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ADMISSIONS AND EDUCATIONAL PROGRAM
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ALVIN J. SITEMAN CANCER CENTER
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SCHOOLS OF WASHINGTON UNIVERSITY
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First Year
M25 507 THE PRACTICE OF MEDICINE I
Instructor: Robert J. Rothbaum, MD, 286-2546
This course employs a variety of teaching techniques, instructors and venues. Some, like lectures, will be familiar. Others, such as one-on-one interviews in the hospital, will be new. Some course material is easily formatted into solid blocks, such as the teaching of statistical methods. Other content streams throughout the course, like interviewing techniques and history interpretation. Particular areas may be stimulating and rewarding, and other areas may seem irrelevant or overemphasized. As with patients, each of you comes with a unique past and active history, previously formed interests, and individual goals. Your prior contacts and personal experiences in science or medicine also influence you. It is impossible to account for all of these unique features, so we designed the course to accommodate a variety of learning interests and styles. Some will resonate with you; others may not. We hope to provide an opportunity for you to hone the skills that you already possess and acquire new skills necessary and important to the practice of medicine.
We intertwine the various content areas to highlight the inter-relationships inherent in the practice of medicine. We attempt to relate your basic science course material to the clinical and patient-based information. In particular, the Integrative Cases are designed to mesh basic science content with clinical questions. The practice of medicine is both a science and an art. We hope to demonstrate the complementary nature of these outlooks.
This course unfolds over three years. The first-year course, POM I, contains six sections: Patient/Physician Communication, Clinical Skills, Experience of Illness, Ethics, Scientific Method of Clinical Medicine and Research, and Health Promotion and Disease Prevention.
Objectives for POM I include:
1. Students can describe and analyze the scientific methodology of clinical studies and apply the results to individuals or groups of patients.
2. Students can perform a complete history and physical examination with thoroughness, accuracy, sensitivity and compassion.
3. Students can investigate the influence of culture, religion, ethnicity, socioeconomic factors and politics on the seeking and provision of medical care.
4. Students can examine and analyze their personal and professional competencies, limitations and behaviors.
Sections:
1. Patient-Physician Communication/History-Taking Section
Patient and caregiver engage in an intimate and delicate relationship. Although everyday skills such as listening and asking questions appear easily mastered, compassionate inquiry into confidential areas in an anxiety-laden environment requires a special combination of patience, quiet confirmation and observation. Learning certain guideposts and checkpoints for orientation and direction can prove useful.
2. Clinical Skills
This content area focuses on history-taking, physical examination, presentation of history and physical exam findings, and selected ambulatory skills.
3. Experience of Illness
The Practice of Medicine is an interpretive activity, and while it relies on complex knowledge and sophisticated technology, it is not a science. Medicine’s goal is to alleviate suffering and to do so brings a body of practical knowledge to bear in individual cases.
Physicians interpret the symptoms and signs from the patient, who has already interpreted their symptoms into a story of their malady. Thus, while modern medicine is founded on complex knowledge of biological science, attained by arduous work, interpretive skill is required for physicians to function. Medicine begins with the understanding of the patient and continues in therapeutic action on behalf of the patient. To do this requires that we understand how to interpret it, both medically and in a way meaningfully understood by the patient.
4. Ethics
Since the earliest days of medicine, physicians have recognized that they have special ethical responsibilities to their patients. Many medical ethics principles have endured through the centuries, but changing technologies and social conditions require physicians to apply these principles to new situations over time.
5. Scientific Methods of Clinical Medicine and Research
This section delineates the variety of statistical techniques and methodologies of interpretation of clinical and research data.
6. Health Promotion and Disease Prevention
The objectives of this section include: to understand the importance of Health Promotion and Disease Prevention, to understand different levels of prevention and to be familiar with possible preventive interventions.
