Internships

POLICIES AND IMPLEMENTING GUIDELINE ON INTERNSHIPS

(Junior and Senior Internship Program)

TERMINAL COMPETENCIES
Junior Internship:

At the end of the Junior Internship (Medical Clerkship, 4th Year), students shall have demonstrated beginning proficiency in the professional roles of a 5-star physician such as clinician, health educator/teacher, epidemiologist/researcher, manager and community mobilizer. The internship will immerse the learner in the clinical and community setting to acquire beginning competencies of a medical doctor.

Senior Internship:

At the end of the Senior Internship (5th Year), students shall have demonstrated advanced knowledge and skills in all of the 10 competencies building towards 5-star physician. The Senior Internship will provide learners the opportunity to develop proficiency in the roles and functions of a medical doctor in various setting including advance competencies in Health Emergency and Disaster Management.

CLINICAL AREA OF TRAINING Major Areas:

Internal Medicine

Surgery

Obstetrics-Gynecology

Pediatrics

Community

ER/OPD (integrated in all areas)

CAM (integrated in all areas)

Research (integrated in all areas)

Minor Areas:

Psychiatry

Radiology

Ophthalmology

ENT

Pathology

Rehabilitation Medicine

ASSUMPTIONS

Junior Intern – is a competent medical student certified by the College to have adequate preparations to perform the beginning roles of a 5-star physician. Activities related to his roles and functions must be done under strict supervision of a licensed physician.

Senior Intern – is a candidate physician eligible to perform, under controlled supervision, the roles and functions of a Medical Doctor. The SI directly supervised by the Chief Resident and/or the Senior Resident in their assigned area.

IMPLEMENTING GUIDELINE A.    WORKING HOURS
  1. Interns are expected to be in the hospital as follows:

Monday to Saturday                  7:00 a.m to 5:00 p.m. (except when on 24- hour duty)

Sundays and Holidays                8:00 to 12:00 noon    (except when on 24- hour duty)

  1. The schedule of rotation and activities will be issued by the Office of the Dean through the Coordinator for Clinical and Community.
  2. Interns must report on time, remain in the vicinity of their assignment and answer all calls promptly.
  3. If, for any reason, they must leave their places of assignment temporarily, they must write their whereabouts and inform proper authorities.
  4. Intern-on-duty are expected to be within the vicinity of the hospital during duty hours and the ward nurses must be informed of his/her whereabouts at all times. Although all interns own mobile phones registered with the Chief Intern’s Office, text messages cannot be totally relied upon because messages may not be able to be transmitted on time at all times and failure to receive these messages is still considered the fault of the mobile owner. Therefore, interns must make sure, their mobile phones are within reach of signals in order to receive messages. After receiving a message, interns shall respond back.
  5. Official team bulletin is issued every Monday morning and interns must be aware of their duties or special details for the week. All concerns related to the schedule and/or bulletins should be reported immediately to the Clinical and Community Coordinator.
  6. While on hospital rotation, interns receive appropriate supervision and instruction from faculty preceptors, residents and consultants in the Department.
  7. All or any intern may be called for special detail by the Department Chair, Chief Resident, Chief of Professional Services and Hospital Director at any time, provided appropriate communication is made with the Clinical and Community Coordinator of BUCM.
DUTIES OF THE INTERN:
  1. Conducts complete health history and physical examination on all patients as assigned by the Chief Resident and/or Department Chair.
  2. Ensures completeness of patient’s chart in appropriate sections and secures signature of supervising attending physician.
  3. Makes order under supervision of a licensed attending physician.
  4. Makes/prepares endorsement to incoming interns and residents at the end of the duty.
  5. Attends to the care requirement of the assigned patients including laboratory, minor medical and surgical procedures under the supervision of a licensed attending physician.
  6. Assists in the clinical procedures deemed appropriate by their respective supervisors.
  7. Presents case/s during rounds and clinical conferences.
  8. Makes daily rounds with the other interns, residents and consultants.
  9. Attends all educational conferences and other clinical activities during rotation schedule.
RESPONSIBILITIES:
  1. Makes daily rounds with the other interns and residents under the supervision of the Department
  2. In surgical service:
  • Must be with the patient at pre and post operative care
  • Observe and/or assist in the Operating Room if his/her patient is operated on or undergoing special diagnostic procedures
  • Follow closely the postoperative management of his/her assigned patient
  1. Attend to all Department or Institutional activities and functions
Excused on the following events:
    • Attending an operative procedure (State name of patient and procedure)
    • Monitoring or watching critically ill patients
    • In a 24-hour duty
  1. Accomplishes Daily Intern’s Form accurately and submits to the Resident-in-Charge. Completed form will be handed over to the chief resident before the beginning of the morning rounds.

Deadlines:

Daily Intern’s Form: 7:00 am from duty (properly checked by senior resident)

Intern In Charge Notes – within 24 hours

Letter of explanation for absence – within the day following absence

  1. Performs the following clinical procedures:
    • Giving IV injections or venoclysis
    • Diagnostic and therapeutic procedures
    • Obstetrical Examinations
    • Minor Surgical procedures
OTHERS:    

1. Teaching and Research

1.1  Interns shall participate actively in teaching and research as part of their training program.

2. DECORUM AND CONDUCT

2.1     Interns shall observe all hospital rules and regulations. Ignorance thereof shall not be an excuse.

2.2     They shall observe decorum, courtesy, kindness and understanding to patients and the public, and shall not make any derogatory comments regarding other physicians and their treatment in the presence of patients and their relatives or friends.

2.3     Physical History and Examination – there shall be no delay in making the physical examination of a patient. Another female shall be present in the physical examination of a female patient and no intern or medical student shall perform them except under the supervision of a resident. Procedures and examinations should be done with the consent of the patient and/or relative and should be under the supervision of the resident.

