Tele-Rotation Experience

Attendings

Dr. Abdulhassan Saad, MD
Addiction Medicine Specialist & Internist

One day before the rotation

My clinical instructor emailed me the instructions for tele-rotation, and he checked my audio, video, and internet speed for a smooth tele-visit. He oriented me towards the most common pathologies seen and their management in the clinic, usage of EPIC EMR, memo templates, SOAP patient notes, check-in/check-out with doxy software, and quick assist (screen-share software), and much more. He spent half an hour over me to orient and answer my queries.

First day of the rotation

My clinical instructor added me to the WhatsApp group, where we got the link of doxy software to enter the patient’s room. We had two shifts, the morning and afternoon shifts. I was in the morning shift throughout my rotation. We had to use that WhatsApp group for every problem if we had. There were two senior interns and PA students in the office who were assisting us. Every tele-intern got a different room with another PA student.

Moreover, the 02 senior interns were on a rotatory basis. With quick assistance, we were sharing the computer screen; even I had access to EPIC. Therefore, I could write my patient notes, explore the patient’s history, labs, prior treatments, refills, and everything.

Then, a patient came inside the room. One PA student was in-person there. She introduced me to the patient. I was able to see and hear them clearly. That day, I observed how things work over there and how she was using EPIC and memo templates. After taking a brief history, we informed Dr. Saad then he came inside the patient room. We presented the case to him, he asked me some questions and taught me some TSH points.

We all interns had to submit our patient notes to the senior intern at the end of the day, which they usually returned to us after 2-3 days with feedback and constructive criticism.

First three weeks

As I got familiar with the system, I used to take the history, write SOAP patient notes, update the charts, order the refills, present the cases to Dr. Saad, and enter orders given by Dr. Saad with the assistance of a PA student. I was feeling just there; it wasn’t like to be a tele-visitor.

Last one week

Now, we got the opportunity to see patients on our own as we were there for the previous three weeks. Then the role of senior interns got more vital. If we needed to get vitals checked-up, we called senior interns with the doxy or WhatsApp group’s help. After that, we used to inform Dr. Saad; then, we used to write down the PLAN for that patient after his assessment.

My recommendation

It’s a positive attitude to modify yourself with the modifying surroundings COVID-19). Therefore, I would say go for tele-rotation provided you should keep some points in mind-

Before starting a rotation, ask-

1. Daily routine.
2. Number of patients to be seen per day.
3. Access to EMR (if it is limited, then how much is limited).
4. Ability to see, hear, and talk to the patients (because you get only to listen to them at some places).
5. Software usage for screen-sharing and tele-visit.

Conclusion

I am satisfied with my rotation. I learned many new things, especially the EMR system, saw various patients, SOAP patient notes, patient-physician relationships, dealing with irritable patients, and much more. Therefore, in my opinion, tele-rotation could be helpful as in-office rotation if taken seriously.

Disclaimer

I have not been paid for this. I am well aware of how financially challenging USMLE is. So any recommendation you find on this blog is from my own experience.