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 eight or fourteen patients. The teams are composed of a dedicated teaching attending physician, a 2nd or 3rd year resident, and either one or two interns.  Sub interns and third year medical students from the 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 providing continuity of care. To provide additional support at night 3-4 senior 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 7:00am and begins with obtaining signout from the night team. Residents participate in morning seminar from 7am until 7:40am. Afterwards, house-staff-led Resident Rounds occur until 8:30am. This is followed by Attending Rounds at 8:30am and multidisciplinary IDT Rounds at 10:30am. The noontime hour is protected house staff education time which includes a variety of conferences. The day residents and interns from each team stay every other day until 5:00pm or 8:00pm.  

The remainder of the day is devoted to patient care during which house staff write their notes, arrange discharges, perform any patient-related work and admit any patients to their team. One member of each team, whether an intern or resident, will stay until 8:00pm to sign out the team’s patients to the night intern and resident. These night interns and residents will complete any work that still needs to be done for the team’s patients and will also do  admissions to the team overnight. Since each geographically located team cares for either eight or fourteen patients, a team is given an admission whenever it discharges a patient and its census falls below these cutoffs.  

Sample Daily Schedule 

 

 

Monday 

Tuesday 

Wednesday 

Thursday 

Friday 

Saturday 

Sunday 

Day Team

7:40-8:30am 

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

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 

Noon Conference

Noon Conference

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

7:40-8:30am 

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

 

Resident Rounds: From 7:40am to 8:30am each resident leads his/her team’s day and night intern 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 8:30am to 10:30am a dedicated teaching attending, who is responsible for all the patients on the service, discusses each patient with the team's senior resident, both the day and night interns, and the night resident. These resident-driven 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 15-30 minute multidisciplinary meeting with the floor’s social worker, nurse manager, and nursing staff to review disposition planning and barriers to discharge. 

Noontime Conference: From 12:00pm to 1:00pm each day are protected resident and intern conferences. 

  • Didactic Conference Series: Residents and interns attend lecture-style conferences given by a variety of faculty from the department of medicine on a broad range of topics applicable to inpatient medicine. This allows all of the housestaff to receive a standardized curriculum on inpatient medicine during their ward months.
  • Morning Seminars take place 2-3 times per week, vary by firm, and provide a forum for residents to share their admissions with their peers review literature regarding diagnostic and management questions, and discuss challenging cases with a firm leader, assistant firm leader, or chief resident as facilitator.
  • 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 that is on the wards in 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.
  • Clinical Reasoning Seminar: Each Friday this hour-long 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 on the East campus. 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 Wednesday a challenging or interesting case from the wards is presented to a chief of one of the medical services. 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 on the East campus and is led by the Pathology department. An autopsy from a medicine patient is reviewed allowing the house staff to hear a patient’s history and see the post mortem findings from the case.
  • Journal Club: Two times per month the residents on the wards meet to discuss, analyze and critically appraise the most recent literature.

Calendar

Grand Rounds will resume in September 2014

East Campus

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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