Selectives
M04 514 CARDIOVASCULAR BIOPHYSICS
Instructor: Sándor J. Kovács, PhD, MD, 454-8146
This elective is intended for students with a background in the physical sciences: physics, mathematics, engineering, computer sciences and comparable fields. Topics covered vary according to the interest of the staff and the clinical spectrum encountered during the course of the elective. Included are quantitative cardiovascular physiology and pathophysiology, nonlinear dynamics and its application to physiology, biophysics, ultrasonics, biomechanics and biomedical engineering. The focus of the elective is the application of quantitative mathematical and engineering principles to solve real problems encountered in clinical practice. Participation in weekly seminars and familiarity with selected topics of current research are included. This course is offered in alternate years (2008-09).
M04 533 TROPICAL MEDICINE
Instructor: Daniel E. Goldberg, MD, 362-1514
Washington University School of Medicine has several faculty members who are actively researching diseases specific to developing countries. This elective is designed to bring these individuals together, in an informal discussion forum with students, to highlight the problems particular to geographical medicine. The elective will cover issues including eradication, prevention and treatment, immunology and vaccine development, as well as descriptions of the different disease syndromes. This selective is cross-listed in the Department of Molecular Microbiology.
Second Year
Teaching by the Department of Medicine is designed to: 1) prepare students for the transition from the preclinical sciences to the study of the sick patient at the bedside, 2) help them analyze the clinical manifestations of disease in terms of the responsible mechanisms, and 3) introduce them to the techniques of examination that are used regularly on all clinical services. This instruction is undertaken jointly with members of other clinical departments and is coordinated with subject matter presented by the Department of Pathology and Immunology.
The major areas of clinical medicine are presented in detail to illustrate the application of biochemical, physiological and anatomical information to the understanding of pathological states. Cardiovascular, renal, neurological, gastrointestinal, pulmonary, hematological, metabolic, nutritional and developmental diseases are discussed. Emphasis is placed on the use of fundamental information in approaching clinical problems as a way of thinking that prepares the student for a lifetime of medicine, during which new information will constantly be acquired.
M25 607 THE PRACTICE OF MEDICINE II
Instructor: Megan E. Wren, MD, 286-2546
Content Area Leaders: Jay F. Piccirillo, MD; Julie K McManemy, MD, MPH; Robb R. Whinney, DO; Rebecca S. Dresser, JD; Stephen S. Lefrak, MD
The goal of The Practice of Medicine (POM) course is to provide students with a set of knowledge, skills and attitudes essential to patient care regardless of specialty. POM II is a continuation of POM I and will continue to address various interfaces between patients, physicians and society and will also introduce approaches to clinical thinking and decision-making in the context of today’s socio-economic and cultural environment. The sections of POM II include Advanced Physical Examination, Case Development, Communication, Ethics and Health Policy, Health Promotion/Disease Prevention, Interpreting Illness, Ophthalmology, Patient Sessions, Radiology and Scientific Methods. The learning objectives for each section of POM II emphasize topics and skills used in all fields of medicine, and the majority of the course work will be taught in small groups or through clinical experiences. 81.25 clock hours.
M25 605A INFECTIOUS DISEASES AND MEDICAL MICROBIOLOGY
Instructor: Nigar Kirmani, MD, 454-8217
The infectious disease pathophysiology course emphasizes both organism-specific and organ-specific approaches to diseases caused by microbes. The course expands on material presented briefly in the first year concerning bacteria, viruses, fungi and parasites, and their involvement in human disease. Mechanisms of disease production, clinical manifestations and therapy are discussed, along with public health implications. In addition to lectures, small group case discussions enable students to apply the information they learn to clinical situations.
M25 606A RHEUMATOLOGY
Instructor: Leslie E. Kahl, MD, 454-7279
The rheumatology pathophysiology course begins with an overview of the structure, function and physiology of the normal joint. The pathophysiology of both localized joint disorders such as osteoarthritis and infectious arthritis are presented, along with systemic inflammatory disorders including rheumatoid arthritis, lupus and vasculitis. Diagnosis, pharmacologic management and rehabilitation of these conditions are included. In small group sessions, students interview patients and observe the characteristic physical findings of these disorders.
