Background: Consultative Medicine is one of the fastest growing branches of Hospital Medicine. We believe that residents require adequate exposure and appropriate level of training to provide excellent care to patients.
Purpose: The goal of the rotation is to train and prepare residents for a successful future as consultants. The rotation has been designed to simulate the complex and challenging environment that helps build strong medical consultants. It highlights their ability to understand and collaborate patient care through a multidisciplinary and unified approach, by working with interspecialty nursing and physician assistants, thereby strengthening their communication and leadership skills
Description: The ECU Internal Medicine Pirate consult service has been structured to integrate consult and co-management skills. The team consists of 2 senior residents from the PGY2 and PGY3 classes of Internal Medicine, Medicine-Pediatrics, Emergency Medicine-Internal Medicine, and Medicine-Psychiatry, as well as one medical attending, who evaluate and offer recommendations for all consultations called to ECU Internal Medicine during the 4-week period. The curriculum involves completion of mandatory consult modules from the Society of Hospital Medicine, one minute consults from the Cleveland Clinic Journal of Medicine, and review of various articles and guidelines. A recommended reading schedule of required articles is provided with modules to complete commensurate with the number of days in the rotation. The majority of our consults involve perioperative medicine for orthopedic procedures, and diabetes and hypertension management. We have successfully collaborated with the General Surgery, Cardiothoracic and Vascular Surgery, Urology, OB/GYN, Orthopedic Surgery, and Psychiatry services. The team has also been able to act as a buffer, admitting observation patients to help with the general admission load.
Conclusions: The successful development of a consult rotation has enabled our senior residents to successfully integrate and demonstrate all ACGME core competencies. Positive feedback from the residents, attendings, nursing and multidisciplinary consultants has made this pilot project a definite success. It has opened new channels for innovative thinking, multispecialty collaborations, and leadership development for our senior residents, who are ready to face the challenges of the real world.