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Department: MEPED-Pediatrics
Course: 547-Pediatric Sub-Internship TCH

Course Director: Dr. Mary Rocha
Course Faculty: Dr. Andrea Hauser
Elective Location: TCH
Elective Offered Terms:
Min. Number of Students:Max: 4
Elective Type:
Credit: 8
Pre-requisites: 6 months of core rotations
Visiting Student Elective: No
Open to International Students: No
Grading: H,HP, P, MP, F Narrative Evaluation
Faculty Approval: Yes

Time Commitment Percentage of time expected
Regular Hours (Mon-Fri): 6:00a-5:00p Inpatient Ward: 90
Night Call: Avg every 4-6 days Inpatient consultations: 0
Number on-call nights: 5 Outpatient clinics: 0
Weekends: Yes Surgery: 0
    Laboratory 0
  Didactic: 10
  Other: 0
Statement of Goals:
SATISFIES THE REQUIREMENT FOR REQUIRED SUBINTERNSHIP. The student will demonstrate pediatric intern level knowledge, attitudes and skills. The student is assigned to one of the Texas Children's Hospital's Pediatric Hospital Medicine (PHM) teams, consisting of an attending, 1-2 supervising residents, 2-3 interns, 1-2 clerkship students, and sometimes a PHM fellow. The sub-I admits patients, evaluates all medical problems, and formulates a therapeutic plan under supervision. S/he is responsible for patient handoffs at the beginning and end of shifts. S/he writes and pends orders for co-signature prior to implementation. Admission orders stem from diagnosis specific EBM order sets. Sub-interns are on call an average of every fourth night and are directly supervised by a resident. A faculty member is available at all times. During call, the sub-I is responsible for cross-cover issues on all of his/her team’s patients. Patient-family centered rounds (PFCR) are conducted daily at the bedside with the medical team. Attendance at educational conferences is highly recommended. The resident lecture series is held at noon on weekdays. Morning report is held Monday through Wednesday and Grand Rounds are on Friday. The exact time and location for these conferences varies and may be confirmed with the house staff office.
Learning Activities
1. 3 days off (4th day off is the Sunday in between rotations) 2. Email schedule requests, including LACE dates to the Course Coordinator a minimum of 21 days prior to the first day of the rotation. 3. Requests for specific days off are not guaranteed and will be determined by the needs of the team. 4. Sub-Is are responsible for 4-6 patients (1/3 to ½ of all patients on the team) 5. Sub-I chart documentation is to be reviewed by the supervising resident (not intern) 6. Sub-Is are responsible to contact the supervising resident after evaluating a new patient, and at other times as requested by resident to ensure patient safety 7. After presenting new patients to the supervising resident, Sub-I may then also present directly to the attending, work-flow permitting 8. Sub-Is take full responsibility for patients as demonstrated by: making a problem list, an assessment including a differential diagnosis and a plan, leading the discussion on rounds, requesting consults, following-up studies, updating patient list daily, writing orders and prescriptions, giving and receiving effective check-out, providing cross cover to team patients, facilitating discharges. CALL: 1. Overnight call five times, on average every 4 to 6 days 2. Call no more frequently than every 3rd night 3. Three calls Mon – Thu, and two calls Fri - Sun 4. Call begins 6am – ends after you have safely handed off all of your patients the following day after rounds, usually by 11:00am 5. Participate in sign-out rounds, evening/night rounds with nursing staff, and sign-in rounds
Evaluation Methods
Your final grade is determined by the following: 90% Direct observation by faculty and supervising residents A three-point global “readiness for internship” scale is correlated with a nine-point performance scale to determine final scores. 10% Thoughtful and timely completion of a multi-step individualized learning plan (ILP) Incomplete or poorly executed ILPs will result in lowering of the final score. At the midpoint of the rotation, the Sub-I will select faculty (a minimum of 1) to evaluate his/her performance. At the end of the rotation, the Sub-I will select faculty (a minimum of 1) and supervising residents to evaluate his/her performance. A final grade (Honors, High Pass, Pass, Marginal Pass, or Fail) will be determined by a composite of the grades as well as the performance on the ILP. REMEDIATION OPTIONS: If you receive a final grade Fail, you may be given an opportunity to repeat the sub-I at the discretion of the course director. If you receive a Marginal Pass, you may be given the opportunity to repeat or remediate the sub-I at the discretion of the course director. MID-COURSE FEEDBACK: Sub-Is will meet with the Course Director or Associate Course Director individually at the rotation’s midpoint to discuss progress toward knowledge, attitudes and skills of pediatric interns as specified by the sub-I’s ILP and comments from the faculty and supervising residents. OTHER: Attending rounds will practice Patient-Family Centered Rounding technique.
When and Where to report on first day of service:
Texas Children's Hospital, Abercrombie Building, Suite A210 "Pediatric Emergency Medicine"
For additional information regarding this elective contact:
Contact Name: Charmaine Savage
Contact Phone: 832-824-5829
Contact Fax: 832-825-5424
Contact Location: TCH Ambercrombie Buildgin, Suite A210
Address: 6621 Fannin St., Suite A210, Houston, TX 77030

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