Medicine Consult

General Information

Daily Workflow

Start of the day: Long call resident should arrive by 7 AM and get sign-out as well as pick up the transfer phone from the night hospitalist on Foreman 7AE (same as hepatology rotation). If it's unclear who the night hospitalist is, find provider under coverage text paging grid under "Medicine Teaching Service" and "Medicine Consult, 24hr"). Rest of residents may then meet in NW8 conference room (code 135)

End of the day: The long call resident is required to see all consults until 7:00 PM and leave no earlier than 8:30 PM (code team coverage until night code leader receives sign-out). 


Consults: Most of the time, you are asked to either complete a preoperative medical assessment (POMA) or provide a medical consultation for a patient on a non-medical service.


Code leader: The long call resident is code leader from 7:00 AM to 8:30 PM. If you are sterile for a procedure, you must assign someone else (another med consult resident or the floor resident) to act as the code leader.

*Please assume that all patients who have a RRT or CAC called could be COVID+/AGP and don the appropriate PPE. Appropriate PPE should be worn with all patient encounters given the current COVID surge. It is OKAY to delay patient care for the time it takes to don appropriate PPE.


​MIDAS reports must be documented for all RRTs/CACs. This is the primary responsibility of the CCM team responding, but this task may be deferred to the code leader. If/when completing this task, please document it in the appropriate place as below.

Please note that EtCO2 application and measurement is now a standardized aspect of intubation during codes, so be sure to keep an eye out for it and document accordingly as applicable.


Death Certificates: From 6 PM – 7 PM, for patients on the PA medicine service, medicine consult is responsible to signing off on death certificates. From 7 PM onward, the night hospitalist is responsible. 


Procedures: You may be contacted by other services in the hospital to perform various procedures (LP, paracentesis, etc). Please remember that it is not your obligation to provide procedures, and should only be attempted if you are certified, agree with the indication, and feel the procedure is safe to perform. If you are not certified (sometimes in the case of LPs), you can explore if neurology or medicine chief resident could come to supervise you.

Transfers: We are responsible for accepting transfers to medicine only. We are not involved in the transfer of patients to/from MICU/CCU/CSICU/NSICU/SDU, or to hepatology, and cardiology. We are not involved in transfer for private, geriatric, or family medicine patients. Discuss each transfer with the attending (this can be before or after acceptance).


On weekends: Attending covering consults is the Green team attending. 

Pre-op Clinic: Thursdays are POMA clinic with Dr. Kristina Chae. POMA clinic starts at 1:15 PM. Go to 5th floor Practice B. POMA clinic is staffed by two short call residents. 


See literature section


Current Block

Upcoming Block

For Issues...

Please contact Firm 1 chief, Daanish Chawala, and Dr. Schafler. Letting us know of issues in real time allow us to better address them and find solutions

Goals and Objectives:

The third year rotation on the General Internal Medicine Consultation Service is designed to provide residents with broad experience in the practice of consultative medicine. To this end, third year residents will spend 4 weeks supervised by a medical attending as the medical consultant to the non-medical services. The goal of the experience is to provide training in the pathophysiology, diagnosis and management of medical problems particular to patients being cared for primarily by other services – particularly surgery, psychiatry, neurology, and OB/GYN. Residents shall gain experience in such care in a variety of settings, including intensive care units, pre- and post-operative settings, inpatient wards, and outpatient preoperative clinics. An additional goal of the rotation is to enhance residents’ effectiveness and communication skills with patients as well as consulting physicians.  

Goals by Relevant Competency (all for 3rd year level residents only):

Disciplines Covered




Infectious Diseases




Your goals for the next 4 weeks in POCUS should be to learn the basics of Cardiac POCUS, develop some proficiency in image acquisition, begin the basics of image optimization, and learn some of the standardized metrics for interpretation and clinical integration of cardiac POCUS in internal medicine.


The course consists of 3 main parts:


The first is self-directed learning. Dr. Galen has compiled two online learning opportunities to familiarize yourself with the basics and terminology that are required to perform cardiac POCUS. We have removed one of the afternoon preop clinics per week to create protected time for you to accomplish this. Please choose an afternoon in the first week and review the following:


First, please watch the NEJM video and complete the post-video quiz.


Next, watch this 1 hr video and review it with your co-residents. Provided by Dr. Galen, please don’t share this link widely it is copyrighted material:


The second part will take place at the bedside. Each day, after rounds, please review the list and look for patient who have had a recent TTE. As there are a high number of preops, there should always be a few. One of the faculty will try to give you an introduction on image acquisition and use of the US with recording clips. You should be trying to practice this skill at the bedside as often as possible. If you are having trouble finding patients, working the machine, or getting images please give me a call or text Dr. Schafler (732-939-4569)


The final part is building a portfolio. Each resident will be expected to record a portfolio of cardiac pocus cases. The portfolio should consist of one clip of each of the following views (parasternal long axis, Parasternal short axis, Apical four chamber, sub costal, and IVC). You should aim to collect a total of 5 sets of these views. At the conclusion of your rotation, you will be required to select your two best cases and submit them in a PowerPoint format (see instructions below). One of the faculty will set up a group review session via zoom to go over your cases and provide feedback and help with clinical integration.

Please compile two of your best sets of images. We would like you to put them in a PowerPoint presentation in the following order. Parasternal Long, Parasternal short, Apical 4, Subcostal, IVC. Please be sure to set them to “play automatically” and “loop until stopped”. One you have your two best cases in this form, please email them to Dr. Galen and Dr. Schafler. The time is TBD but it should likely be around 12pm on the protected day.


First insert the video clop into the presentation either with copy and paste or drag and drop. Then select the video clip on the slide. When you do the follow menu option will appear:
Click playback and select “automatically” from the drop down as well as click the box for “loop until stopped” as seen below: