Medical Student Orientation for Rehabilitation Medicine Rotation
Updated September 2016
DAY ONE
1. You will have lectures on the first Monday of your rotation.
2. On the first Tuesday of your rotation, be at the 4W residents’ room at Harborview at 10AM. You will receive a brief orientation from your attending that day.
COURSE EXPECTATIONS
1. Give a brief presentation (15-20 minutes) the last week of the rotation to your attending and resident. Please discuss with your attending early in your rotation what an appropriate topic should be.
2. Conduct at least one visit to a patient’s home or extended care/hospice facility
-Submit a written report to your attending and resident
3. Use a manual wheelchair for one day during the rotation
4. Observe physical, occupational, and speech therapy sessions on your patients
-if possible observe swallow evaluation, orthotic/splint casting, wheelchair fitting, etc
5. Optional outing with recreational therapy with your patient
6. Observe a rehab psychology session with your patient’s consent
7. Talk with the social worker about disposition, attend sessions b/w SW & patient
PROFESSIONAL EXPECTATIONS
1. Dress appropriately for the professional setting. This communicates to patients that you take yourself and their care seriously. Men: button down shirt and slacks. Women: blouse, slacks, knee length or longer skirts. All: close-toed dress shoes. If you are uncertain, ask your resident or the attending.
2. If you will be late or absent, you should discuss this with your resident or the attending.
3. You are expected to have no more than 2 unexcused absences during your rotation.
JOB DUTIES
1. Admit patients with core rehab diagnoses
2. Write orders for your patients with signature/review from the resident
-Includes day-to-day orders, admit orders, discharge orders, outpatient therapy orders, follow-up visits, discharge medications
3. Discuss medical issues during team huddles
-Mon, Wed, Fri 9:00-9:15 (green), 9:15-9:30 (blue), 9:30-9:45 (orange)
4. Call consultants on your patients
5. Call PCP before discharge
LECTURES
1. Lectures are held every Tuesday morning at UW from 7:30am to 9:20am and Thursday morning from 7:30am/8:30am to 9:50am. Check with your resident about which lectures will be the most useful for you to attend and the exact times of the lectures.
WEEKLY TEAM CONFERENCE
1. Green team conferences are Tuesdays 1pm-3:30pm (4WH73, code1-2-3-4).
2. Blue team conferences are Wednesdays 1pm-3:30pm (4WH73, code1-2-3-4).
3. Orange team conferences are Thursdays 1pm-3:30pm (4WH73, code1-2-3-4).
4. Discuss with your resident when you should attend conferences vs engaging in alternative activities
CORE REHAB MEDICINE DIAGNOSES
1. Spinal Cord Injury
2. Traumatic Brain Injury
3. Stroke
4. SAH/AVMs
5. CNS Tumors
6. Burns
7. Amputations
8. Post-flap
9. Polytrauma
10. Deconditioning (cancer, transplant, post-MI, etc)
11. Multiple Sclerosis
TOPICS TO UNDERSTAND
1. Autonomic dysreflexia
2. ASIA spinal cord examination/classification
3. Neurogenic bowel and bladder
4. Neurogenic skin
5. Neuropathic pain
6. Orthostatic hypotension
7. Ventilator management
8. Immobility hypercalcemia
9. DVT prophylaxis
10. Spinal fractures
11. Stroke subtypes
12. Dysphagia
13. Aphasias
14. Spasticity
15. TBI agitation
16. Diffuse axonal injury
17. Post-traumatic seizures
18. Glasgow coma scale
19. Autonomic storming after TBI
20. Cerebral salt wasting, SIADH, Diabetes insipidus
21. Heterotopic ossification
22. Neuropsychological testing
23. Critical illness neuropathy/myopathy
24. Orthotic prescriptions
25. Prosthetic prescriptions
26. Wheelchair prescriptions
27. Home modifications (ramps, bathroom equipment, etc)
28. Physical modalities (TENS, E-Stim, U/S, paraffin, etc)
29. Therapy functional terminology (SBA, CGA, MinA, independent, etc)
30. Functional independence measure (FIM scores)
31. Gait abnormalities
32. Neuropathies (diffuse vs focal)