Medicine

Acting Internship in General Internal Medicine

This clerkship is offered year-round to fourth-year medical students. Two students are accepted for four- or six-week rotations.

The student is assigned to a medical teaching unit where the student becomes an integral member of the house staff team at UPMC Mercy. A carefully chosen and limited number of patients are assigned, with the students' responsibilities and duties similar to those of the intern.

The student will be responsible for the patient's initial evaluation and will implement appropriate diagnostic and therapeutic measures. During this rotation, emphasis will be placed on the student's involvement and active participation in daily patient care and management. Direct supervision and guidance will be provided by residents and attending physicians.

The student also will participate in the night call schedule and will be given the opportunity of admitting and treating medical emergencies. Working closely with the resident, the student will be permitted to develop and assume meaningful patient responsibility.

In addition to daily management rounds, formal teaching rounds are conducted three times weekly by the attending physician and twice weekly by the clerkship directors. The student will attend professor rounds and ethics rounds per the monthly schedule, and also will be required to attend selected teaching conferences. Students will be encouraged to develop independence and to rely increasingly on their own resources.

Cardiology and Coronary Care

The cardiology and coronary care clerkship is offered year-round to fourth-year medical students. One student is accepted for each four week rotation.

Cardiology and coronary care medicine at UPMC Mercy is highly specialized and technical. Students will be actively involved in the evaluation and management of patients with complicated and uncomplicated myocardial infarctions, unstable angina, decompensated valvular heart disease, and congestive heart failure. Students also will have the opportunity to observe and assist with the management of cardiac arrests. Daily teaching rounds with a full-time staff cardiologist on the medical floors and in the coronary care unit provide ample opportunity for clinical experience and learning Students on this service function as acting interns under the supervision of a senior resident during the rotation. Students will be required to admit one to two patients per day as well as provide follow-up on inpatients. Students will be expected to present patients on daily teaching rounds. Areas covered in great detail include:

  • Cardiac physical diagnosis
  • Treatment of myocardial infarction and unstable angina
  • The recognition and management of arrhythmias and conduction of disturbances
  • Indications for temporary and permanent pacing and management of acute pulmonary edema
  • Cardiogenic shock
  • Refractory congestive heart failure

Cardiac hernodynamics and interpretation of data obtained from cardiac catheterization will be emphasized. There will also be an opportunity for daily EKG interpretation with the cardiologist. The student will be expected to attend the weekly cardiology-cardiothoracic surgery conference and medical grand rounds. During this rotation, time can be allowed for the student to observe noninvasive diagnostic procedures such as exercise testing, nuclear studies (thallium and MUGA scans), and echocardiography, as well as invasive procedures such as cardiac catheterization and coronary angioplasty. A bibliography is provided for in-depth study of topics pertaining to coronary care.

Endocrinology

This clerkship is offered year-round to fourth-year medical students. One student is accepted for each four-week rotation.

The student will see patients in outpatient clinics in diabetes and general endocrinology. Hospitalized patients with endocrine problems will also be seen in consultation by the endocrine team on a daily basis. Students will be responsible for the initial evaluation and daily follow-up of selected patients. Students will work closely with the attending endocrinologist and a senior medical resident. A wide variety of endocrine diseases are seen. Students are not required to participate in night call or weekend call.

Gastroenterology

The gastroenterology clerkship is offered year-round to fourth-year students. One student is accepted for each four-week rotation.

The study of gastroenterology at UPMC Mercy is challenging and rewarding for the medical student. Students will be involved actively in the evaluation and management of patients with acute and chronic gastroenterology issues on the general medical units and in the intensive care units. Daily management rounds will be made with a full-time gastroenterologist. The medical student will have ample opportunity for case presentation during rounds and for bedside visits with the attending physician. Medical students will be expected to attend medical grand rounds.