M25 611B CARDIOVASCULAR DISEASE
Instructor: Dana R. Abendschein, PhD, 362-8909
The purpose of this course is to consider the mechanisms and manifestations of acquired and congenital cardiovascular disorders as well as their pharmacologic treatment. Lectures and small group discussions that emphasize the major areas of cardiac pathophysiology and pharmacology are provided.
M25 612B PULMONARY DISEASE
Instructor: Michael B. Lippmann, MD, 289-6306
The objectives of the pulmonary pathophysiology course include review of normal pulmonary physiology as related to specific pulmonary disease states. The focus of the course will largely be upon presentations in lectures concerning pathophysiologic principles of abnormal lung structure and function. In addition, case study problems will be discussed.
M25 613B RENAL AND GENITOURINARY DISEASES
Instructor: Stanley Misler, PhD, MD, 454-7719; David Windus, MD, 362-7261
This course uses basic principles of renal physiology and ion homeostatis to understand commonly encountered fluid and electrolyte disorders (especially hyper/hypo-natremias, acidoses/alkaloses) and the action of diuretic drugs. The pathophysiology of diabetic kidney disease, glomerular and tubulointerstitial diseases, hereditary kidney diseases, and the relationship between hypertension and the kidney are discussed. It also applies basic principles of urinary system anatomy and physiology to the understanding of kidney stones, disorders of the bladder and prostate, and of micturition. The course also introduces basic principles of dialysis and kidney transplant. Lectures, small group problem-solving and team-based learning sessions focus special attention on: 1) how a working knowledge of fundamentals, diagnostic testing and arithmetic manipulation can have important predictive value; and 2) how the courses of acute and chronic renal failure are both adaptive and maladaptive for the organism.
M25 614 DERMATOLOGY
Instructor: David Sheinein, MD, 996-8005
The Dermatology second-year course is designed to teach medical students how to describe skin lesions and the pathophysiologic basis and clinical characteristics of major dermatologic diseases. Major categories of clinical skin diseases and their most prominent constituents will be discussed, including papulosquamous diseases, blistering diseases, infectious diseases, and benign and malignant neoplasms.
M25 615A ENDOCRINOLOGY AND METABOLISM
Instructor: William E. Clutter, MD, 362-8094
This course aims to develop understanding of the pathophysiology, clinical manifestations and diagnosis of common endocrine disorders. History, physical examination and interpretation of diagnostic laboratory tests are emphasized. Principles of treatment of endocrine disorders and pharmacology of relevant drugs also are discussed. Students are expected to apply their knowledge in clinical case discussions.
M25 620A GASTROINTESTINAL AND LIVER DISEASES/NUTRITION
Instructor: Deborah C. Rubin, MD, 362-8935
This course discusses the pathophysiologic mechanisms related to the diseases of the gastrointestinal tract including esophagus, stomach, small and large intestines, liver, gallbladder and pancreas. The emphasis is on changes that occur in normal physiology, biochemistry, anatomy, immunology and cell biology that result in human gastroenterologic diseases. Included also are lectures on the pharmacology of gastrointestinal drugs and basics of human nutrition in clinical practice. Lectures are supplemented by group seminars that focus on clinical case presentations.
M25 625A HEMATOLOGY AND ONCOLOGY
Instructor: Scot G. Hickman, MD, 289-6308
The hematology and oncology pathophysiology course exposes students to common hematologic disorders and hematologic malignancies. The course uses lectures, clinical case discussions and practical sessions involving microscopy.
