Internal Medicine Rotation (PhPr 810a)
(Also refer to the general goals and objectives for PhPr 810)
The primary purpose of the internal medicine rotation is to develop an understanding of pharmacotherapy for the patients followed by internal medicine. Both ambulatory care and inpatient management may be available. An ancillary goal is to allow the student to develop the ability to effectively gather and disseminate information, and communicate with patients, nurses, physicians, pharmacists, and other health care practitioners specific information necessary in the care of patients.
At the beginning of this rotation, the preceptor and student will review the objectives. In addition, the student is expected to develop his/her own objectives. The preceptor and student will review particular topics for reading/discussion. These topics should be primarily based on improving the individual's weaknesses and strengths as viewed by both student and preceptor.
At the completion of PhPr 810A, the student should be able to:
- Demonstrate the ability to identify specific drug-related problems for patients with acute and/or chronic illness.
- Authoritatively discuss the pathophysiology of patient's illness.
- Authoritatively discuss the therapeutic plans of the patients encountered on the medical services and in the clinics.
- Identify optimal variables for monitoring patients including the identification of adverse drug reactions.
- Conduct monitoring of patient's drug therapy.
- Write a complete and formal drug therapy consult note.
- Provide patient education regarding the optimal use, expected outcomes, and adverse effects of drug therapy regimens.
- Work with other health care professionals to ensure the safe, correct, and cost-efficient administration of medications.
The responsibilities of the students during this rotation shall include the following:
- Closely follow patients from a medical team as assigned by the preceptor.
- Closely review all the drug therapy of each patient being followed including pharmacology, toxicology, pharmacokinetics, drug interactions, and monitoring parameters. From these data, a therapeutic plan will be developed.
- Write progress notes on patients. (Consult preceptor regarding limitations to student generated progress notes at the institution.).
- Evaluate serum drug concentrations for patients being followed.
- Document all patient care activities in manner outlined by the preceptor.
- Prepare and give a formal presentation. To meet this objective at least one presentation shall be given during each PhPr 810 rotation. A copy of the outline developed for the presentation must be submitted to the director of experiential programs with the final evaluation and grade.
- Attend patient conferences, pharmacy in-service presentation and pharmacists' meetings.
Expected areas of emphasis
The different sites may have different patient populations that make defining disease processes that must be followed impossible. Students are expected to participate in the care of variety of patients. Some areas of emphasis can be established, however, that will be consistent between sites. The following areas should be part of an educational plan the student and preceptor develop. These areas of emphasis should focus on drug literature evaluation. Any of these areas can form the basis of the required presentation.
1. Infectious Diseases
- Respiratory infections
- Immunocompromised hosts
- Sepsis syndrome
- Skin, soft tissue, joint, and bone infections
- Myocardial infarction
- Congestive heart failure
- Acute renal failure
- Chronic renal failure
- Solid tumors
- Adrenal diseases
The student should expect feedback on a regular basis (i.e. daily). Feedback is intended to provide assistance in improving the quality of the student's pharmacotherapeutic skills. Each student will also have an evaluation completed during the rotation that will retrospectively assess progress. Each student will perform a self-evaluation at the third and sixth week. The evaluation will be simultaneously be performed by the preceptor. The preceptor and the student will compare and discuss the evaluation before a final evaluation and grade is completed.