Senior Clinician position description

 

If you are a Columbia medical student interested in volunteering as the senior clinician, please read the following job description and email your contact information to:

 

Each Senior Clinician will work independently under the direct clinical supervision of the attending physician.  The Session Coordinator will oversee all administrative and operational aspects of the clinic and the Senior Clinician should look to the Coordinator for guidance in these matters. 

 

Requirements:

1.      Completion of 5 weeks of either medicine or primary care

2.      Participation in a CoSMO orientation session

 

Saturday Responsibilities:

1.      Arrive at CoSMO by 8:30am

2.      The Session Coordinator will assign a Junior Clinician for you to work with during the day.

3.      Each student clinician will be assigned an exam room in which to see patients.  On any given Saturday the student clinician will see between three and five patients.  This necessitates an efficient, but thorough, approach to each patient encounter.

4.      For each:

            NEW PATIENT perform a complete H&P, addressing chief complaint

      F/U PATIENT review patient’s chart & problem list, perform focused H&P

5.      The first scheduled patient will be seen first by the you. 

            All subsequent patients will be seen first by the Junior Clinician.  The Junior 

            Clinician will then briefly present the patient to you before you see the patient.

            The Junior Clinician is there to help you and to learn.  Please include him/her and

            teach when appropriate.

  1. All patient encounters require a note to be entered in the chart and on WebCis.  You have the option of writing the entire note in WebCis, printing, signing and placing it in the chart or writing a handwritten note in the chart and a shorter focused note in WebCis.  The shorter note needs only include a problem list, medications and follow-up. 

ALL NOTES PLACED IN THE CHART MUST BE COSIGNED. 

  1. Present to the attending.  With the attending you must decide on an appropriate course of action and the category of any medications[1] that the patient requires.
  2. After you have finished discussing the case with the attending and completed your note, hand the session coordinator the chart with a list that includes: the class of medications the patient needs, return visit timing, referrals, lab studies, and/or x-rays that the patient needs.  The session coordinator will take it from there.

 

Helpful Hints:

  1. An Interpreter will be provided for you.  If you do not speak Spanish, please let the coordinator know at the start of the day.
  2. Unlike the wards and primary care rotations, at the end of the day, you have much more responsibility, especially when it comes to teaching the Junior Clinician.  This is a unique teaching experience that we usually do not get as medical students.  Try to think about the Junior Clinician and whether he/she is having a valuable experience.  As you see fit and are comfortable, feel free to teach the Junior Clinician how to do the physical or allow them to take as much of the history as they can with you interjecting as necessary.  Perhaps even teach him/her to do a portion of the presentation for the attending.  It is entirely up to you how you prefer to structure the patient encounter and the presentation to the Attending Physician in order to incorporate student learning in light of potential time constraints.
  3. There is an onsite Social Worker available to patients.  If you see a patient you feel would benefit from the service of a social worker, let the coordinator know or grab the social worker and ask him/her to speak to the patient while you present to the attending.      
  4. Likewise, there is an onsite Health Educator who is skilled at discussing nutrition, exercise, cancer screening, hypertension, diabetes and high cholesterol.  Utilize their services as needed either by contacting them directly or letting the coordinator know.
  5. Bring your own opthalmoscope/otoscope.
  6. You are free to wait until the end of clinic to enter the WebCis notes.
  7. Keep track of the time the Junior Clinician is spending with the patient if you are sitting around waiting.  It’s OK to knock on the door and ask them to wrap it up.
  8. Think fast and efficient.  As interns we will be seeing anywhere from 6-10 patients in a morning/afternoon.  Scary! 

 


[1] To clarify the meaning of “category of medication”:  the pharmacy program that we are using remains complicated and cumbersome.  To save your time and allow you to focus on the patient encounter and care we are going to have the session coordinator deal with the specifics of medication choice.  So, what you will need to tell the coordinator is merely what classification of medication the patient requires, for example, hypoglycemic, beta-blocker, or diuretic.  The student coordinator will then sit with the attending and look through the pharmaceutical options available to us and select a specific drug.