|Group of Internal Medicine Residents following noon conference
Texas Health Presbyterian Hospital Dallas is one of 17 acute-care hospitals in Texas Health Resources hospital network, the largest healthcare system in North Texas. Texas Health Presbyterian Hospital Dallas is a 898-bed community hospital located in North Dallas and is a major regional referral center. A large and diverse patient population provides the residents with ample exposure to rare as well as common diseases.
Residents also gain exposure to a variety of health care delivery systems including Medicare, Medicaid, indigent care, managed care, and private payors. The diversity of patient population and health care delivery systems assures residents a comprehensive exposure to the full spectrum of medical problems. Residents provide increasingly independent patient care as they progress to the next postgraduate year level. By completion of their Internal Medicine training, all residents are able to provide independent comprehensive medical care, even for patients with the most complicated and serious illnesses.
Residents receive admissions from the emergency room, private attending physicians, the ambulatory clinic patient population, and from our large hospitalist group. Each ward team, which is on-call every fourth night, consists of one resident and one or two interns. Each intern can carry a maximum of 10 patients.
Interns are responsible for admitting/discharging patients, writing orders and daily progress notes, and following up on studies. The resident is encouraged to develop teaching skills and review medical literature in order to provide the interns with guidance to optimally manage patients. Each member of the ward team is scheduled four days off per month.
Formal teaching rounds are conducted three times a week by a faculty member. Pathophysiology, diagnosis and treatment plans for patients are discussed in detail. Medical students from The University of Texas Southwestern Medical School complete their third year clerkships at Texas Health Dallas and are assigned to each ward team.
The ICU rotation is an opportunity for residents to develop proficiency in the care & management of critically ill patients. The ICU uses a multidisciplinary approach in which all members collaborate to determine the best course of treatment for the patients, with the goals being quality care and patient safety. The team consists of the resident, intern, intensivists, nurses, respiratory therapists, pharmacists and social workers. Texas Health Dallas uses an open ICU system which facilitates continuity of care and communication between the ICU and primary team.
Categorical residents spend one half day per week in the Internal Medicine Clinic. Residents are assigned patients for whom they are responsible during the entire training experience. This continuity of care model provides residents with exposure to a patient care setting similar to one many will enter upon completion of their training. An additional month, dedicated to ambulatory medicine, must also be completed in the second or third year of training.
The clinic staff consists of two faculty, registered nurses, medical assistants, a patient care representative and a licensed social worker. A multidisciplinary approach to patient care is practiced by using the services of nurses for patient education as well as a pharmacist and a registered dietician who specializes in diabetes education.
In addition to providing primary care for hospitalized patients, residents at all levels perform subspecialty consultations. Each resident will have the opportunity to spend at least one month in each subspecialty of Internal Medicine. One-on-one teaching and mentoring from faculty provide for the optimal subspecialty learning experience. Interns and residents have no scheduled night call responsibilities while on consultation services and generally do not work on weekends.
Private Practice Experience
Faculty members have very active private practices. The residents have the opportunity to work with these physicians in their offices. This experience provides exposure to both the medical as well as the business issues of private practice.