MDU-MDL 2025
Med U and Med L General Medicine Teaching Services¶
Revised May 2025
High Yield Service Guide (Click here to advance to full service document)¶
MDL Attending pager: 123-2000 MDU Attending pager: 123-7097 Sample Daily Schedule Multidisciplinary Team Members Sign in to your pager on day one of service and sign in as Attending Provider for all patients on the list. It is a privilege and an honor to serve as an inpatient attending and it is a full-time job and should be prioritized over all other duties while on service. Be available 24/7 while on service. Be flexible and adaptable to the needs of the team daily. Prioritize patient care and education. Ensure residents can attend their conferences every day. Senior resident is the leader of rounds. Rounding should be done at the bedside when appropriate. Rounds should begin promptly at 8:45 and finish no later than 11:00 AM. Teaching is an expectation and a core mission for our Division. Expectation setting and in-person, individualized feedback is expected. Please complete evaluations promptly (click for more information on evaluations and contacts) More resources are available on SharePoint in the Med U and Med L Resources folders
Full Service Guide¶
History: Med U (MDU, Burnett Service) is one of three (U/L/W) General Medicine teaching services at UNC Medical Center. It is staffed solely by Division of Hospital Medicine faculty and has the unique privilege of Eric Allman, ACNP who works within the team structure. It is named in honor of Charles H. Burnett who came to Carolina in 1951 as the first chair of the Department of Medicine in the newly expanded four-year medical school. 7 General Medicine Unit is the geographic home unit for MDU (and its service line partner MDW). Med L (MDL) started in 2018 as Med BEST (Bondurant-Ehringhaus Service for Teaching) at the Hillsborough Campus. The service was named honoring Dr. Stuart Bondurant, Dean of UNC SOM from 1979-1994, and his wife Susan Ehringhaus. The service moved to the Medical Center in 2020 during the COVID-19 pandemic. MDL is staffed by Division of Hospital Medicine faculty and Chief Residents. 6 Bedtower is the geographic home unit for MDL.
Expectations and Responsibilities:
Teaching is an expectation¶
We encourage use of clinical “pearls” and brief teaching points during daily bedside rounds AND 10-20 minute “white board” talks a minimum of 3x/week. Be clear about Expectations at the beginning of your rotation and as each new team member rotates onto the service. Provide a written list of your expectations and priorities. Discuss individual and team goals at the beginning of your week on service. Sample expectation documents are available on Med U or L Additional Resources Folders. Feel free to use and adapt. Feedback evaluations in MedHub (for residents) or One-45 (for medical students) for all team members are expected within 2-3 weeks. To ensure the opportunity to provide feedback to residents and students, you might need to specifically request a link from Julie Golding for residents ([email protected]), Raquel Reyes for MS3 clerkship ([email protected]), or Ryan Bonner for Ais ([email protected]). Please review the TEC 2.0 Common Assessment Form and the document titled, Reyes Info on MS Evaluations, available in the Med U or L Additional Resources Folders on SharePoint before filling out your med student evaluations for guidance on appropriate scoring. Attendings receive anonymous evaluations once annually from the residency program. Consider asking residents and medical students specifically to complete their attending evaluations since many residents never complete them or include it as part of your expectations for the rotation. Feedback is a key educational tool and learners often benefit from brief feedback earlier in the week followed by individualized feedback toward the end of the week.
Availability 24/7¶
Attendings should be available 24/7 while on service. The attendings should be signed into the team attending pager for the duration of time on service and be available by pager 24/7. Consider providing your personal/hospital cell phone to the team for rapid communication. MDL Attending pager: 123-2000 MDU Attending pager: 123-7097 The attending should always be available to the team and have active involvement with the team, patients and families. The attending should see every patient every day, independent of the team when necessary. Attendings must be available to see or staff patients in the ED or in other emergent situations. Overnight, attendings should always be available by phone to discuss patient care, new admissions, or other concerns. Attendings remain available to the team for any questions, teaching and admissions throughout the day. Responsibilities to patients and the team take priority over other duties.
Rounding¶
Senior resident should “own” or lead rounds Bedside rounding should be the predominant format. Prioritize patients: unstable patients, new admissions/transfers, discharges, ED patients/boarders, stable patients. Encourage the resident to have a plan for rounds each day.
Attending communication¶
The outgoing attending initiates verbal or written “sign-out” to incoming attending and should be available for any follow-up questions or concerns. Attendings should be available to discuss patient/team issues or concerns with attendings from other services when necessary. Attendings must assign themselves as the “Attending Provider” in Epic on the first day of service and for all new patients and sign in to the attending pager.
