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Fourth  Year Medical Subinternship

Fourth year medical students may be assigned medical subinternship at Staten Island University Hospital. The goals of the subinternship are to:

  1. Assist the student in recall, synthesis and application of knowledge at the bedside.

  2. Gain experience in the delivery of medical care and develop clinical judgment.

  3. Emphasize the importance of professional behavior and humanisticattributes in daily patient care.

The subintern functions as an integral part of the medical delivery team, which includes senior and junior medical residents as well as third year students. The subintern assumes the primary clinical care and responsibility for approximately 5-6 patients from the time of admission to discharge.  They are responsible for the initial evaluations and daily care of patients, including admitting and follow-up orders (which must be countersigned and reviewed with the senior resident assigned to the unit as well as be clearly indicated that the note was documented by a medical student), daily progress notes and diagnostic/therapeutic procedures as defined below. The daily interaction with patient and family encourages the student's involvement in the personal aspects of medical care and the awareness of numerous resources available for patient education and post-hospital care.

The day begins with work rounds at 7:30 A.M. each morning with the resident team.  Morning Report occurs at 8:00 A.M. when a member of the teaching staff reviews each new admission at the bedside with the admitting resident/subintern. The non-admitting resident/subintern is expected to be doing work rounds at this time. Following morning report, work rounds continue until 11:00 A.M. At 11:00 A.M., teaching rounds take place, which include the presentation of 1-2 new admissions by the resident student. The patients are discussed in depth, including the admitting history and physical, initial laboratory date, problem list, pathophysiology, diagnostic and therapeutic plan.

At 12:00 P.M.  there is a daily medical conference presented by the subspecialty divisions, which emphasizes the presentation and discussion of patients' cases. During the afternoon, bedside care and procedures, new admissions, subspecialty ward rounds, ward radiology rounds and literature review of current medical problems complete the day.

Saturday is a ½ day for subinterns not on call. Subinterns are expected to be in to see their patients and write a daily Progress Note. Sunday subinterns not on-call, are off. If you are on call on Sunday you are off on Saturday. You will write notes on your patients on Sunday instead of Saturday.

The subinterns are paired with another subintern. They will be assigned to the same resident. In addition, they are expected to take call together functioning as one intern. All admissions must be discussed with the PGY II on-call and all admitting orders must be countersigned.  An on-call schedule is provided to each student. Subinterns average six calls per month. On-call rooms are provided for the students to stay overnight and lockers are available for your use (these lockers are located in the on-call rooms on 3B and 3C).

EVALUATION

At the end of the rotation, the ward attending evaluates the student and forwards the evaluation to the medical school.  The student will also evaluate the rotation & clinical site.

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