KAISER NORTH BAY CONSORTIUM CLERKSHIP HANDBOOK



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KAISER NORTH BAY CONSORTIUM CLERKSHIP HANDBOOK Vallejo Steven Seibert, DPM Department Chief Gordon Sinclair, DPM Gray Williams, DPM Ronald Paterno, DPM Thomas Lee, DPM Klaus Kernbach, DPM Santa Rosa Steve Palladino, DPM Department Chief Sharon Wiles, DPM Kenneth Lopez, DPM Thomas Jordan, DPM Department Manager: Denise Lincoln, RN Department Manager: Troy Scherer Residents James Kinchsular, DPM R3 Daniel Sunboliyan, DPM R3 Yuko Miyazaki, DPM R3 Kathy Chou, DPM R2 Marcie Zdarko, DPM R2 Gordon McCrary, DPM R2 Mher Vartivarian, DPM R1 Jessica Prebish, DPM R1 Jamie Bakal, DPM R1

Welcome to the Kaiser rth Bay Consortium clerkship program. It is our goal during your month with us to provide an experience memorable for its educational value and to include you as an integrated member of our team. Please read through this manual both before and upon arrival and refer to it as needed. For more information on the residency program as well as our residents and attendings, visit our website: follow the links at Residency.kp.org/ncal. General Info: You MUST check in with Christine Osias in person at the Vallejo GME office at 9 am on your first day. Christine will have a checklist of things to do before you get started. She typically arranges to have your health clearance information forwarded from your school ahead of time. If you are ppd + or have other health clearance issues, it is mandatory that your files contain documentation that you are under the appropriate treatment or monitoring. You will get a Username and Password which enables you to access the Electronic Medical Record (see Supervision Grid below) The clerkship month divides time between Kaiser Vallejo and Kaiser Santa Rosa with 2 weeks in each location. You will be randomly assigned to one site or the other unless you notify us of a preference General clinic attire is preferred during weekly clinical encounters. Scrubs will be provided to you as appropriate surgical attire. Wear your white coat with your Kaiser ID. Fill your pockets with the usual suspects (stethoscope, bandage scissors, PDA/Pharmocopoeia). Avoid all perfume and cologne. Unfortunately meals and housing are not provided. For housing information, contact the Chief Resident (R3) at 707-651-3327. It is recommended that you have a car during the month as public transportation in the rthern SF Bay area is poor. We have great access to electronic journals and textbooks so there is no need for you to transport bulky texts/literature. Responsibilities & Expectations: *Take an active role. Be proactive *Shadow attendings or residents during clinic. Never initiate contact with any patients unless approved by the clinician. Do introduce yourself as a podiatry student so that patients know your role. *Assist first year with collection of inpatient laboratory information prior to morning rounds. We generally begin rounding at 8:00 a.m. unless we have scheduled morning didactics or elective surgical cases. *Participate in above-mentioned categorical clinics. You will see patients and present cases to appropriate attending or resident. *Scrub all elective surgeries (and add-on as desired). Assist the resident in preparation of the surgical suite (local anesthetic, tourniquet, gloves, etc)

*You are not responsible for weekend duties with the resident on call. Take this time to enjoy the northern San Francisco Bay area. We are an active department (full of cyclists, hikers, surfers, outdoor enthusiasts) and can recommend a myriad of activities to meet your interests. *During clinic time seek out the on-call attending to assist or shadow them as instructed. *Assist on-call resident with hospital and emergency department consults. Goals and Objectives for KNBC Clerkship: - Trauma Be able to recognize different fracture patterns via plain X-ray Understand when to order advanced imaging Understand rationale for operating vs. treatment with cast Understand basic classification systems o Lauge Hansen, Danis-Weber, Sanders, Gustillo-Anderson to name a few - Reconstructive Rearfoot Surgery o Understand basics of evaluation of reconstruction o Understand basic rationale of surgical therapy o Understand various conservative options prior to reconstructive rearfoot surgery - Forefoot surgery o Understand basics of bunion evaluation o Understand rationale of Lapidus vs. Austin o Understand basics of post-operative management o Understand normal and abnormal radiographic anatomy - Diabetic surgery o Understand basics of wound care o Understand basics of evaluation of the infected diabetic o Understand reconstructive surgery of diabetics to prevent ulceration o Understand etiology of diabetic ulcerations. Supervision Grid: Podiatry Students see patients and perform various activities only under direct supervision by attending staff and/or residents in both the inpatient and outpatient setting. All documentation in the Electronic Medical Record is signed off by an attending staff. Students do not write orders or prescriptions in the EMR. Operating Room Direct supervision by attending Clinic Visits Direct supervision by attending or resident Inpatient rounds Direct supervision by attending or resident History & Physicals Cosignature by attending Progress tes and general documentation Cosignature by attending Order to Admit Order to Discharge General Orders Discharger Summaries Transfer Summaries Prescriptions

Kaiser Vallejo Specifics: During your 2 weeks at Vallejo, you will be a part of all things podiatric. In other words, we want you to be where the action is to get the most education out of your experience. Generally this means you will participate in all clinics, surgeries, hospital work (rounding, consults) and weekly educational didactics (lectures, journal club, radiology rounds, grand rounds). Our weekly clinics are usually organized into various visit types (post operative, pediatric, fractures/trauma, wound care, pre-operative, minor surgical procedures). Concurrently, general podiatric clinics will be in session which are maintained by our attending physicians. We have designated surgical days (Monday and Friday) during which elective podiatric surgical cases are performed. You are also invited to participate in after hours and add-on surgical cases but are not obligated to attend. Seek out the chief resident for all questions. Directions to Kaiser Vallejo: Location: 975 Sereno Drive Vallejo, CA 94589 From I-80 in Vallejo take the Redwood West exit; turn Right on Redwood; Turn R at the second light: Tuolomne Street; Turn L at the second light: Sereno Drive Turn L at the light marked Kaiser Entrance and proceed straight to the parking garage at the back end of the campus see attached map. Kaiser Santa Rosa Specifics: - The site coordinator at Kaiser Santa Rosa is Dr. Lopez and he can be contacted at Kenneth.T.Lopez@kp.org or 707-566-5354. - X-ray and laboratory evaluation is performed across the hallway on the second floor of the Stein building. - There is a pharmacy located on the first floor of the Stein building. - Vasovagal episodes must have an LVN and an attending involved immediately. - Cast Room - in the cast room is the grinder, plastizote, etc. for orthotics/insoles modifications to be made. Please clean up after yourself. - The Depot Store: Do not give out wound care supplies to the patients. The Depot Store is a cheap alternative to the regular pharmacy for our patients. Located across from the elevators on the 2 nd floor of the Stein building. All equipment will be dispensed by the cast technician. This is to assure that the patient leaves with the correct size of device. There are no refunds available on any items through the depot store. All items in the depot store are not covered by Kaiser. - Custom Orthotics These are not covered by Kaiser insurance As of January 2007 the cost for a custom orthotic is $275. Turnaround time from the date of orthotic casting is three weeks. Currently all orthotic casting is performed by the cast technician and chief resident. Directions to Kaiser Santa Rosa Clinic:

Location: 3925 Old Redwood Highway Santa Rosa, CA 95403 From 101 rth, exit Medocino. Turn left on Old Redwood Highway. The clinic building is on the left approximately ½ mile up this road. The Foot and Ankle Surgery department is on the second floor and shares a reception area with Pediatrics. You should check in with Dr. Lopez or Dr. Palladino prior to your first day.

Podiatry 1 st Flr, Hallway F GME Office, Christine Osias, 707-651-5033