This rotation provides training in the care of hospitalized patients and it is the only general medicine sub-internship experience available at Milstein Hospital , a tertiary-care teaching hospital. There are no interns or second/third-year medical student clerks on the service. This affords students the opportunity to interact more closely with their supervising attendings than on traditional general medicine rotations. Students will be challenged to develop the clinical skills and knowledge necessary to care for hospitalized patients in preparation for intern year, regardless of specialty.

Learning objectives: By the end of this elective, students should be functioning at the level of an intern in all aspects of patient care.

Format: As sub-interns, students are expected to take on all of the clinical responsibilities of an intern. Students will admit their own patients and assume the primary role for the complete care of those patients, while being supervised by a senior medicine resident and Hospitalist attending. Responsibilities will include writing admission and daily progress notes, entering orders, active participation in the development of diagnostic and therapeutic plans, performing all routine procedures, communicating with nurses and consultants, as well as coordinating discharge planning at daily multidisciplinary case management rounds. Students will present new admissions during attending rounds and are expected to independently formulate a comprehensive differential diagnosis and evidence-based management plan. Attendance is required for all Senior Medicine didactic sessions, which will cover a broad range of topics pertinent to the care of the hospitalized patient. Students are also encouraged to attend departmental conferences, including Intern Report, Noon Conference and Grand Rounds. On average, work hours are from 7:30am to 6pm during the week. Students are expected to rotate with their team on the admitting call schedule, including on weekends. Over the course of the month, there will be an average of one day off per week.

Assessment methods: Evaluations will be done through direct observation by residents and attendings. There is no exam for this course. Verbal feedback will be provided to students on a regular basis throughout the month and a final written evaluation of their performance will be submitted upon completion of the elective.