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Training Experiences
Inpatient Training
Medical care for inpatients is provided
by a team of one to three first-year residents, two second- or third- year
residents, a senior medical student and a private attending physician. Teaching
attending physicians, chosen for their clinical competence and teaching ability,
hold teaching rounds for 1 1/2 hours per day, four days per week. Intensive
care units, in which attending staff rounds occur daily, are covered by separate
house staff teams.
Inpatient teaching activities include:
- Morning Report four days per week
- Weekly Medical Grand Rounds
- Daily Noon Conferences (core curriculum lectures, morbidity and mortality conference, journal club, chief resident's rounds)
The Internal Medicine Residency Program is affiliated with the University
of Missouri-Columbia School of Medicine. Faculty members from that institution
visit several times each year to present Grand Rounds. Visiting professors
from other institutions visit St. John's Mercy 15 to 20 times per year.
Experience in emergency medicine is gained in a one-month rotation during the first year in the St. John's Mercy Emergency Medicine Department under the supervision of the full-time Emergency Medicine Department staff.
Ambulatory Care
Ambulatory Care training occurs in two settings: The John F. Kennedy (JFK)
and Clinic and in private general internal medicine clinics.
Each incoming house officer
is assigned to the JFK clinic every other week for three years and sees 5-9
patients per session. These sessions are morning sessions and provide the
house officer with exposure to the types of problems he or she would encounter
in office practice and promotes familiarity with the ancillary services used
there. The resident cares for patients during an extended period and develops
an appreciation of the social and psychological aspects of patient care.
During the second and third years a longitudinal
continuity experience in ambulatory care is obtained by working in an afternoon
clinic in a private ambulatory care setting one half day every other week.
This the allows resident to obtain real life experience with patients in
the community that participate in a variety of managed care and private insurance
plans. This very practical experience is vital to the preparation of residents
as they transition into private practice.
During
each of the first two years, each resident spends one month entirely in the
Ambulatory Care Clinic. This rotation allows them to increase their patient
population and enhance overall experience in the outpatient setting. The
John F. Kennedy (JFK) Clinic is located in St. John's Mercy Medical Center.
Resident supervision in the JFK Clinic is provided by two attending physicians.
In addition, staff subspecialists are available for consultation when needed.
Each
resident is assigned a group of patients in the JFK Clinic for whom he or
she is the primary care physician. When a patient from this clinic is hospitalized,
the resident who has been caring for him as an outpatient continues to work
with the hospitalist team to deliver coordinated care.
An annually recurring series of practice
management noon lectures in structured to complement our outpatient training
as residents are well prepared for the private practice of internal medicine.
Long Term Care Experience
In the 120-bed St. John's Mercy Medical Center Skilled Nursing Facility, which was established in 1988, care is provided for private-pay patients and for those covered by Medicare or Medicaid.
Residents also obtain experience in nutrition management and in the management of dementia, polypharmacy, incontinence, patient falls, and skin disorders. They are invited to participate in the design of patient care plans.
One month of Geriatric experience is required during the 36-month training program.
Clinical Research
Clinical research is conducted in several divisions of the department.
Division of Oncology-Hematology
St. John's Mercy is the headquarters
of the St. Louis-Cape Girardeau Community Clinical Oncology Program, an NCI-sponsored
program, designed to make clinical trials available to patients through their
community oncologists. We participate in SWOG, NSABP, RTOG, and other cooperative
group studies through this mechanism. We offer Phase II studies in many cancers
through our membership in the University of Chicago Phase II Consortium.
Division of Neurology
This division offers two NIH-sponsored
trials:
- CREST
- SPS3
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