Third Year
M25 710 MEDICINE CLERKSHIP
Instructor: Thomas M. De Fer, MD, 362-8050
Family Medicine Site Director: Walton Sumner, MD, 454-8164
VA Site Director: Scot G. Hickman, MD, 289-6308
The medicine clerkship provides supervised study of patients in both inpatient and ambulatory settings. The 12-week clerkship is divided into three four-week rotations: two inpatient and one outpatient. For the inpatient rotations, students are assigned as clinical clerks to patients admitted to the cardiology and general medical teaching services of Barnes-Jewish Hospital and the John Cochran Veterans Administration Medical Center. For the outpatient rotations, students are placed with community-based internal medicine or family practice physicians. Teaching is provided by the chief of service, attending physicians, house staff, consultants, chief residents, community-based preceptors and regularly scheduled conferences. Formal instruction is given regarding core internal medicine topics during the clerkship. Teaching activities include Chief Resident Rounds, Core Lecture Series, Physical Diagnosis Rounds, Radiology Rounds, Professor’s Rounds and other departmentally based conferences.
Clinical Pathological Conference
The clinical course, laboratory and radiologic studies, and pathological findings of a patient are discussed using a problem-solving format at a weekly conference by members of the Departments of Medicine, Pathology and Immunology, and Radiology; Melvin Blanchard, MD, internal medicine; chief residents and medical staff; Louis P. Dehner, MD; and pathology staff.
M25 707 PRACTICE OF MEDICINE III
Instructors: Robert Rothbaum, MD, Megan E. Wren, MD, 286-2546
In this course, themes and topics introduced in POM I and II are revisited and refocused on the students’ ongoing clinical experiences. The course has quarterly sessions. Each session begins with a short talk or panel discussion. Faculty preceptors then facilitate small group discussions as students reflect on their recent clinical experiences and dilemmas. The group develops potential solutions and management schemes.
Recent topics have included:
1. My most challenging or rewarding clinical experience. Who, what, when, where and why?
2. Medical errors and patient safety: What happens and why?
3. Ethics: What challenges occur? How are decisions made?
4. Doctoring: Am I the doctor that I expected I would be?
5. Family violence: Recognition, investigation and intervention.
6. Interactions with pharmaceutical companies: What is really going on here?
7. How to care when you cannot cure: Treating patients with chronic or terminal illness.
M25 714 AMBULATORY: EMERGENCY MEDICINE
Instructors: Mark Levine, MD, 362-6743
The WUMS III Ambulatory Care Rotation takes place in the main emergency department of Barnes-Jewish Hospital. Three to five students at a time are assigned to this four-week rotation. Students will spend their first day in an orientation session that will include a brief survival in the ED introduction, a suture lab, an airway lab, and a slit lamp lab. Domestic violence is covered during this four-week rotation. A course "text" will be provided for the students on orientation day and is theirs to keep. On day two, students will begin primarily evaluating non-emergent patients in the emergency department (EM 2) and Urgent Care Area and report directly to an attending or senior resident. There are four hours of mandatory conferences per week: 8-10 a.m. on Tuesdays and 8-10 a.m. on Wednesdays. Students can expect to gain a wide range of skills in evaluating a variety of complicated and non-complicated patients. At the end of their rotation, students should be familiar with the approach to complex medical conditions like heart attacks, undifferentiated abdominal pain, and complications of pregnancy as well as the "bread and butter" of complaints of ambulatory medicine such as lacerations, simple respiratory tract infections and minor trauma.
WUMS III will be graded on their ability to make a formal patient presentation during a shift, their clinical skills, and their conference attendance. There will be a written test on the last Friday of the rotation based entirely on the material provided to the students at the start of the rotation.