Discharge considerations¶
Attending participation in discharge planning is critical. At time of discharge, the attending should ensure that accurate, problem-based discharge summaries have been completed, follow-up appointments scheduled within 14 days, and “warm handoffs” provided to outpatient providers.
Healthcare system initiatives¶
Each medicine service line team (with physicians and nurses) sets goals for the year for patient safety and quality improvement initiatives. On occasion, attendings may be asked to help with these initiatives while on service particularly if it impacts day-to-day operations of the team. Examples include: falls prevention, reduction in hospital acquired infections, length of stay initiatives, reducing readmissions initiatives
Typical Schedule: Prior to rounds: Independently review new admission H&Ps and updates on current patients. Independently see patients that are scheduled for morning discharge if appropriate (such as patients going to SNF or have early transport arranged). 8:00 am - 8:30 am: Resident morning report on Mon, Wed, Fri DOM expects all attendings on service to attend resident morning report. Location: 133 MacNider 8:45 am - 10:45 am: Bedside Rounding Bedside Rounds on selection of patients, prioritizing unstable patients, new patients, discharges and patients who present good teaching opportunities. Rounding is a significant teaching opportunity for clinical pearls. Also, consider brief teaching on physical exam findings. Ideal for a team member to touch base with bedside nurse when rounding. Remember: Two hours is only 10 min per patient to see 12 patients and 15 min to see 8 patients. Consider deferring more in-depth discussions with patients and families to the afternoon. 10:45 am – 11:00 am: Finish rounding (“table rounds”) “Table Round” on rest of patients not seen during Bedside Rounds. 11:00 am – 12:00 pm: Attending alone (or with Resident) rounds on patients not seen during rounds with team and in-depth assessments of specific patients. 12:15 pm - 1:00 pm: Resident noon conference It is expected that interns and residents attend noon conferences. Please complete rounds in a timely manner so they can attend. Grand Rounds on Thursdays (except summer months).
Afternoons: Staff new admissions Help with patient and family meetings More in-depth assessments of complex or interesting cases Consider radiology or laboratory / microscopy sessions End of the day: Check-out with team Review patients with the team before departing for the day, especially new admissions, important clinical changes on patients, and plan for next day discharges
Regularly Scheduled Activities: Interdisciplinary Rounds (IDR): Team-based, multidisciplinary care rounds to strengthen partnerships between care partners (providers, nurses, CM staff, UM), to support efficient patient throughput, achieve better continuity of care and follow-up, and streamline communication. If the resident cannot attend (or they are involved in patient care such as RRT), the attending should be available to attend. Med U: 1:45 pm – 2:00 pm, M-F on 7 GMU conference room Med L: 11:30 am – 11:45, M-F in the 6 BT conference room Meeting with documentation specialist for MDU: Wednesdays 2 pm Med L x Pulmonology Radiology “Walk-In” Rounds: Tuesdays at 1:00 pm Zoom: Meeting ID: 993 8535 8085, Passcode 730914 Meeting with ID CASP team for MDU: Thursdays 2 pm Teaching sessions for team.
Multidisciplinary Team Members¶
MDU APP: Eric Allman ACNP Physician Service Line Leader: Christina Kahl MD PhD Resident Service Line Leaders: Samuel Mickel MD and Mackenzie Owen MD Pharmacist: Jen Barrow, PharmD CM: TBD SW: Tyreese Jones 7GMU Nurse Manager: Nikia Smith RN MDL Physician Service Line Leader: Aaron Fried MD MBA Chief Resident Service Line Leader: TBD Resident Service Line Leader: TBD Pharmacist: Ryan Merchant, PharmD 6BT Nurse Manager: Turkeisha Brown RN CM: Jason Heidecker SW: Dontez Ward
Additional documents¶
DOM Expectations for Inpatient Attendings Sample expectations document for MDU/MDL Pulmonary Education Tip Sheets (Med L Resources folder on SharePoint)
Sample Teaching Topics for MDU and MDL¶
GI/hepatology (cirrhosis and complications, acute liver failure/injury) GI/luminal (GI bleeding, IBD) Palliative care, pain control, symptom management Malnutrition management Electrolytes and acid-base Sepsis management and antibiotics Bronchiectasis (Tip Sheet Available) Pulmonary Hypertension (Tip Sheet Available) Chest Tubes and Pleural Effusions (Tip Sheet Available) Alcohol withdrawal, complications of substance abuse and treatment Discharge planning and hospital system utilization