Medicine resident responsibilities consist of clinical assignments which include patient care, participation in the clinical teaching of senior veterinary students, participation in lectures and laboratories for underclassmen, participation in the resident lecture series, and possible participation in selected continuing education courses. Responsibilities also include rotating night and weekend emergency duty (this is shared by all of the small animal residents) as well as providing Medicine backup assistance to the other house officers on emergency duty. Third year residents have reduced emergency responsibilities. Medicine residents are required to:
- Assist and direct the daily admission, care and monitoring of patients assigned to the medicine service.
- Provide for the care and treatment of referral cases under the supervision of the medicine faculty member and communicate with referring veterinarians in a timely fashion.
- Attend rounds, seminars, and meetings as scheduled by the medicine service; active instruction of students is expected.
- Assist and supervise student patient care including reading daily students' SOAPs.
- Correspond with clients and referring practitioners by phone (on a regular basis during the patient's hospitalization) and discharge letters, and complete medical records promptly.
- Provide back up (nights and weekends) medical advice/assistance for other house officers seeing emergencies. This may require the medicine resident to take over emergency case responsibility if it is in the best interest of the patient
- Provide instruction to veterinary students on the diagnosis and treatment of patients during their clinical rotations.
The resident will be involved in the diagnosis and treatment of internal medicine cases under direct faculty supervision and will be responsible to the faculty member with whom he/she is rotating on the medicine service. The resident will be “the clinician of record” on all cases he/she receives and will assume the responsibilities of the attending veterinarian. Residents are expected to consult with their on-duty faculty clinician whenever questions arise. In this way, the resident will be afforded optimal responsibility and will, at the same time, receive continuous feedback on their diagnostic, clinical teaching, and communication skills.
Specific Resident Teaching Responsibilities
Each resident has numerous interactions with veterinary students and should realize that they are role models for these students. Professional attire and language, and appropriate interactions with referring veterinarians are expected. Residents must also take care never to use denigrating or insulting language when referring to other veterinarians or to students (within the hospital or a public place). Residents should refer to each other and other veterinarians as “Doctor” while in the hospital and should instruct the students to do the same.
- Residents should allow and encourage students to perform diagnostic procedures on their patients except when the animal is in a life threatening situation or the procedure would subject the animal to unnecessary pain.
- Students benefit from one-on-one discussions with clinicians about cases, as well as talking with owners. Students should be included in case discussion whenever possible.
- Residents must ensure that students understand the need for accurate completion of appropriate paperwork and forms, timely and ample submission for laboratory testing, correct medication dosing and administration, timely completion of ICU and discharge orders, and appropriate client communication. While these items are the student’s responsibility, the resident must oversee the case to minimize possible mistakes.
- During the final year of the residency, senior residents will be in charge of a medicine receiving service. This requires leading all rounds discussions and overseeing both their cases and the cases received by the other resident.
Referral Case Communication
The vast majority of cases seen in small animal internal medicine are referrals from veterinarians in Iowa and surrounding states. Communication with the referring veterinarian must be made in a timely and professional manner. The referral population provides cases for teaching, professional development, and hospital income.
- When an animal is hospitalized at the Medical Center, the referring veterinarian should receive a phone call on the day of admission to update him/her on the case. When an animal is discharged from the hospital, the referring veterinarian should receive another phone call to update them on the final disposition of the case.
- Discharge information is written for both the referring veterinarians and the client. A copy of the discharge (or case summary if the animal is deceased) is faxed or mailed to the referring veterinarian within 24 hours of patient discharge.
- Copies of laboratory results, biopsy reports, necropsies, etc., are not automatically sent to the referring veterinarian. It is the resident’s responsibility to make sure the referring veterinarian receives this information.
- If there is a concern about an interaction with a referring veterinarian or a client is unhappy about the service/outcome of their pet’s stay in the hospital, the senior clinician and Hospital Director should be informed as soon as possible.
There are numerous requests for telephone consultations from the referring veterinarians. These interactions are very important to the University in that they offer a possibility for referral and as a source of public relations. They also serve as a learning tool for residents. Most calls are from Iowa and the surrounding states. All calls should be returned within 24 hours. If a call is returned and a veterinarian is not available, make sure to leave a message and document on the phone message the date and time you returned the call. Some receptionists will ask you to call again at a specific time. It is generally best to tell them that your schedule is unpredictable and it is better to have the referring veterinarian return your call.
Remember that you cannot diagnose over the telephone. Preface your advice with phrases like “From what you are telling me, I would consider...” or “If I understand you correctly, you might want to....” Keep a record of your telephone consultations with notes you make, for 12 months. This is for the possibility of needing legal documentation, and also in case the patient comes in on referral.
There may be some instances where practitioners want an entire continuing education course. There is not enough time to do this. In those cases, offer to mail or fax them a review article or send a list of references on the subject.
It is required that all telephone consultations will be performed with the same professionalism as all other collegial interactions.