M26 713 AMBULATORY: FAMILY MEDICINE
Instructor: Walton Sumner II, MD, 454-8164
The Family Medicine clerkship offered in the third and fourth years allows medical students to work one-on-one with board-certified family physicians in outlying areas of Missouri and Illinois, and in other states. Students may review preceptor profiles and comments that previous students made about preceptors. The clerkship makes every effort to accommodate student preferences for working with specific preceptors. Most students will work with a single preceptor for the duration of the four-week rotation. Students may work with small groups, potentially including family medicine residents. The student will work closely with preceptors on a daily basis in the physician's office. Students often accompany their preceptor on nursing home visits, hospital rounds, medical conferences and other educational activities. Housing will be provided to students working outside the immediate St. Louis vicinity. Weekend call schedules are arranged with the preceptor: students can often return to St. Louis on the weekends. Each student will receive a description of the goals and objectives for the four-week rotation. Students maintain patient encounter logs on hand-held computer and receive short e-mail assignments during this rotation. Grades are calculated from preceptors’ subjective evaluations (normalized for the preceptor), essay responses and an evaluation of students’ attention to primary care issues.
M25 740 DERMATOLOGY CLERKSHIP
Instructor: Lynn Cornelius, MD, 454-8622
The goal of the dermatology clerkship is to provide a guide for the student to appreciate dermatology within the broader perspectives of medicine and biology. The student will develop familiarity with dermatologic vocabulary, learn to recognize and initiate therapy of common dermatologic disorders and become cognizant of uncommon or complicated dermatologic problems that require specialty care. Emphasis will be placed on careful history taking and physical examination. Students will always work under the direction of the resident physician and the attending physicians in the clinic setting.
The student will participate in outpatient care at the following hospitals and affiliated clinics: Barnes-Jewish Hospital, St. Louis Children’s Hospital, Barnes-Jewish West County Hospital, the Veterans Administration Medical Center and Connectcare Hospitals. These hospital settings will provide the student with ample exposure to a diverse patient population. Students will attend all clinical teaching rounds and conferences in addition to the basic science and cutaneous histopathology conferences. Normal workday hours are 8 a.m. to 5 p.m. with no night or weekend on-call responsibilities. Each student is provided with copies of the two recommended textbooks, Principles of Dermatology by B. Looking and The Color Atlas and Synopsis of Clinical Dermatology by T.B. Fitzpatrick for use during the clerkship; the textbooks are returned to the clerkship coordinator at the end of the clerkship for use by other students rotating in the dermatology division.
The rotation attending physician and the resident physician will submit an evaluation based on the student’s clinical skills, presentation, attitudes, overall performance and the end-of-rotation written exam score.
M25 750 GERIATRICS CLERKSHIP
Instructor: David B. Carr, MD, 286-2706
The primary goal of the four-week clerkship in Geriatrics is to provide an opportunity for students to gain proficiency in the principles of geriatric evaluation, including the medical, psychological, social and functional assessments of older adults. Direct, hands-on experience with patients is a major feature of the clerkship. Students are expected to participate in the evaluation of three to five patients per week, in a variety of settings including the hospital consult service, geriatric palliative care, geriatric rehabilitation, long-term care and the outpatient geriatric assessment center. Students will also participate in the Alzheimer's Disease Research Center, hospice and geropsychiatry rounds and attend geriatric conferences while on the rotation.
Students are assigned to a variety of attendings to enhance the experience. There is no night call or call on weekends. Participation on the hospital consult service will occur depending on volume. The day normally begins at 8 a.m. and is usually finished by 5 p.m. There will be time to read the detailed syllabus/bibliography. Students will be asked to present a brief topic of their choice at the end of the rotation and demonstrate knowledge of the geriatric screens and assessments.
M25 730 PHYSICAL MEDICINE AND REHABILITATION
Coursemaster: Neringa Juknis, MD, 454-7757
Clerkship in PM&R for third-year medical students provides an opportunity to gain basic knowledge and clinical skills in evaluation and management of a wide range of neurological and musculoskeletal diseases and conditions that require specialized rehabilitative medical and therapeutic care. Students spend two weeks on the Spinal Cord Injury Unit (SCI) and two weeks on the Brain Injury (BI) and Stroke Unit at The Rehabilitation Institute of St. Louis. Students are expected to be a part of the rehabilitation team, follow three to five patients, participate in daily morning rounds, participate in performing consults and attend team meetings and family conferences.
