Specific Consult Guidelines:
- Triage Consult Rotation
- Leukemia Consult Rotation
- Geriatrics Consult Rotation
- Liver Consult Rotation
- IBD Consult Rotation
- Sickle Cell Disease Consult Rotation
- ID consults: This rotation requires Saturday rounding by both residents (PGY2 and 3). Residents should split the Saturdays. Interns are not required to come in on the weekend.
- Consult teams do not have caps however residents should primarily be balancing patient load with educational experience. If a resident feels they are primarily responsible for too many patients and thus hindering their education, please reach out to the Chief Residents
- 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.
- On your first day on an inpatient consult service, contact your team’s fellow at or around 8 AM.
- Procedure Svc-1111
- 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 are expected to attend morning report (11:30-12:15 pm) every day – if you are seeing patients during this protected time, please let the Chief Residents know
- Consult attending rounds will vary but should allow for conference attendance. Please let the Chief Residents know if rounds are going through conference.
- Residents that are post-call from MROC or Night Float are excused the following day.
- ID consults require Saturday rounding residents. Residents should split the Saturdays. All other consult services have weekends off. Residents may have jeopardy duties while on consult blocks.
- 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).
- 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.
- Residents are expected to attend outpatient clinics while on consult services (GI, Endo, Rheum, Renal).
- Residents are expected to attend their regularly scheduled continuity clinics while on the +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.
- Consult residents are excused from consults to attend their continuity clinics; all other absences must be discussed with the consult attending.
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 consult 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.