, our goal is to help you develop interview, exam and medical decision making skills. Our intention is that you will master the following:
- Conduct a focused patient interview
- Perform an accurate and appropriate physical examination
- Provide a prioritized and comprehensive problem list
- Record the information collected and management plans in an organized medical record
- Present the information in a succinct, focused oral presentation
- Describe pertinent testing and possible management
- Describe interventions to modify high risk behavior and activities
- Be able to discuss medical recommendations and choices with the patient and family in a caring manner to help the patient make medical decisions
While undertaking the complexities of medical decision making and making informed decisions, you should begin to incorporate:
- Awareness of the structure and economics of various health care systems
- Awareness of the patient's social and cultural background
- Principles of medical (or clinical) ethics
- Awareness of appropriate community resources
- Knowledge of clinical epidemiology and outcomes research
We understand and appreciate that each student brings different skills, attitudes and ability to acting internships in the Department of Medicine. We ask that at all times you recognize your own personal and professional limitations by requesting assistance as needed, openly accepting criticism to improve performance, showing enthusiasm and a willingness to take responsibility for your education.
All ward teams are led by an R2 or R3 resident in internal medicine with one or two interns, yourself as an acting intern in medicine, and one or two clinical core students from the MMC.Tufts University School of Medicine "Maine Track" or University of New England. The teams meet daily with a Teaching Attending, a full-time faculty member who supervises the overall work of the team. You will be asked to attend and participate in the Teaching Attending sessions, the focus of this program being the clinical work of the team.
As an acting intern, you are a valuable part of our clinical team. The senior team resident will assign you patient care responsibilities that nearly match those of our practicing interns. We expect and rely on you to be assertive in your own education and participating in the ward team.
Each acting intern will have similar responsibilities as our R1 interns. You will have the first opportunity to work up patients admitted to your team and assigned to you by your senior resident.
As an acting intern, you should confirm the accuracy of your histories and physical examinations by comparison with the write-ups and exams by the senior resident. Where discrepancies are noted, students will consult with the resident to clarify the differences.
Acting interns will participate with the team in caring for assigned patients by accepting appropriate and assigned responsibilities for patient management. These responsibilities include:
- Writing daily progress notes
- Obtaining the results of tests
- Performing procedures under appropriate supervision
- Researching medical topics pertaining to the care of team patients
- Communicating with patients and families
You will be asked to make rounds on your own patients before 9:00 AM and before afternoon check-out rounds. The goal of this activity is to stay up-to-date on your patients' conditions, the diagnostic or treatment plans or results, the clinical issues presented by your patients, and the impact of illness and hospitalization on patients and families. You are responsible for obtaining physician countersignature for all orders you write.
We believe that the comprehensive care of your patients should be part of your responsibilities and this should include performing applicable procedures needed by your patient while they are under your care. You will have the opportunity to perform clinical procedures on patients when qualified by experience and ability and with the approval and appropriate supervision of your residents or attending physicians.
We pride our program on the quality of our teaching opportunities. You should attend all scheduled conferences including Teaching Attending Rounds, Medical Grand Rounds, Morbidity and Mortality Conference, and Friday Conference. You will also attend all clinical conferences (radiology, sign-out rounds, etc.) as assigned by your residents. Absences must be approved by your resident and the Medical Education Director. As part of our efforts to improve your education, we ask you to evaluate residents and teachers using the departmental evaluation forms.