Upon completion of the internal medicine rotation, the neurosurgery resident shall be able to:
- Discuss a working classification of respiratory failure, and list common causes for each classification (e.g. hypoxia, hypercapneia).
- Interpret arterial blood gases, including calculation of the A-a gradient and identification of acid-base abnormalities (e.g. uncompensated acute metabolic acidosis).
- Diagnose and treat common fluid balance disorders, including hypovolemia and hypervolemia.
- Diagnose and treat common electrolyte disturbances, including: hypo/hypernatremia, hypo/hyperkalemia, hypo/hypermagnesemia, hypo/hypercalcemia and hypo/hyperglycemia.
- Interpret an electrocardiogram, including identification of common dysrhythmias (.e.g. atrial fibrillation, ventricular tachycardia).
- Identify and initiate treatment for common, acute cardiac events (e.g. myocardial infarction, defibrillation for pulseless ventricular tachycardia).
- Outline the common causes and initial empiric treatment of the patient with: pneumonia, urinary tract infection, endocarditis, meningitis, and other common infections.
- Classify antibiotics, describe their mechanisms of action and the primary indications for use.
During the rotation, all residents should fulfill the Royal College’s CanMEDS Competencies.
- Establish therapeutic relationships with patients and families, especially with respect to medical illness that affect the nervous system and pituitary disorders.
- Conduct, document and present a thorough medical history and physical exam.
- With appropriate supervision discuss relevant information with patients and family, especially conditions that have implications in acute surgical patients, such as cardiac, pulmonary and hematologic issues.
- To be able to share pertinent information with other health care providers involved in care.
- To participate in efficient and effective team handovers
- Work/collaborate effectively in an interdisciplinary team, including pharmacists, nurse practitioners, physiotherapists/occupational therapists/speech therapy.
- Be able to consult other specialists and subspecialist appropriately to care for more complicated patients.
- Be fully involved in educational activities and teaching offered by the service.
- Be able to share workload and duties appropriately with other teams, residents and students on the medical service.
- Be aware of finite resources utilize in an appropriate cost effective manner.
- On a busy service, learn to manage own time, education and personal life for a balanced lifestyle
- To learn time management skills in the medical setting.
- Be able to triage patients being able to identify medical emergencies that require prompt and immediate management; be able to appropriately triage emergency room and ward consults, and ask for help when required.
- Optimize safe and effective care in the acute and chronic care of medical patients
- Identify factors which contribute to overall medical health and counsel effectively for illness prevention.
- Advocate for timely investigations and tests in management of medically ill patients.
- Contribute to overall patient well-being and outcome
- Facilitate return of patient to community/alternate care
- Put in place community care and follow up to promote health and avoid readmission
- Appreciate barriers to care, particularly in underserviced patient groups
- Participate in medical/ICU/endocrine rounds and educational activities as able.
- Identify and seek out personal learning needs, especially to conditions relevant to neurosurgical patients, such as ICU/cardiac/hematologic/endocrine/pulmonary disorders
- Apply principles of critical appraisal to medical information, attend journal clubs
- Encourage student and peer learning, take opportunities to teach those junior.
- Contribute to development of new knowledge, be involved in appropriate research projects as able.
- Demonstrate commitment to appropriate bioethical standards of clinical practice
- Demonstrate a commitment to their patients, profession, and society through ethical practice
- Exhibit appropriate professional behaviors in practice, including honesty, integrity, commitment, compassion, respect and altruism
- Maintain appropriate relations with patients and other health care providers.
- Show appropriate respect for opinions of other health care providers
- Be able to appraise and identify own limits with respect to knowledge and patient care, and when to ask for assistance and consult effectively