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Click on the programs below for
more information about each clerkship. If you are interested
a particular one, contact the Office of Academic Affairs at
(215) 829-8764.
Ambulatory Care Internal Medicine
Provides clinical exposure to a wide variety of medical experiences
relevant to the practice of general internal medicine in the
ambulatory setting, including opportunities to participate
in various subspecialty clinics. Faculty supervision provides
ample opportunity for one-to-one teaching, and students are
encouraged to assume responsibility for clinical decision making
at levels appropriate to their experience.
Although a four-week clerkship does not allow for continuing
patient care, conferences and clinical experiences enable students
to better understand the principles or primary care: clinical
epidemiology, periodic health examinations, screening for disease,
psychosocial aspects of health and illness, nutrition and medicine,
and in-depth discussion of common ambulatory problems. Students
work with interns and residents assigned to these clinics and
contribute to daily teaching conferences in the
primary care curriculum. They also participate in daily conferences
on common diseases in primary care, as well as daily medical
subspecialty conferences.
Clinical Cardiology
This elective aims to teach the student about the diagnosis
and management of common cardiac disorders. The importance
of history taking and physical examination in clinical evaluation
of the patient is emphasized. Students are exposed to non-invasive
testing (exercise tests, echocardiography with Doppler flow
studies, electrocardiography, nuclear imaging) and invasive
testing (cardiac catheterization, coronary angioplasty). These
goals are achieved through the students’ participation
in inpatient rounds with the designated staff cardiologist
and Coronary Care Unit Rounds.
Students will also be encouraged
to participate actively in the cardiologist offices and can
perform cardiac consultations under attending supervision.
A core curriculum of lectures is offered. Intensive instructions
on the physical examination of the cardiac patient are a
key element of the course.
Critical Care Medicine
The student will spend four weeks as a working member of the
critical care team. He or she will work-up patients who are
admitted to the combined Medical Intensive Care/Coronary Care
Unit under the supervision of the critical care residents and
attendings. The student will have the opportunity to perform
many bedside procedures that are routinely done in the critical
care units. Formal rounding will take place each day the Pulmonary
and Cardiology staff.
The student is expected to take night
call every fourth night. Emphasis is placed on ventilator
management, invasive hemodynamic monitoring and problem-oriented
assessment
and management of critically ill patients. The critical care
team is responsible for responding to all cardiac arrests
in the hospital. The goal of the course is to provide the student
with clinical experience in the broad field of critical care
medicine, which encompasses both cardiac and multi-system
disease.
Emergency Medicine
Under direct faculty supervision, students develop the ability to rapidly evaluate
patients and plan the management of a spectrum of medical, surgical, obstetrical
and orthopaedic problems. They are given excellent opportunity to sharpen
their history taking and clinical skills as they have initial contact and
are primary caretakers of their patients. They will be instructed on and
encouraged to perform routine procedures such as wound prep and suturing,
splinting, IV, foley, and NGT insertion, ABG and venipuncture. Students are
on duty in Emergency Services approximately 40 hours per week on rotating
shifts and participate in all regularly scheduled Emergency Medicine conferences
offered by the Pennsylvania Hospital Emergency Attending Staff.
Clinical Endocrinology
The clinical endocrinology program allows the student to develop
the skills needed to diagnose and treat patients with various
endocrine problems using their own basic and clinical knowledge.
The student will learn to identify the typical and atypical
features of endocrine disorders, their presentation, clinical
course and expected outcome. The student will also improve
his or her ability to perform a comprehensive physical diagnosis
of the endocrine system; order, perform and interpret endocrine
tests and make important decisions that affect therapeutic
outcomes. This is achieved by utilizing all of the services
available to the Section on Endocrinology and Metabolism.
The student is supervised by Endocrinology faculty and has
the opportunity to evaluate patients and make clinical decisions
during hospital rounds and outpatient visits in private offices
and the Endocrine Clinic. The student also works with the consulting
resident while performing inpatient endocrine consultation.
Ample time to follow patients through surgery, review ultrasound,
CT and MRI studies and examine results from fine needle aspiration
biopsies is provided.
In addition to daily patient rounds, teaching is provided
by Endocrinology Faculty during daily office and clinic hours,
and conferences which cover the core of endocrinology. Ample
time is allowed for reading and literature searches. Night
and weekend coverage is not required.
Gastroenterology
The gastroenterology rotation enables students to witness
gastroenterologic consultations on a first-hand basis and then
present the cases to the fellow and attending physicians in
the section. Students will also observe several types of gastroenterologic
endoscopic procedures on a daily basis, including upper gastrointestinal
endoscopy and cessation of hemorrhage from ulcer disease, colonoscopy
and colonoscopic polypectomy, endoscopic retrograde cholangiopancreatography
and sphincterotomy with stone extraction and biliary stent
placement.
