While rotating on the inpatient wards, the transitional intern serves as the primary provider for inpatients with resident and attending physician supervision. As a member of a ward team, the transitional intern is expected to participate in daily team and group educational conferences including morning report, combined team teaching, noon conferences and grand rounds. Like the medicine interns, transitional interns are expected to write daily progress notes, perform necessary procedures for their patients, and mentor medical students on their team.
Medicine-Intensive Care Unit
The transitional intern serves as the primary provider for critically ill patients hospitalized in the MICU/CCU with resident, fellow and attending physician supervision. The intern is expected to participate in daily educational conferences including group intake rounds, bedside teaching, and didactic lectures. Like the medicine interns, transitional interns rotating through the MICU/CCU perform necessary procedures for their patients, write daily progress notes, and help conduct family meetings.
The intern rotating through pediatrics is the primary provider for pediatric patients admitted to the wards and the pediatric ICU. This rotation provides an independent but supervised experience in common pediatric illnesses.
Neonatal Intensive Care Unit (NICU)
The intern rotating through the NICU assumes the major responsibilities for neonates that are admitted from high risk deliveries. He or she will become proficient with evaluating and caring critically ill neonates with a variety of medical issues including sepsis, respiratory failure, fluid and electrolyte abnormalities.
The intern rotating on general surgery becomes an integral part of the ward team and, as such, gains independent but supervised experience in day-to-day management of surgical problems in pre- and post-operative patients. In addition to assuming primary care of hospitalized patients, he or she evaluates surgical patients in the surgical clinics, assists in performing operations such as appendectomy, inguinal herniorrhaphy, breast biopsy, and excision of soft tissue lesions with attending supervision and assists and observes performance of more complicated operations.
Obstetrics and Gynecology
The intern on this rotation is the primary provider for full term pregnant patients admitted to Labor and Delivery. There, he or she will become familiar with the care of the pregnant patient including evaluation of patients in triage, and in the labor and delivery process.
The rotation in emergency medicine affords the intern the opportunity to be the "first provider" for the acutely ill patient. Emphasis is placed on the initial assessment and evaluation, treatment priorities and rapid decision making in a logical, ordered fashion. The intern is encouraged to develop technical skills including, but not limited to, suturing of lacerations, general wound management, placing of central and peripheral intravenous lines, lumbar puncture, endotracheal intubation and interpretation of x-rays and EKGs. There is direct supervision with attending physicians trained and experienced in emergency medicine. The intern is also exposed to the pre-hospital care system by virtue of VMC's status as a paramedic base station. Utilization of the poison center and familiarization with the poisindex is encouraged in conjunction with the management of the poisoned/intoxicated patient. Rotations are in 4 week blocks and consist of 18 shifts that are 10 hours in length. Elective rotations in the emergency room are also available.
The transitional intern has the flexibility to choose from ambulatory rotations in internal medicine, pediatric urgent care, or general surgery. This allows the intern to focus on an ambulatory rotation that will help better prepare them for the future careers, and truly make the year an individualized pathway.
The following are a list of some of the elective options available at SCVMC:
- Behavioral health
- Cardiology (consult is one type, and echo reading is another)
- HIV/Pace clinic
- Homeless clinic
- Infectious disease
- Medical examiner (Coroner’s office)
- Palliative care
- Social Medicine
- Stanford VA or Stanford University Hospital rotations
- Surgery/surgical specialties (including ENT, ortho, burn/plastics)
- TB/Refugee clinic
- Urgent Care