2.4     Accidents and unusual occurrences – No information shall be given out to the public concerning accidents and unusual occurrences in the hospital without the permission of the Chairman of the Department/Chief of Hospital.

2.5     The intern is expected to behave professionally at all times, attending to their duties promptly and faithfully, and respecting hospital property as to its proper utilization and maintenance.

2.6     Loitering in the corridors, conversing loudly boisterous laughter, singing and whistling are forbidden in the hospital. Smoking is not allowed within the hospital premises i.e. wards, corridors, conference rooms, laboratories, x-ray rooms.

2.7     Gambling, drinking alcoholic beverages, use of prohibited drugs are punishable by an indefinite suspension or outright dismissal from the Hospital by Law when indicated.

2.8    Social activities maybe carried out with proper permission from the appropriate hospital authorities.

3. RELATIONSHIPS WITH OTHER STAFF MEMBERS

3.1 Relationship among members of the house staff- Seniority in position, appointment and length of service shall apply in all questions of discipline and precedence.

3.2 Relationship with nurses and other employees – they have no jurisdiction over nurses and other employees of the hospital. They shall not reprimand them, but shall report any discourtesy, inefficiency or neglect of duty on their part to the Director or the Chief Nurse, or to their respective chiefs.

                 3.3 Residents shall have interns under their supervision.

 4. STANDARD HOSPITAL ATTIRE

INTERNS shall wear the prescribed uniform with their name printed on the left pocket within the hospital premises and in all prescribed functions or meetings. In the Operating room and Delivery Room, the appropriate surgical gown or scrub suits, mask and cap are required.

Each Intern is expected to have the following basic instruments:

-          Stethoscope

-          Sphymomanometer

-          Thermometer

-          Penlight

-          Tape measure

-          Minor Surgical Set:

a. 2 pcs of Mosquito Forceps (curved)

b. 2 pcs Mosquito Forceps (straight)

c. 1 Tissue Forcep

d. 1 Mayo Scissors

e. 1 Needle Holder

f. Scrub suit

g. OR shoes/slippers

 5. LEAVES AND ABSENCES

A formal letter requesting for leave of absence should be addressed to the Chairman of the Department concerned. A copy of the approved leave of absence shall be submitted to the Dean.

RULES ON STUDENT DISCIPLINE DURING INTERNSHIP

Offenses related to student conduct and behaviors covered by existing university rules shall be treated in accordance with existing policies. Jurisdiction of any case during Internships will be determined by a joint panel composed of BUCM and BRTTH Officials. Sanctions shall be designed jointly by the teacher/mentor and the learner and to be approved by the Joint Panel. Sanctions, in general, must be in connection with the learning objectives and tied to competency development.

The following are the list of offenses classified accordingly: GRAVE OFFENSES
  1. Failure to submit specimen for histopath
  2. Lost Chart
  3. Leaving post without permission
  4. Leaving serious patients unattended or in labor without appropriate endorsement or authorized arrangements
OTHER GRAVE OFFENSES:
  1. Loss of surgical specimen
  2. Dishonesty
  3. Gross neglect of duty
  4. Grave misconduct
  5. Conviction of a crime involving moral turpitude
  6. Falsification of official document
  7. Physical or mental incapacity or disability due to vicious habits
  8. Disgraceful and immoral conduct
  9. Inefficiency and incomplete in the performance of official duties
  10. Frequent unauthorized absences or tardiness in reporting for duty, loafing, or frequent unauthorized absences from duty during regular office hours.
  11. Refusal to perform official duty
  12. Gross insubordination
  13. Conduct grossly prejudicial to the best interest of the service
  14. Directly or indirectly having financial and material interest in any transaction requiring the approval of the office.
  15. Disclosing or misusing confidential or classified information officially know to him by reason of his office an not made available to the public, to further his private interest or give undue advantage to anyone, or to the public interest.
MEDIUM OFFENSES
  1. Simple misconduct
  2. Discourtesy in the course of Official duties
  3. Insubordination
  4. Reporting to duty under the influence of prohibited drugs and alcohol
  5. Unfair discrimination in rendering public service due to party affiliation of preference
MINOR OFFENSES
  1. Incomplete uniform
  2. Violation of reasonable office rules and regulations
  3. Discourtesy in the course of official duties
  4. Gambling prohibited by law
  5. Refusal to render extended service
  6. Lending money at usurious rates of interest.
  7. Pursuit of private business, vocation or profession Promoting the sale of tickets
MAKE UP:

For deficiency incurred during internship training, a make up slip is required before any deficiency can be completed and shall be done after the Internship program.

Steps for obtaining make up slip:
  1. Secure request from the Dean’s Office
  2. Settle corresponding fee
  3. Submit request form and receipt to the Dean’s Office
  4. Present to authorized Hospital Personnel for schedule
TEACHING-LEARNING STRATEGIES

The Internship is designed for Medical Students to practice the professional roles of a Physician under controlled supervision of a competent licensed doctor. The combined clinical/hospital and community setting shall serve as the venue of the teaching and learning process with a competent mentor to facilitate learning and adaptation to the roles of a 5-star doctor. The mentors will use diverse and multiple instructional strategies, assessment measures and evaluation parameters to ensure attainment of desired terminal competencies as prescribed by the curriculum.

EVALUATION Competency evaluation shall be based on the following criteria:

Terminal Departmental Exam                                      30%

Clinical Skills as evaluated by Department                 65%

Deportment                                                                 5%

A standardized exam will be jointly administered by the BUCM and BRTTH Clinical Departments for this purpose. Likewise, a standardized evaluation checklist using appropriate rubrics will be used to rate the overall clinical skills of the Intern.