Students are required to attend several outpatient clinics such as SCI, BI, Amputee and Stroke. During the entire rotation, students work with PM&R residents and fellows, and under direct guidance of the NeuroRehabilitation faculty. The usual duty hours are 7:30 a.m. to 5 p.m. weekdays and 8 a.m. to noon on Saturdays. There is no night call.
Students are required to attend all PM&R curriculum lectures and conferences. On the first day of rotation, students meet with the PM&R program director to go over goals, objectives and schedules. Upon completion of the rotation, students are required to fill out the evaluation form to provide feedback regarding rotation experience.
Fourth Year
Electives
M25 801 HONORS MEDICINE—GENERAL MEDICINE
Instructor(s): Thomas De Fer, MD, 362-8050
Location: Barnes-Jewish Hospital
Elective Contact: Sarah Littlechild, 362-8050
Other Information: Students will receive e-mail communication regarding where to report on the first day prior to the beginning of the period.
Enrollment limit per period: Limit 6/period for Week 1; 6/period for Weeks 5, 9; 2/period for Weeks 13, 17, 21; and 1/period for Weeks 25, 29, 33, 37, and 41.
Valid start weeks for 4-weeks blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
The purpose of the "Honors Medicine" elective (subinternship) is the development of expertise in the care of hospitalized patients in a well-supervised teaching environment. Subinterns act as their patients’ interns under the supervision of residents and attending physicians. Subinterns have the same on-call and admitting schedules as the interns on their teams and are assigned up to two new patients on each admitting day. Subinterns are not required to spend call nights in the hospital. Except in emergencies, subinterns are the first individuals to evaluate patients admitted to medical service teams. A diagnostic and therapeutic approach to the patient is planned in consultation with the resident. Subinterns assume primary responsibility for the daily care of their patients, under the supervision of resident and attending physicians. This includes evaluation on daily rounds, scheduling and obtaining results of diagnostic studies, planning therapy, making arrangements for care after discharge and communicating with patients and their families. Subinterns attend the same conferences as the house staff.
Student time distribution: Inpatient 90%, Conferences/Lectures 10%; Primary Care 50%, Subspecialty Care 50%
Major teaching responsibility: Attending, chief resident, and resident
Patients seen/weekly: 8-12
On call/weekend responsibility: Yes
M25 805 RHEUMATOLOGY
Instructor(s): Richard Brasington, MD; Leslie Kahl, MD; and Prabha Ranganathan, MD, 454-7279
Location: Barnes-Jewish Hospital,
5C Center for Advanced Medicine
Elective Contact: Department secretary, 454-7279
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Students will be involved in the diagnostic work-up and management of patients with rheumatic illnesses including systemic lupus erythematosus, rheumatoid arthritis, vasculitis (polyarteritis, Wegener’s, temporal arteritis), spondyloarthropathies (ankylosing spondylitis, reactive arthritis), osteoarthritis, gout and regional musculoskeletal problems. By working closely with a faculty member, fellows and medical residents, students become integral and active members of the rheumatology service for inpatient consultations and outpatient clinics at Barnes-Jewish Hospital. An emphasis is placed on the physical examination of joints and the musculoskeletal system, synovial fluid analysis, and interpretation of diagnostic tests and radiographs. Students attend a rheumatology conference held weekly. An extensive collection of self-study materials, including reprints, textbooks, slides and CD-ROM discs is available.
Student time distribution: Inpatient 40%, Outpatient 50%, Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings
Patients seen/weekly: ~25 per student
On call/weekend responsibility: None
Other Information: Students should contact the Rheumatology office,
454-7279 prior to first day for assignment.
M25 807 HONORS MEDICINE—VA MEDICAL CENTER
Instructor(s): Scot Hickman, MD, 289-6308
Location: St. Louis Veterans Affairs Medical Center
Elective Contact: Scot Hickman, MD, 289-6308
Other Information: Students meet in A701 VA Medical Center, 7:30 a.m. first day of elective.
