j********u
发帖数: 235 | 1 参加了今天的ACAP seminar,作了一些笔记，比较潦草，仅作抛砖引玉之用。
ACAP 3/30/14
GI fellowship application by Dr. Jackson Kuan
-Befriend with current fellow, talk to chief to get rotation early, research
(related to the specialty, ongoing with fellow, creative, clinical research
, publish), take elective early, do well in service test.
-Time line for match: July first, ERAS opens; July 15, program download
applications; August first, GI match opens for registration, July-Nov
interview; Oct. 10, ROL opens, Nov 14, ROL deadline; DEC 5th, Match day. www
. Inforesidency.com
The postgraduate reality of medical practice by Dr. Vincent Wang
-Healthcare reimbursement has shifted from “fee for service” to “
capitation and bundle payment reflecting quality”
-certain specialty outsourcing like radiology
-large hospital merge to form health systems and form their own insurance
company
-third party consultation company to evaluate your service, or you
voluntarily submit data to see if you meet their quality criteria to
increase your payment
-If pt visits hospital or even ED after your service, your score will drop
-what is out there: open own practice: insurance credentialing, overhead and
business risk;
Work for a hospital: not a lot freedom, no need to deal with insurance;
Join a group practice: how to negotiate contract, potential partnership but
tricky
-health cost in us: 2 trillion/year, more than 17% of its GDP
Contract negotiation by Tanja Getter, community health systems
-read it, understand it, get another opinion (health attorney or accountant)
-Heath attorney: clear about fee, specialize in health, ask colleagues or
coworkers, talk to someone you trust
-contract is prepared by the institution or practice, may, to the extent
possible or under certain circumstance, not guarantees. If not written in
the contract, it does not exist
-Thing can change from offer letter to contract
-hand shake, letter of intent, promise, understanding, what someone says or
thinks
-basic contract: income guarantee vs employment
Resident report by Qin Ouyang, pgy3, fellowship application and match
results
Timeline : 6/18 token, register with eras, submit application documents;
Package: application, ps, mspe, medical school transcript, photo, LoR, USMLE
transcript, once certified and submitted, cannot be changed anymore. LoR:
clinical skill and ability, current physicians, only 4 letters, provide cv
and ps to assist, familiar with your lor authors, whether or not waive right
to see the letter.
How to be a good resident by Dr. Jin Li, Directors, Neurology residency
program, Westchester Medical center
-get familiar with the environment, know the place and people, spend time
ahead of time, two weeks before, know the rotation schedule, know the
curriculum, object and goals to meet.
-ACGME: regulate all the programs, all residents are evaluated by
standardized system. Six core competencies:
pt care: compassionate, appropriate, effective for the treatment of health
problems, and promotion of health: know everything of the pt before July 1st
, plan after each round, dose, duration, frequency, big picture, plan for
long term,
medical knowledge: established and evolving biomedical clinical and cognate
sciences and the application of this knowledge to pt care: attend all
lectures/conferences, crush all tests,
practice based learning and improvement: to investigate and evaluate their
pt care practices, appraise and assimilate scientific evidence, and improve
their pt care practices. Follow guideline and be flexible, learn more from
pt than form book, cannot make the same mistakes second time
interpersonal and communications skill: to demonstrate interpersonal and
communication skills that result in effective info exchange and teaming with
pt, pt’s families, and professional associates: get along with everyone
around you, you are the leader, be confident, be respectful, align with
other, be friends, communicate with pt and their families, be around when
attending talking to pt/families.
Professionalism: to demonstrate a commitment to carrying out professional
responsibilities, adherence to ethical principles, and sensitivity to a
diverse pt population
System based practice: an awareness of and responsiveness to the larger
contest and system of health care and the ability to effectively call on
system resources to provide care that is of optimal value.
Intern life by Dr. Chen Zhao, pgy1, St. Luke hospital
Schedule in 1 st year: block, 2 wks, floors: general medicine,
subspecialties, night float,
Unit: ICU, CCU. consult, elective, clinic, vacation
Chief email you the possible schedules, to pick up one asap. Don’t start
with night float, start with floor or unit,
Who work with you: attending, nurse, fellow, social workers, case managers,
consult service, physical therapist, resident, intern, medical students.
Typical day: 5: 50, wake up, 630, leave for work, 7 sign out, 720 preround,
6pm leave. On call: 4pm get signout from other teams,
Read: text book, Harrison, Pocket books, MGH pocket medicine, ucsf book, own
institution's book
Smart phone: apps: medabbr, medcalc, abg, mircomedex, epocrates, medspanish,
Sanford guide
Dress code: ask co-interns
Binder: pt list, phone number, to do list, pager use
Get the signout from night float, overnight event, any sick pt need to see
first,
1 min with computer: vital, labs, medications (fluid, abx), culture result
2 min with rn: night event
5 min with pt: how are you? PE, plan, any question,
Run the list with resident before round, decide what to do first
Present case: new pt tell story, old pt: update yesterday, overnight, pe,
lab result, ap plan
Run the list again with resident: to do list, discharge
Call consult/social
Place orders
Do procedures asap
Progress note
Check the ed note, ems notes, previous
Why pt is here, who is pcp, write down
On call: sign out from others, pt to do list, follow up labs, make sure
there is right order, rapid response
Signout: before finish all the notes, run the list with resident before
signout
Signout: give the brief hx, dx, code status, sick , to do list, contingency:
sleep, pain, fever,
The house of God.
Intern life pathology by Dr. Zhengtong Pei
Teaching, basic and clinical research, diagnostic medicine
Career: community practice, academic, industry. Job market very good | J*********4
发帖数: 1274 | | j********u
发帖数: 235 | 3 谢版主赞。钢铁是怎样炼成的之续集：记忆抹不去是怎样炼成的。 | t******a
发帖数: 408 | | z******8
发帖数: 844 | 5 记忆抹不去练得是过目不忘的本领吗？求真传
记忆是抹也抹不去！ | r*****1
发帖数: 805 | 6 谢谢分享了，因为其他事情，机票定了都没去成～～
在这里好好咀嚼下了 |
|
