Internal Medicine: Elective Rotations

Allergy: Common disorders of immunology and allergy are stressed in an ambulatory setting. This rotation is offered only at our suburban training sites.

Clinical Skills in Internal Medicine (CSIM): This rotation, completed early in the internship year, focuses on clinical skills. It reviews history taking, physical examination skills, procedural skills and laboratory interpretation. In addition, it covers topics not often found elsewhere, including managed care, risk management, quality improvement, ethics, team learning, and preventive health. Computer skills, basic science skills and critical review of medical literature are stressed.

Cardiology Clinic: In-depth encounters with cardiovascular diseases will be met. Outpatient cardiology experience will also be provided. Attendance at all cardiology conferences is required. Some inpatient consultative work will be done in Cardiology, however, the majority of time will be spent in the outpatient cardiology clinic.

Dermatology: During this session, the emphasis will be placed on those disorders that will be commonly treated by internists, including knowledge of when to refer patients to this specialty.

Gastroenterology Clinic/Consults: Inpatient GI consults are combined with outpatient management. Common conditions such as peptic ulcer disease, hepatobiliary disease, liver transplantation, diverticular diseases and various endoscopic procedures are seen.

Geriatrics: This rotation emphasizes the care of elderly patients and is experienced in-depth at multiple geriatric sites including the Center for Senior Living and Boulevard Temple Nursing Home.

Hematology: In addition to inpatient hematology as taught on P2, this rotation exposes residents to the disorders and treatment of hematological abnormalities. The outpatient management of anemia and hematological malignancies is emphasized.

Infectious Diseases: Inpatient consultation on the ID Service is combined with some time in the outpatient clinic. HFH has a substantial HIV population, both inpatient and outpatient, allowing for adequate learning about this illness. As HFH is a major transplantation center, residents can also learn about infectious disorders of the transplant patient. The entire spectrum of infectious diseases is seen at HFH. This month complements the F6 experience.

Nephrology Consults: Consults and in-patient nephrology, in-patient renal consultation and renal dialysis will be studied. Discussions on fluid and electrolyte balance, and management of Acute Renal Failure are stressed. Again, this experience is meant to complement the inpatient rotation of Nephrology (H2).

Oncology Clinic: In addition to patient oncology as taught on P2, this rotation exposes residents to the disorders and treatment of solid tumors. The outpatient management of breast, colon, prostate and lung cancers is emphasized. Caring for the “healthier” cancer patient offers a different perspective on these diseases.

Pulmonary Clinic: Approach to different pulmonary diseases, such as asthma, COPD, sarcoidosis, lung nodules will be emphasized through the outpatient clinic and consults, to complement the learning experience on the inpatient floor (F2) and the Medical ICU. Time will also be spent on pulmonary function test interpretation and other tests.

Radiology: Exposure to a wide-spectrum of radiology procedures, including interpretation, knowledge of when to order, and cost effectiveness.

Research: Scholarly activity is required of all house officers and may include research, case reports, intensive literature reviews or presentations at scientific meetings. Up to 3 months (one month per academic year) can be spent on approved research projects, providing opportunity to learn; preparation of research proposal, IRB approval, data collection, database utilization, and writing skills. Both clinical and basic science research opportunities are available, with nationwide renowned researchers.
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Rheumatology: Not often encountered in the inpatient service, this month offers exposure to rheumatology, orthopedics, and sports medicine, connective tissue disorders, joint problems, back pain, and some sport injuries.

Sports Medicine: This month will expose the resident to the most common sports-related injuries, including developing physical examination skills and learning about the therapeutic role of physical therapy, pharmacological therapy and surgical intervention.

Additional Electives: At the discretion of the program director, interested residents are able to propose and design other elective rotations in their fields of interest. Some examples are: Anesthesia (for intubations), flexible sigmoidoscopy, cardiac electrophysiology, office gynecology, heart failure service, renal transplant service, HIV clinic, Transplant Infectious Diseases, tropical medicine, ambulatory medicine, quality improvement, etc.