TEAM:

  • Consult teams do not have caps
  • Interns and students may be assigned though this is based upon request.
  • On most consult services there will be at least a fellow and a senior resident.
  • Consult services have a team structure that is dependent on which individuals are scheduled to participate.
  • Consult services with more specific guidelines:
    • General Medicine Consult rotation: Please go to http://genmedconsults.uchicago.edu/
    • Hepatology Consult rotation: Please see the service rules.
    • ID consults: This rotation requires Saturday rounding by both residents and interns. Residents should split the Saturdays, and the intern(s) will help out on one of the Saturdays during their rotation.
    • IBD Service Guidelines
  • On your first day on an inpatient consult service, contact your team’s fellow at or around 8 AM.
    • Cardiology-3547
    • GI-9894
    • Liver-2543
    • Pulmonary-4277
    • Palliative-7255
    • Renal-6320
    • Procedure Svc-1111
    • ID-7023
    • IBD-4423

Timeline:

  • Medicine housestaff arrive on the wards to follow-up on established consults and to gather information on new consults at ~8:00 am.
  • Residents and Interns attend morning report (11:30-12:15 pm)
  • Residents and Interns attend the noon conference (12:30-1:15 pm)
  • Consult attending rounds will vary but should allow for conference attendance.
  • Residents that are post-call from MROC or Night Float must leave by 12 PM the following day.
  • Some consult services may require weekend day rounding. Talk with your fellow and team.
  • ID consults does require Saturday rounding by both residents and interns. Residents should split the Saturdays, and the intern will help out on one of the Saturdays during their rotation.

Teaching/Conferences

  • Residents expected to attend morning report on all days of the week.
  • Residents expected to attend noon conference on all days of the week.
  • Residents expected to attend respective sub-specialty clinical conferences (vary by service).
  • Residents expected to attend sub-specialty clinics on “ambulatory” consult services (GI, Endo, Rheum, Renal).
  • The team resident is responsible for the education of the team interns and students and should consider themselves the primary teacher for these trainees.
  • The team attending is responsible for the education of the entire team. It is expected that teaching will take place in combined teaching/management rounds each day during the afternoon.
  • The team attending is expected to provide structured feedback at the mid-way point of the rotation and at the end of the month.
  • The attending is expected to provide a written evaluation on all members of the house staff team at the end of the month.

Clinics

  • Residents are expected to attend sub-specialty clinics on “ambulatory” consult services (GI, Endo, Rheum, Renal).
  • Residents are expected to attend their regularly scheduled continuity clinics [one per week if on ambulatory (+2) block].

Other Important Points

  • The consult team must proactively communicate with the primary team regarding any initial or follow-up recommendations. This communication should be both written and verbal and should be in a timely fashion.
  • The consult team should NOT write orders on any patient without the expressed consent of the primary team.
  • Residents on consults may moonlight only ONCE per 2 week period when on consult services.
  • Consult residents are excused from consults to attend their continuity clinics; all other absences must be discussed with the consult attending.

Supervision

The attending physician is responsible for ensuring the highest level of care to consult patients. This is accomplished through regular supervision of the work completed by the resident, intern and students on the team. The attending should see and evaluate all patients at initial consultation. At their discretion, they will see and evaluate all patients on other days during the admission. In all cases, the plan of care should be reviewed with the consutl team delivering appropriate feedback where necessary. The attending should be available 24 hours a day to the consult and primary teams for question or concerns arising in the course of patient care.