Medical Degree Program Admissions Application Criteria & Process Admission Requirements How to Apply FAQs Transfer Policy & Procedures Information for Incoming Students Contact Us Curriculum Electives Student Support 605B - Surgical Intensive Care Unit This course satisfies the ICU requirement for UCI students. This rotation is not accepting international students. Home Education Medical Education Medical Degree Program MD Programs Curriculum Clone of Anesthesiology Elective > 605B - Surgical Intensive Care Unit Course Director, Coordinator and General Administrative Information Faculty & Staff Office Location Phone Email Director: Maria Allison, MD LBVAMC 5901 E. 7th Street Bldg. 126, 3rd Fl., UCCU/SICU Workroom Long Beach, CA 90822 714-456-6882 maria.allison@va.gov Coordinator: Dean Wong UCI Medical Center 101 The City Dr. S. Bldg. 53, Rm. 205 Orange, CA 92868 714-456-5342 deanw@uci.edu DESCRIPTION Pain is the most common clinical condition encountered by a physician. Its prevalence exceeds that of diabetes, coronary artery disease and cancer put together. We encourage you all to take this opportunity to inculcate the skills of doing a thorough pain evaluation and developing a comprehensive treatment plan. Irrespective of the clinical specialty you chose to follow, this rotation will offer you tools to excel in your practice. Students will have the opportunity to be an integral part of the team that provides interventional and medical management of chronic and acute pain in both the outpatient continuity care setting and the inpatient consultation setting. PREREQUISITES This course is intended for fourth-year students enrolled in the undergraduate medical education program at UCI School of Medicine. RESTRICTIONS This course is intended for fourth-year students enrolled in the undergraduate medical education program at UCI School of Medicine. This rotation is not accepting international students. COURSE DIRECTOR Ariana Nelson, MD, HS Associate Clinical Professor and Director, Medical Student Clerkship Rotations Dr. Ariana Nelson believes that contribution to the education of students at all levels is a tacit obligation of faculty at any university hospital. Therefore, Dr. Nelson has devoted much of her time to training students spanning from the early stages of secondary education to post-doctoral fellows. This includes her presentations to high school students, cadaver dissection alongside medical students, intraoperative slideshow presentations to residents, and education sessions for fellows. Although formal didactics have value, Dr. Nelson also feels that bedside or day-to-day instruction is more memorable for trainees. She prides herself on spending a few minutes after each patient encounter to highlight the learning points from the interaction. Additionally, she feels that students have a more comprehensive understanding of the medical field when they are exposed to a variety of settings, such as with the Global Outreach Initiative. Dr. Nelson enjoys being part of a faculty group at UCI dedicated to education, student development and research that will resonate with the burgeoning clinicians that we train in our operating rooms, inpatient wards and clinic procedure suites. Dean Wong is the course coordinator for the 605E course. INFORMATION FOR THE FIRST DAY Who to Report to on First Day: Gina Peralta, Nurse Manager Location to Report on First Day: Gottschalk Medical Plaza, Second floor, Center for Comprehensive Pain Management Time to Report on First Day: 7:45 a.m. SITE: Gottschalk Medical Plaza, 1 Medical Plaza Drive, Irvine, CA. DURATION: two to four weeks Scheduling Coordinator: UCI students please call (714) 456-8462 to make a scheduling appointment. Periods Available: The time of the course must be pre-approved by the elective director at least three months prior to the start of the course. No exceptions. NUMBER OF STUDENTS ALLOWED: one per rotation WHAT STUDENTS SHOULD DO TO PREPARE FOR THE COURSE Review pain pharmacology Review musculoskeletal and neurological examinations COMMUNICATION WITH FACULTY Questions about logistics should be directed to the course coordinator. Direct questions, comments, or concerns about the course can be directed to the course director. Contact information and office location are at the beginning of this document. The course director is also available to meet in person. Please email deanw@uci.edu to arrange an appointment. To ensure that your email will not be lost in the large volume of email received, please use the following convention for the subject line: SUBJECT: COURSE NAME, your last name, your issue (e.g. XXX, Smith, Request for appointment) Course Objectives and Program Objective Mapping The following are the learning objectives for the 605B course. Students are expected to demonstrate proficiency in these areas in order to satisfactorily complete the course. In addition, the extent of a student's mastery of these objectives will help guide the course evaluation and grade. Course Objective Mapped UCI School of Medicine Program Objective Sub Competency Core Competency Assess patients’ overall status – the ABC’s. A-3. Knowledge of basic clinical skills required to meet the skills objectives, including interviewing, physical diagnosis, communication and clinical reasoning processes. Structure and Function of Organ Systems Knowledgeable Improve basic skills in chest radiograph review, intravenous and arterial cannulation, order writing and oral case presentation. B-3. The ability to articulate a cogent, accurate assessment and plan, and problem list, using diagnostic clinical reasoning skills in all the major disciplines. Patient Management Skillful Interpret and manage hemodynamic variables. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Interpret normal and abnormal ECGs. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Assess adequacy of ventilation/oxygenation and treat dysfunction A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Understand fluid, electrolyte and acid-base management. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Understand blood product transfusion indications and concerns. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Recognize and manage shock and shock states. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Recognize and manage single and multiple organ dysfunction. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Understand inherent post-operative changes and problems. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Perform sedation and pain management skills. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Understand social and ethical aspects of critically ill patient care and end-of-life issues. C-3. Sensitivity and awareness of diverse cultures, health beliefs and social factors impacting patient health and illness. Cultural and Social Awareness Altruistic Understand ventilator management and modes. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Perform ACLS. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Perform ATLS. A-2. Knowledge of the pathogenesis of diseases, interventions for effective treatment, and mechanisms of health maintenance to prevent disease. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices. A-2: Disease Pathogenesis and Treatment B-5: Patient Management A-2: Knowledgeable B-5: Skillful Course Resources COURSE RESOURCES TEXTS AND READINGS: SUPPORTING AND REVIEW Handbook of Critical Care - Jesse B. Hall (September, 2009) Critical Care Medicine: The Essentials - John J. Marini and Arthur P Wheeler (November - 2009) The Washington Manual of Critical Care - Marin H Kollef, Timothy J Bedient, Warren Isakow, and Chad A Witt (October - 2007) Irwin and Rippe's Intensive Care Medicine 6th edition - Richard S Irwin and James M. Rippe (August - 2007) The ICU Book, 3rd Edition - Paul L. Marino (September - 2006) Major Exams, Assignments and Grading ASSIGNMENTS AND GRADING MAJOR ASSIGNMENTS AND EXAMS For all of us, the ICU is the best ILU (Intensive Learning Unit). The diversity and intensity of pathology to which you are exposed is incomparable to any other clinical setting. You are privileged to take care of the sickest patients in the hospital. Cherish the experience and do your best to make the most of it. Your faculty are there to make your learning experience as meaningful and effective as possible. If there are problems hampering your growth, approach them. Show enthusiasm and interest; you will be taken seriously and will witness reciprocal enthusiasm. Try to carry 2-3 patients at each time. You will learn more if you expose yourself to a variety of pathophysiologic processes, so work with your team to try and avoid repetitive cases. Every patient on the team is “your patient”. Pay attention to all the patients on rounds. You will multiply your experience. Offer to do short 5-10 minute presentations on topics relevant to your patients. The best way to master a topic is to teach it. GRADING Your final grade is a composite based on your clinical evaluations, participation and elective presentation. The clinical evaluations are based on motivation, knowledge of clinical medicine, clinical skills, and personal characteristics. A passing grade requires daily attendance at rounds, attendance and participation in lectures, discussions, and clinical assignments, as well as satisfactory scores for the categories listed in the clinical evaluations. Absences will be excused only upon approval by the course director. Comments will be made available for your Dean’s Letter. Students can be eligible for Honors if they receive a satisfactory score on all clinical evaluation categories, have perfect attendance, and show exceptional skills in a number of clinical categories and prepare a relevant presentation. Students who receive a failing grade will meet with the course director to discuss options for re-evaluation that may include additional time in the ICU. Attendance: You are expected to participate as a team member, every weekday. You are encouraged to take call with one of your team interns; you should coordinate the details regarding hours of attendance and the call schedule with your site clerkship director and ICU faculty. Absence: With prior notification, you are allowed a maximum of three (3) days of absence during your four-week rotation. You will need to reschedule your rotation for another date if you miss more than three days. Any questions or issues regarding your critical care clerkship grade should be presented to your course director and the grading faculty. You have 30 days from the date of the grade to appeal any aspect of this grade. Please contact your Clerkship/course Director should you have any questions. Requirements for “Pass” To receive a grade of Pass, students must demonstrate successful performance in all the following areas: Knowledge Patient Care Practice-Based Learning Interpersonal & Communication Skills Professionalism Systems-Based Practice Requirements for “Honors” To receive a grade of Honors, students must demonstrate exceptional performance in all the following areas: Knowledge Patient Care Practice-Based Learning Interpersonal & Communication Skills Professionalism Systems-Based Practice You must score at least 80% on the post-test to be considered for honors. Grounds for “Incomplete” You will not be issued a grade until all elements of the course have been completed. REMEDIATION Remediation, if needed, will be designed by the Course Director to suit the issue at hand. Grounds for “Fail”: You will receive a grade of "Fail" if the requirements for passing the course have not been met. Please refer to the Grading Policy for the impact of the "Fail" grade to the transcript.