Enrollment limit per period: Limit 3/period for Weeks 1, 5, 9; 1/period for Weeks 13, 17, 21, 25, 29, 33, 37, and 41
Valid start weeks for 4-weeks blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Subinternship in medicine offers practical experience in the care of patients. Subinterns are an integral part of the house staff team, working under the supervision of a resident and attending physician. Their responsibilities for patients assigned to them are similar to those of interns. Patients are followed by the subintern throughout all levels of care including ICU, telemetry, stepdown, and general wards. Subinterns take call with their team and participate in the teaching conferences of the Department of Medicine.
Student time distribution: Inpatient 80%, Conferences/Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Single attending, chief resident and team resident
Patients seen/weekly: 6.8 on average
On call/weekend responsibility: Every fourth night
M25 809 HYPERBARIC MEDICINE AND PROBLEM WOUND MANAGEMENT
Instructor(s): John D. Davidson, MD, and staff, 205-6818
Location: St. Lukes Hospital, Barnes- Jewish Hospital
Elective Contact: John D. Davidson, MD, 205-6818 or pager 424-2626
Other Information: Interested students should contact Dr. John D. Davidson to discuss in what way this elective can be tailored to their particular interests and goals. Mini-electives of one to two weeks duration can be arranged. (PLEASE contact Dr. Davidson at 205-6818 three weeks prior to the first date of elective to try to tailor the elective as much as possible to your primary interests.)
Enrollment limit per period: 2
Valid start weeks for 2-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.
The specialty of hyperbaric medicine centers on the use of oxygen under increased atmospheric pressure as a drug for the treatment of many disparate diseases and clinical problems. This elective allows a student to have an acquaintance with this technology, which has a definite role in a wide range of differing specialties including emergency medicine, otolaryngology, plastic and reconstructive surgery, military medicine, rheumatology, dermatology, oral surgery, radiation oncology, internal medicine, neurology and psychiatry, to name a few.
Since students going into these specialties do not need to learn about hyperbaric medicine in depth, but nevertheless would benefit by some exposure to it, we can arrange a mini-elective of one to two weeks duration. This "exposure elective" can be tailored to a student’s special field of interest just as we attempt to do in the usual four-week program. Please call Dr. John D. Davidson for more information.
Student time distribution: Inpatient 3%, Outpatient 92%, Conferences/ Lectures 5%; Subspecialty Care 100%
Major teaching responsibility: John D. Davidson, MD, and Jane Kelly, Supervisor
Patients seen/weekly: 20
On call/weekend responsibility: Attending physician will call student regarding select cases
M25 810 GERIATRIC MEDICINE
Instructor(s): David Carr, MD, 286-2700, press option 1
Location: Washington University, Health Key Building, Third floor, Room 360
Elective Contact: David Carr, MD, 286-2700, press option 1
Other Information: Meet at the Division of Geriatrics office, Health Key Building, 4488 Forest Park Blvd., Suite 201, 8:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 5, 13, 17, 21, 25, 29, 33, 37, and 41.
Students will participate in patient care at the rehabilitation center, the skilled nursing facility Barnes-Jewish Extended Care in Clayton, the inpatient geriatric consultation service, the outpatient primary care and geriatric consultation center, and palliative care. Attendance at scheduled research and clinical conferences in geriatric medicine, memory and aging, geropsychiatry, and hospice meetings is also required.
Student time distribution: Inpatient 20%, Outpatient 80%; Primary Care 20%, Subspecialty Care 80%
Major teaching responsibility: Attendings
Patients seen/weekly: 10-15
On call/weekend responsibility: None
M25 814 CLINICAL EMERGENCY MEDICINE, BARNES-JEWISH HOSPITAL
Instructor(s): Mark Levine, MD, 362-6743
Location: Wohl Clinic
Elective Contact: Mary Hummert, 747-4156
Other Information: Contact Emergency Medicine Division office at 747-4156, for scheduling one week prior to the rotation.
