Background: Perioperative co-management has become an increasingly important part of a hospitalist’s role. A new MSIV course was created to teach and showcase this unique aspect of hospital medicine to medical students. Perioperative co-management can provide excellent educational value and a new framework of thinking for medical students regardless of the specialty they pursue.
Purpose: Incorporate MSIV students onto existing attending based co-management services to teach the principles of perioperative medicine. This course includes learning about preoperative medical optimization, postoperative management of both acute medical issues and chronic comorbidities, and the role of a hospitalist as a member of a greater team. Our goal is to also improve students’ critical thinking, problem solving, and provide exposure to a different side of hospital medicine.
Description: Medical students choose to pursue a 2 or 4 week course and are assigned weekly to a co-management service led by a hospitalist attending. These services include Urology, Orthopedics, Spine, Cardiothoracic, and Head and Neck Surgery. Students gain experience in diagnosis, treatment, and disposition of common perioperative issues. They also gain exposure in team-based management during rounds with the surgeons, advanced practice providers, and case managers. Students underwent a curriculum of case-based learning and journal review of landmark articles. The students are required to analyze and present landmark articles and apply the knowledge to patient care. They participated in assigned independent learning activities to observe and learn from other members of the health care team. These activities include watching physical therapy and occupational therapy sessions, nerve block placement by anesthesiologists, and ostomy education by nursing staff. Since 2018, of 26 MSIVs signed up for the course. 50% of the students applied into a surgical specialty, 38% of the students applied into Internal Medicine, Med-Peds, and Family Medicine, and 22% applied into other specialties including IR, Psych, ER, and Anesthesia. On a scale of 1 (Unlikely) to 5 (Very Likely), the students rated the course a 4.77 for being a valuable experience they would recommend to their peers, 4.88 in regards to the assigned activities helping develop their confidence, knowledge, skills in perioperative co-management, 4.85 for the number and variety of patients sufficient to meet the objectives of the course, and 4.71 in feeling like a valuable member of the hospitalist team.In the comment section of the survey, several students stated that they appreciated the direct interaction with faculty and dedicated teaching. They enjoyed learning from practical case-based didactics. Many also liked seeing an alternate side of hospital medicine in comparison to their prior exposure to internal medicine wards. In regards to areas of improvement, some students stated they would have preferred to stay on the same service during their rotation as opposed to a weekly change and would have wanted to choose which co-management services they work with.
Conclusions: Our new rotation and curriculum has helped provide exposure to a different side of hospital medicine compared to traditional internal medicine wards. It gained a platform to teach principles of co-management to medical students who will become future internists, subspecialists, and surgeons. This can be implemented at other medical schools to help increase interest in and awareness of hospital medicine.