Students will also observe new technological advances in endoscopic
ultrasonography and laser therapy for ablation of esophageal
and rectal malignancies. Didactic clinical case conferences
are held twice each week with pathologists and general surgeons.
Hematology and Medical Oncology
A rotation through hematology and medical oncology at Pennsylvania
Hospital will provide students with a broad exposure to both
subspecialty areas. Daily inpatient rounds and consultations
will be coupled with extensive emphasis on outpatient treatment,
evaluations and follow-up. A multidisciplinary approach to
the management of malignancies is emphasized by regular cancer
conferences with other specialty areas. The goal is to provide
an overall conceptual approach to oncology, dealing with general
medical, oncologic and psychosocial issues.
Infectious Disease
The Infectious Disease Section provides consultative service
for adult medical, surgical and OB/YN patients, providing opportunities
for broad exposure to all types of disease-related illnesses.
As consultants, students have initial contact with patients
and work with attending staff and fellows to formulate diagnostic
and therapeutic plans. These plans are presented daily to the
teaching attending for discussion and review. Students are
expected to follow their patients for the duration of the patients’ active
infectious illness.
There will also be exposure to the Microbiology Laboratory
where students will obtain a basic knowledge of antibiotic
susceptibility testing and develop proficiency at interpreting
gram stains.
By the end of the rotation, students should be capable of
explaining the indications for and mechanisms of action on
the commonly used antibiotics and understanding the pathogenesis
and pathophysiology of common infectious diseases. Students
are required to have completed all basic clinical clerkships
prior to enrolling in this course. Prior completion
of a sub-internship in internal medicine is preferred but not
required.
Medicine Sub-Internship
A general medical subinternship with significant student responsibility
for the care of hospitalized acutely ill patients. Provides
experience with diagnostic and therapeutic procedures. Students
learn to work efficiently and rapidly, and to trust their clinical
skills, leading to better preparation for the work load and
responsibilities of internship. Faculty supervision provides
ample opportunity for one-to-one teaching.
Students will be members of the inpatient team, which includes
a teaching attending, supervising resident, and two interns.
Students will be expected to admit new patients during call
days, write up and present cases to the attending physician,
and have direct responsibility for all diagnostic procedures
and management decisions related to these cases. Students gain
experience in writing orders and progress notes, and taking
night coverage team admissions.
In addition to direct patient care responsibilities, students
actively participate in three hours of didactic teaching sessions
daily. These conferences include teaching attending Rounds,
daily Morning Report and Noon conferences. The daily Noon conferences
are divided into subspecialty conferences, weekly Medical Grand
Rounds and multi-disciplinary conferences including CPC’s.
Pulmonary Diseases and Critical Care Medicine
In addition to exposure to acute care medicine in an intensive
care setting, the elective in pulmonary diseases and critical
care medicine will offer students a broad exposure to a wide
variety of pulmonary diseases and disorders.
Students are expected to make daily rounds, Monday through
Friday, with both house and attending staffs. Rounds commence
daily at 7:30 a.m. in the Intensive Care Unit Conference Room.
This exercise will expose students to a wide variety of disorders
characterized by acute respiratory failure. It will also provide
an opportunity to familiarize the student with ventilator management.
Students will be asked to write up consults on any new admissions
with respiratory failure.
In addition, students will be asked to see consultations that
are placed with the Pulmonary Disease Service. This will provide
exposure to a wide variety of acute, sub-acute, and chronic
lung disorders of hospital patients. Students will be asked
to evaluate the patients and later in the day present the patients
to one of the attending physicians on the Pulmonary Disease
Service. In addition to performing an initial evaluation and
presentation, students will be expected to complete independent
library research on questions of interest.
Students will be provided an opportunity to interact with
all members of the attending staff in the Section on Pulmonary
Diseases and Critical Care Medicine. They will be exposed to
pulmonary function study interpretation, radiograph interpretation
and general management issues in the day-to-day care of patients
with pulmonary disorders.
Renal Diseases and Hypertension
Offers students the opportunity to participate in an active
nephrology program involving acute and chronic renal diseases,
fluid and electrolyte disturbances, acid-based abnormalities,
peritoneal dialysis and hemodialysis. Basic physiologic mechanisms
are stressed, particularly as they relate to clinical nephrology.
Students are taught to perform and interpret urinalysis and
clearance measurements.
Students observe nephrology consultations and work up new
patients admitted to the clinical services. Students also present
new cases to the attending physician, participate in daily
teaching rounds and observe peritoneal dialysis, hemodialysis,
and renal biopsies. Renal conferences permit active student
participation. Extensive reprint files are available as educational
aids.
Rheumatology
The clinical and pathophysiological study of rheumatic diseases
with emphasis on differential diagnosis of arthritis and connective
tissue disease, synovial fluid analysis, serologic and radiographic
interpretation, and management. Rheumatology as it pertains
to general internal medicine is stressed. Patient workups,
rounds, clinic, and inpatient consultations. Provides an opportunity
for close faculty supervision. |
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