Areas that will be covered in great detail during this rotation include:

  • Esophageal motility disorders
  • Peptic ulcer disease
  • NSAID-induced gastropathy
  • Acute and chronic pancreatitis
  • Acute and chronic diarrhea
  • Irritable bowel syndrome
  • Celiac sprue disease
  • Inflammatory bowel disease
  • Ischemic intestinal disease
  • Diverticulitis
  • Colorectal cancer, including screening and surveillance
  • Acute and chronic hepatitis
  • Nonalcoholic fatty liver disease
  • Alcoholic liver disease
  • Autoimmune and chronic cholestatic liver disease
  • Complications of cirrhosis, including management of portal hypertension and spontaneous bacterial peritonitis
  • Acute cholecystitis
  • Acute upper and lower gastrointestinal bleeding
  • The interpretation of peritoneal fluid analysis

In addition, medical students will have an opportunity to observe common gastroenterology procedures including upper endoscopy, colonoscopy, and endoscopic retrograde choangiopancreatography (ERCP). The student also may observe the placement of jejunostomy and gastrostomy tubes. Finally, medical students may have the opportunity to observe and possibly perform a supervised paracentesis.

Hematology and Oncology

This clerkship is offered year round to fourth-year medical students. One student is accepted for each four-week rotation.

Emphasis in this elective is placed on the clinical evaluation of patients with a variety of hematologic and oncologic diseases. The student will work closely with the attending physicians on a service which is exclusively subspecialty-oriented. This is primarily a consultative service where the student will see and evaluate hospital inpatients with a variety of hematologic and oncologic problems. In addition, the student will spend one day a week in the outpatient office setting seeing patients with the faculty member. The number of patients followed on the hematology/oncology unit will be limited so as to allow the student opportunity for the evaluation of selected hematology/oncology consultations (requested by other services). Each of these consultations will be thoroughly reviewed with the attending physician. Peripheral blood smears, bone marrow aspirates, and histopathology utilizing a teaching microscope will be reviewed regularly with faculty. The student will also attend and participate in the weekly Tumor Board meeting and other regularly scheduled hematology/oncology conferences as well as weekly medical grand rounds. Students are not required to participate in night call.

Infectious Diseases

The infectious diseases clerkship is offered year-round to fourth-year medical students. One student is accepted for each four-week rotation.

The student selecting the infectious diseases rotation at UPMC Mercy will be introduced to the diverse infections present at a 535-bed community teaching hospital with general and specialized medical, surgical, obstetrical/gynecological, and pediatric services under the direct supervision of one to two residents and the attending physician. The student will learn appropriate interviewing and examination techniques and how to analyze available data to perform an infectious disease consultation. Didactic sessions will cover the diagnosis and management of infectious diseases. The importance of appropriate use of diagnostic tests, culturing methodology, and antibiotic susceptibility testing will be reviewed. The student also will be exposed to the therapeutic approaches used in the management of a variety of common infections. The student will attend the monthly Infectious Disease Conference at UPMC Mercy. In addition, the student, with faculty support, will present a critical review of a self-elected infectious disease topic.

Intensive Care

This clerkship is offered year round to fourth-year medical students. One student is accepted for each four-week rotation.

This intensive care elective provides a broad-based clinical experience in the care of critically ill and injured patients, encompassing acute problems demanding immediate intervention, as well as ongoing management problems in complex cases. Multidisciplinary care of these patients is provided under the guidance of critical care medicine residents, fellows, and staff. The student will participate in all aspects of care of critically ill patients in the ICU. Emphasis is placed on bedside titration of care and knowledge of multiple organ system interactions and the patient's response to therapy during critical illness.

Recognition and appropriate treatment of respiratory failure, arrhythmias, complications of medical and surgical procedures, and hyperalimentation techniques also are emphasized. The student also participates in cardiac resuscitation efforts. A series of lectures focusing on the management of critically ill patients will be presented by the critical care medicine faculty. These lectures, the daily ICU rounds, and assigned readings provide the student with a broad introduction to the appropriate care of the critically ill patient. Students are not required to participate in night call. Students are expected to attend weekly medical grand rounds as well as the monthly critical care medicine conference.

Nephrology

The nephrology clerkship is offered year-round to fourth-year medical students. A maximum of two students are accepted for each four-week rotation.

This elective affords the student an opportunity to evaluate and manage patients with a wide variety of renal and electrolyte disorders. The student will see nephrology consultations and evaluate patients with renal disease admitted to the hospital. In addition to the initial evaluation, the student will follow patients and assist in their management. Daily teaching rounds will be made with the nephrology resident and attending nephrologists. Exposure to hemodialysis, peritoneal dialysis, and renal biopsy will also be provided. All renal biopsies will be reviewed in conjunction with the pathology department. Two outpatient nephrology clinic sessions will he conducted. The student will also attend daily noon conferences (including a monthly nephrology conference), weekly grand rounds, and one nephrology morning conference. Students are not required to participate in night call.

