During my 4 weeks on the inpatient Palliative Care unit at Victoria Hospital, I worked exclusively with Dr. Shiraz Malik, a UWO family medicine graduate who completed his additional training in Palliative Care at the University of Toronto. Dr. Malik and Dr. Gil Schreier are the two primary doctors in Palliative at Victoria and they alternate between the Inpatient Ward and Consult Service.
Teaching to Service ratioEdit
Far more teaching than service on this rotation. Dr. Malik would sit us down at least once a day for a 15-20 minute session about a topic that had come up with one of our patients. This was in addition to informal bedside teaching during rounds and during the day.
I did this rotation as a PGY-1, and there was a PGY-2 on the rotation at the same time. There were no medical students on the rotation with us.
Typical palliative inpatient population, range of patients from days to months of life expectancy. Some patients are long-term intended to spend their remaining time at VH, some are awaiting transfer to Parkwood, remainder are in hospital for an acute issue requiring treatment with the goal being discharge home.
Week in the Life of...Edit
What does a typical work week look like on this rotation? Edit
Each of the residents is responsible for 7 of the 14 patients on the inpatient Palliative Unit, with the staff always typically on the floor or somewhere nearby to ask for support. The day typically begins at 8-830am. We are each expected to deal with any issues that have arisen the night before and to begin rounding on our patients. Rounding usually takes the better part of the morning, as it involves conversations with patients, family, social work and other services. Twice a week the entire team rounds on all 14 patients during "walk-around rounds" to give everyone a sense of the patients' issues. Afternoons are usually spent completing any leftover issues from morning rounds, new admissions (when a patient passes, there is usually a patient elsewhere in the hospital awaiting transfer to Palliative Care) and informal teaching sessions. Keep in mind that the teaching sessions are quite frequent and take place when there is down time for the residents. The day is usually complete by 4-430pm depending on the day's workload.
Typically 1-2 home calls per week, plus 1 weekend during the 4-week rotation. During the week you are called for floor issues (a couple of times per night), and you typically only go into the hospital if there is a death before midnight to sign the death certificate and speak with family. For weekend call, you round with staff and complete admissions by mid-afternoon, with the floor calling you with issues the rest of the day.
Other Things to addEdit
This entry was last edited by Mario Elia on December 26, 2010.