Einstein/Montefiore Department of Medicine

General Medicine Wards: East and West Campus

The General Medicine Ward rotation provides house staff with the opportunity to care for the Bronx’s diverse patient population and become skilled and confident in the diagnosis and management of a breadth of pathology. The structure of the Medical Wards allows interns and residents to develop as independent thinkers within a team-based patient care setting.

Medicine Ward Structure  

The West and East Campus medicine teaching services are broken up into eight and six house staff teams, respectively.  Each team is geographically located on a hospital floor and cares for either 8-10 or 14-16 patients. The teams are composed of a dedicated teaching attending physician, a second- or third-year internal medicine resident, and either one or two interns. Sub-interns and third-year medical students from Albert Einstein College of Medicine are part of most teams throughout the year. In addition, each team has an overnight intern who cares for its patients and admits any new admissions to that team. This intern covers the same patient panel each night, thus providing continuity of care. To provide additional support at night, 3-4 residents oversee two teams each and admit with the overnight interns, providing not only teaching but also assistance with any questions that may arise. 

Daily Schedule 

  • A typical work day starts at 7:00 am with interns pre-rounding, and residents attending Morning Seminar. 
  • This is followed at 7:45 by resident-led work rounds, followed at 8:30 by Attending Rounds. 
  • Residents attend Interdisciplinary (IDT) Rounds at 10:30.  
  • The noontime hour is house staff education time which includes a variety of conferences. 
  • The remainder of the day is devoted to patient care, during which house staff write notes, perform any patient-related work and admit any patients to their team. 
  • One member of each team, whether it is an intern or resident, will stay till 8:00 pm to sign out the team’s patients to the night intern and resident; day residents and interns alternate days in which one member stays until either 5:00 pm or 8:00 pm. 
  • The night interns and residents finish any work that still needs to be accomplished for the team’s patients and will also do any admission to the team overnight.

Since each geographically located team cares for a set number of  patients, a team is given an admission whenever they discharge a patient and their census falls below the cutoffs.

Sample Daily Schedule 

 

 

Monday 

Tuesday 

Wednesday 

Thursday 

Friday 

Saturday 

Sunday 

Day Team

7:00-7:45am 

Intern Pre-Rounding/ Sign-in

Intern Pre-Rounding/ Sign-in
Morning Seminar

Intern Pre-Rounding/ Sign-in
Morning Seminar

Intern Pre-Rounding/ Sign-in
Morning Seminar

Intern Pre-Rounding/ Sign-in
Morning Seminar

Team Pre-Rounds/ Sign-in

Team Pre-Rounds/ Sign-in

7:45-8:30am 

Resident Rounds

Resident Rounds

Resident Rounds

Resident Rounds

Resident Rounds

 

 

8:30-10:30am 

Attending Rounds

Attending Rounds

Attending Rounds

Attending Rounds

Attending Rounds

Attending Rounds

Attending Rounds

10:30-11:00am 

IDT Rounds

IDT Rounds

IDT Rounds

IDT Rounds

IDT Rounds

Patient Care

Patient Care

11:00-12:00am 

Patient Care

Patient Care

Patient Care

Patient Care

Patient Care

12:00-1:00pm 

Intern/Resident Reports

Core Curriculum Conferences

Chief of Service

Grand Rounds

Clinical Reasoning Seminar

1:00-5:00pm 

Patient Care

Patient Care

Patient Care

Patient Care

Patient Care

5:00-8:00pm 

 

 

 

 

Night Team 

8:00pm-7:00am 

Patient Care

Patient Care

Patient Care

Patient Care

Patient Care

Patient Care

Patient Care

7:00-7:45am 

Intern Pre-Rounding/ Sign-in

Intern Pre-Rounding/ Sign-in
Morning Seminar

Intern Pre-Rounding/ Sign-in
Morning Seminar

Intern Pre-Rounding/ Sign-in
Morning Seminar

Intern Pre-Rounding/ Sign-in
Morning Seminar

Team Pre-Rounds/ Sign-in

Team Pre-Rounds/ Sign-in

7:45-8:30am 

Resident Rounds

Resident Rounds

Resident Rounds

Resident Rounds

Resident Rounds

Resident Rounds

Resident Rounds

8:30-10:30am 

Attending Rounds

Attending Rounds

Attending Rounds

Attending Rounds

Attending Rounds

Attending Rounds

Attending Rounds


 Morning Seminar 

From 7:00 to 7:45 am, Tuesday through Friday, all residents meet with selected faculty to present cases posing challenging management questions, and follow up with evidence-based answers to clinical questions which these cases generated. 

Resident Rounds 

From 7:45 to 8:30 am, each resident leads his/her team’s day and night interns and students on walk-style rounds, reviewing with them overnight events and active issues in preparation for Attending Rounds.  This allows the residents and interns to formulate each patient’s daily plan.

Attending Rounds 

From 8:30 to 10:30 am, a dedicated teaching attending, who is responsible for all the patients on the service, discusses each patient with both the day and night team members. These rounds are an opportunity to incorporate the most recent evidence-based approaches into patient care. 

IDT Rounds 

Each team’s second- or third-year resident attends a 30-minute multidisciplinary meeting with the floor’s social worker, nurse manager, and nursing staff to review disposition planning and facilitate patient discharge. 

Noontime Conference 

Resident and intern conferences run from 12:00 to 1:00 pm each day.  

  • Intern and Resident Reports
    Residents and interns break into their respective groups in these two conferences. An intern or resident will present a current case on the wards followed by an attending-led group discussion centered around the case’s key teaching points. 
  • Department of Medicine Grand Rounds
    Every Thursday, this weekly state-of-the-art lecture features a prominent leader in medicine. Grand Rounds include both internal and outside speakers who are pioneers in their fields.
  • Clinical Reasoning Seminar
    Each Friday, this seminar centers around a challenging case used to illustrate the core principles of clinical reasoning. This is accomplished by separating the house staff into smaller groups that use both biologic and probabilistic reasoning to arrive at a correct diagnosis. 
  • Morbidity and Mortality Seminars
    Two times per month, the medical service meets to examine a case where a patient morbidity or mortality occurred. An attending physician facilitates the group’s examination of the case and explores ways in which a different outcome or improvement in care could have been provided. 
  • Chief of Service
    Every week at each campus, a challenging or interesting case is presented to a chief of one of the medical specialties. He or she uses this time to lead a group discussion on the important teaching points. 
  • Autopsy Rounds
    This monthly conference takes place in the morgue and is led by the Department of Pathology. An autopsy from a medicine patient is reviewed, allowing the house staff to hear the patient’s history and see the post-mortem findings from the case. 
  • Journal Club
    Three to four times per month, the residents on the wards meet to discuss, analyze and critically appraise the most recent literature.

Calendar

Thursday, January 08, 2015

Department of Medicine Grand Rounds
Tim Buchman, MD
8:00 AM : Forchheimer Medical Science Building 3rd Floor Lecture Hall

Grand Rounds

Einstein (East) & Moses (West) Campus

Archive

Contact Us

Department of Medicine
Albert Einstein College of Medicine
Jack and Pearl Resnick Campus
Belfer Building - Room 1008
1300 Morris Park Avenue
Bronx, NY 10461 (directions)

718.430.2591
Fax: 718.430.8563

 
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