Neurology

This clerkship is offered year-round to fourth-year medical students. One student is accepted for each four-week rotation.

The clinical neurology elective provides an opportunity to study a wide range of neurologic disorders. The student will participate actively in the diagnostic investigation and management of patients on both inpatient and outpatient services. The student will present cases at teaching conferences where basic mechanisms of neurologic diseases will be emphasized. The student will be expected to undertake new patient evaluations in the form of history taking and performance of detailed physical and neurologic examination on approximately three patients each week. Although the student may examine a larger number of patients, depending on time and interest, he or she will not be expected to do a detailed history and physical on more than three patients per week. The student will attend weekly medical grand rounds as well as the weekly neurology/neurosurgery conference and the monthly neurology conference. Students are not required to participate in night or weekend calls.

Operation Safety Net®

This clerkship is offered year-round to fourth-year medical students. One or two medical students are accepted for each month rotation.

The Operation Safety Net® clerkship involves visiting homeless persons in the inner city streets and riverbanks with a primary care physician. Medical students will: be exposed to the urban, underserved population; apply methods to incorporate medical care to this destitute group; identify medical problems specifically experienced by the unsheltered homeless and barriers to care; and participate in the management of their complex sociomedical reality. In addition, students will participate in hospital consults for the street homeless case-management meetings, and discuss selected readings with the medical director.

Operation Safety Net® is a registered service mark
owned by Mercy Life Center Corporation.

Pulmonary Medicine

The pulmonary medicine clerkship is offered year-round to fourth-year medical students. One student is accepted for each four-week rotation.

This elective is offered to senior students who wish to expand their knowledge of pulmonary physiology and disease. The student will work closely with the pulmonary attending physician and the medical resident on service. The student will be an integral part of the team. The student will have exposure to a full spectrum of pulmonary diseases, including:

  • Chronic obstructive pulmonary disease
  • Asthma
  • Pneumonia
  • Fibrotic lung disease
  • Sarcoidosis
  • Tuberculosis
  • Pulmonary embolism
  • Various sleep disorders (sleep apnea, obesity hypoventilation, insomnias, and parasomnias)

Further, the student will come to understand and interpret pulmonary function tests, sleep studies and pulmonary exercise studies, as well as receive instruction in the indications and contraindications for bronchoscopy, pleural biopsy, and thoracentesis. The student will experience the procedures performed in a state-of-the-art sleep lab. History, physical findings, and management of these patients also will be emphasized. The student will be expected to develop competence in physical examination and history taking and to achieve an understanding of pulmonary pathophysiology. By the end of the rotation, the student should be comfortable taking a pulmonary history and performing a detailed examination of the chest. He or she will also develop the ability to formulate a differential diagnosis, as well as a workup and treatment plan. The student will attend daily noon conference, weekly grand rounds, as well as the monthly pulmonary medicine conference. Students are not required to participate in night call.

Rheumatology

The rheumatology clerkship is offered year-round to fourth-year medical students. One student is accepted for each four-week rotation.

This elective provides an excellent opportunity for medical students to develop their history and physical exam skills, especially with regard to performing a complete review of systems of the musculoskeletal system and a complete joint examination. The student will perform the initial history and physical examination on new patients seen in the outpatient setting daily with a faculty member in the Division of Rheumatology. A wide variety of diseases are seen, including

  • Rheumatoid arthritis
  • Juvenile rheumatoid arthritis
  • Systemic lupus erythematosus
  • Dermatomyositis
  • Vasculitis
  • Osteoarthritis
  • Regional musculoskeletal syndromes

There are regularly scheduled teaching sessions. The student also is encouraged to attend weekly medical grand rounds as well as the rheumatology grand rounds at the University of Pittsburgh. There also is opportunity for the student to become involved with case report or a small research project that could continue after the rotation, under the supervision of faculty. Students are not required to participate in night call.

Contact

Department of Medicine
UPMC Mercy
1400 Locust St.
Pittsburgh, PA 15219

Phone: 412-232-5533
or 1-800-637-2946
Fax: 412-232-5689

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