Medical Genetics Outpatient and Inpatient Consult Service
Introduction
The neurology (pediatric and/or adult) resident in this position will spend four weeks with one or both Clinical Geneticists and Genetic Counselors in the outpatient clinics and on the inpatient service, including the neonatal intensive care unit and the pediatric wards of Brenner Children's Hospital and the neonatal intensive care unit at Forsyth Medical Center. They also will travel to outreach clinics held at Boone, North Wilkesboro, Statesville, Greensboro, and Hickory NC. The vast majority of patients seen are in the pediatric age group. Occasionally, adults are also seen, both as inpatients and outpatients
I. PATIENT CARE
1. Interview patients more skillfully.
2. Examine patients more skillfully.
3. Improve detection of dysmorphic features.
4. Formulate a diagnostic approach to children with congenital abnormalities and/or dysmorphic features
5. Formulate a diagnostic approach to children presenting with developmental delay and or mental retardation.
6. Develop an understanding of inborn errors of metabolism and their relevance to pediatric neurological problems
7. Appropriately select and interpret pertinent laboratory and imaging studies.
8. Improve ability to counsel families of patients with genetic disorders
9. Improve technical skills like performing skin biopsy.
10. Effectively implement and coordinate long-term medical care of the pediatric genetics patient.
11. Develop more effective ways of communicating with families of children with chronic and serious conditions.
12. Improve efficiency of care in the hospital setting.
II. MEDICAL KNOWLEDGE
1. Improve basic genetics knowledge base.
2. Expand clinical knowledge base regarding common genetic problems, including common chromosomal abnormalities, single gene disorders pertinent to pediatric neurology, malformation syndromes, mitochondrial and other disorders with non-traditional inheritance.
3. Obtain and interpret pedigrees.
4. Improve understanding of modes of inheritance of genetic disorders.
5. Improve understanding of evaluation and diagnostic testing for common genetic disorders.
6. Expand knowledge of potential interventions to anticipate and prevent future complications relative to the patient's illness.
7. Assess and critically evaluate current medical information and scientific evidence relevant to patient illness.
8. Present clinical cases at the regular section meetings in genetics and actively participate in the discussion.
III. PRACTICE-BASED LEARNING AND IMPROVEMENT
1. Identify and acknowledge gaps in personal knowledge and skills in the care of patients with genetic disorders.
2. Develop and implement strategies for filling in gaps in knowledge and skills.
IV. INTERPERSONAL SKILLS AND COMMUNICATION
1. Communicate effectively with patients and families
2. Communicate effectively with physician colleagues at all levels, especially regarding effective written communications.
3. Communicate effectively with all ancillary care personnel involved in the care of the patient to ensure comprehensive and timely care.
4. Present patient information concisely and clearly, verbally and in writing.
5. Teach colleagues and medical students effectively.
V. PROFESSIONALISM
1. Demonstrate respect, compassion and integrity when dealing with patients and families.
2. Demonstrate sensitivity and respect for patients' age, culture, race, gender and religious beliefs.
3. Demonstrate a commitment to ethical principles of providing or withholding care, patient confidentiality and informed consent, and business practices.
4. Demonstrate a commitment to carrying out professional duties including punctuality, reliability, chart maintenance and independent learning and professional development.
5. Demonstrate professional respects for superiors, colleagues, students and all members of the health care team.
VI. SYSTEMS-BASED PRACTICE
1. Understand and utilize the multidisciplinary resources necessary to care optimally for patients in the outpatient setting.
2. Collaborate with other members of the health care team to assure comprehensive patient care.
3. Use evidence-based, cost-conscious strategies in the care of outpatients.
4. Understand the long-term consequences of patient care in relation to the individual's socioeconomic status.
Duties
1. The house officer is directly involved in the management of patients in the outpatient and inpatient service. This includes:
· Obtaining a comprehensive history and reviewing medical records on the patients prior to the evaluation.
· Interviewing and examining new consults and outpatients.
· Composing an abbreviated consult note on every patient.
· Discuss the differential diagnosis and formulate a plan for management.
· Coordinate care by effectively communicating with other members of the patient's health care team.
2. The house officer must write a progress note on all patients. Notes must be in "SOAP" - note format and must be written in addition to a medical student note.
3. The house officer will see consults in the ED or the general pediatric floors during daytime hours as directed by the attending.