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Hospitalist Resident Rotator Elective: Formal Academic Expectations and Educational Experiences

While on the Hospitalist service, visiting residents will be expected to participate in at least one on-going quality improvement and hospital throughput research projects designed to evaluate and improve patient safety and bed utilization on the unit. Opportunities for continued participation in these projects following completion of the elective will be considered on a case-by-case basis for visiting residents who are interested in gaining additional research experience. At the end of the month, the visiting resident is expected to give a brief presentation to the Hospitalist group on the rationale and current status of this project.  We recognize that one month is insufficient time to become a study investigator. It ensures, however, that residents are briefly exposed to the types of research and quality improvement initiatives that Hospitalists are expected to participate in and direct at their institutions.

Specific evidence-based conferences will be provided on the following topics:

  • Thromboembolic disease prevention and assessment in medical inpatients
  • Prevention and management of delirium in the hospitalized patient
  • Optimal maintenance of mobility in hospitalized patients
  • Managing glycemia in the hospitalized patient

Other specific clinical topics in Hospital Medicine and consultative medicine that may be covered (by request) include:

  • Evidence-based management of acute inpatient cardiac diagnoses: 
    i. New-onset atrial fibrillation
    ii. Medical management of acute myocardial infarction
    iii. Evidence-based inpatient treatment of congestive heart failure
    iv. Management of incidental dysrhythmias detected on inpatient monitoring (nonsustained ventricular tachycardia, frequent ventricular ectopy)
    v. Hypertensive crisis
    vi. Cocaine-induced chest pain
  • Inpatient evaluation of syncope
  • Pre-operative cardiac risk assessment
  • Inpatient management of decompensated cirrhosis
  • Pancreatitis management
  • Inpatient management of alcoholic hepatitis
  • Ischemic bowel syndromes (ischemic colitis, acute and chronic mesenteric ischemia)
  • Evidence-based approach to gastrointestinal bleeding
  • Anemia in the hospitalized patient
  • Heparin-induced thrombocytopenia
  • Evidence-based approach to neuroimaging prior to lumbar puncture
  • Use of steroids in meningitis and suspected meningitis
  • Beta-adrenergic blockade in patients with chronic lung disease
  • Approach to pleural effusions
  • Thyroid tests in the inpatient setting (the euthyroid sick syndrome)
  • Portopulmonary hypertension
  • Evidence-based use of urinary electrolytes
  • Approach to acute renal failure
  • Evidence-based approach to rhabdomyolysis
  • Electrolyte disarray in the hospitalized patient (diagnostic and therapeutic approaches to hyperkalemia, hypokalemia, hypercalcemia, hyponatremia, hypernatriemia)

Visiting residents will be invited to attend other Johns Hopkins conferences, including:

  • Department of Medicine Grand Rounds
  • Osler Resident Noon Conferences (4 times/week)
  • Osler Resident Afternoon Report (2 times/week)
  • Division of General Internal Medicine Grand Rounds
  • Hospitalist Sub-Intern lectures

 

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