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Critical Care Consults & Procedures - MEDC 542

Prerequisites:

None.

Location: 

UMMC 

Description and Goals:

The senior medical student will experience various facets of critical care medicine that may be underemphasized within the core curriculum.  This elective’s curriculum will include the following:  Critical care consultation, billing and coding practices, intensivist career mentorship, and the teaching and performance of a variety of in-hospital procedures (e.g. central venous catheter insertion, thoracentesis, tube thoracostomy; occasionally, paracentesis and lumbar puncture).

The rotation’s educational content will feature clinical exposure to critically ill patients with a wide variety of medical problems, but also occasionally serious surgical disease, major trauma, psychiatric illness, and pregnancy.  In addition to the consults, after being taught the proper techniques to perform the medical procedures previously listed on simulated patients and through formal didactics, the senior medical student will perform them on appropriate hospitalized patients under direct supervision.  Additional learning pertaining to critical care topics will occur via online modules, review of pertinent literature, and small group discussions.

The senior medical student will perform the initial consultation and develop a management plan under the direct supervision of an intensivist. The senior medical student will engage in self-directed learning outlined in the curriculum, including online modules emphasizing key elements of medical procedures, a review of the latest critical care management guidelines, details on cost-effective practice, and analysis of good general consultation practice.  In addition, if desired, the senior medical student will have access to intensivist career mentoring.

During this training the senior medical student will:

  1. Perform timely initial comprehensive assessments of patients, including evaluations for procedures requested by the consulting service.
  2. Follow patients on the consultation service, leaving meaningful recommendations at appropriate intervals for referring services.
  3. Cogently present patient care data during attending rounds with the critical care attending.
  4. Identify aspects of inpatient medicine that are not emphasized on inpatient service rotations, including:
    1. Billing levels, including the clinical justification and required documentation to achieve such levels.
    2. Cost-effective approach to evaluations and recommendations.
    3. The medical legal aspects of critical care.
    4. Appropriate techniques for the performance of the above-mentioned medical procedures.
     
  5. Utilize primary literature to support patient care recommendations.
  6. Communicate effectively as a consultant with the referring physician to optimize patient care and safety.
  7. Document initial assessment and subsequent care notes that clearly list recommendations.
  8. Document recommendations that directly answer the questions asked by referring physicians.
  9. Respond to consultation requests in a timely fashion.
  10. Interact courteously with requesting physicians.
  11. Recognize the importance of professional interaction as it pertains to the business model of successful consultation in private medical settings.
  12. Perform a thorough system-based evaluation of critically ill patients and manage their complex array of medical problems in a detailed an organized fashion.
  13. Demonstrate appropriate triage of patients for transfer to a higher level of medical care.
  14. Define the role of the critical care consultant as a liaison within a complex multi-department medical center.
  15. Engage proactively in the care of patients on the consultation service, taking initiative to ensure high patient care quality by the primary team.

Number of Students:

1

Time of year Available: 

Throughout the year.

Hours:

Monday through Friday - Yes; 8 a.m. - 5:30 p.m.
Evenings - No
Weekends - No
Call - No

Faculty Responsible:

Michael T. McCurdy, M.D.
Assistant Professor of Medicine & Emergency Medicine

Administrative Contact:

Suzanne Ventura
(410) 328-8141
sventura@medicine.umaryland.edu  

Last Revision: January 14, 2014