Enrollment limit per period: 6
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
This rotation offers practical experience in the evaluation and management of acutely sick and injured patients. Students will function as subinterns, initially evaluating their assigned patients and developing a plan for further diagnostic studies and therapy. They will report to a senior level resident or an attending physician. The student can expect to get an opportunity to perform a wide variety of procedural skills such as suturing, splinting, peripheral and central venous access, and cardiopulmonary resuscitation. Shifts will be eight hours and students will rotate between day, evening and night shifts, including weekend shifts, in order to gain maximum exposure to all types of emergencies. A core content of lectures will be provided. Students are offered the opportunity to ride with EMS, though this is optional and not required or evaluated. Students desiring a letter of recommendation from Dr. Larry Lewis, Director of Research, or any other EM attending should take this WUMS IV Emergency Medicine rotation.
Student time distribution: Outpatient 80%, Conferences/Lectures 20%; Primary Care 40%, Subspecialty Care 60%
Major teaching responsibility: Attendings and senior residents (PGY 3 & 4)
Patients seen/weekly: ~5 per shift
On call/weekend responsibility: Evenings and weekends; no on call
M25 821 INPATIENT CARDIOLOGY
Instructor(s): Benico Barzilai, MD, 362-1297; David Schwartz, MD; Michael Beardslee, MD; Arthur Halle, MD; Sudhir Jain, MD; Andrew Kates, MD; Keith Mankowitz, MD; and Joshua Stolker, MD
Location: 13th Floor, Northwest Tower
Elective Contact: Benico Barzilai, MD, 362-1297
Other Information: Students meet on the 13th Floor, Northwest Tower, 9:00 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Students will participate as members of the Barnes-Jewish Cardiology at Washington University Consultative Team. They will be part of a team composed of faculty members, fellows, residents, and nurse specialists that sees a large population of cardiac patients and follows them through all aspects of their in-hospital care. Emphasis will be placed on physical examination and the interpretation of modern cardiac diagnostic tests including electrocardiograms, echocardiograms and coronary angiograms and their role in clinical decision making.
Student time distribution: Inpatient 75%, Outpatient 15%, Conferences/ Lectures 10%; Primary Care 5%, Subspecialty Care 95%
Major teaching responsibility: Attending and fellow
Patients seen/weekly: 10-15
On call/weekend responsibility: None
M25 822 HONORS MEDICINE - CARDIOLOGY
Instructor(s): Thomas De Fer, MD, 362-8050
Location: Barnes-Jewish Hospital
Elective Contact: Sarah Littlechild, 362-8050
Other Information: Students will receive e-mail communication regarding when/where to report on the first day prior to the beginning of the period.
Enrollment limit per period: Limit 2/period for Weeks 1, 5, 9, 13, 17, and 21 and 1/period for Weeks 25, 29, 33, 37, and 41.
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41
The structure and functioning of the "Honors Medicine-Cardiology" elective (subinternship) is very similar to the general medicine subinternship (M25 801). The basic purpose is to develop expertise in the care of hospitalized patients in a well-supervised teaching environment. The majority of patients admitted to the service will have a cardiology diagnosis as the main reason for admission. Some general medical problems will also be seen. All attendings on the service are cardiology subspecialists. Cardiology fellows act as the chief resident for the service on a monthly basis. Subinterns act as their patients’ interns under the supervision of residents and attending physicians. Subinterns have the same on-call and admitting schedules as the interns on their teams and are assigned up to two new patients on each admitting day. Subinterns are not required to spend call nights in the hospital. Except in emergencies, subinterns are the first individuals to evaluate patients admitted to medical service teams. A diagnostic and therapeutic approach to the patient is planned in consultation with the resident. Subinterns assume primary responsibility for the daily care of their patients, under the supervision of resident and attending physicians. This includes evaluation on daily rounds, scheduling and obtaining results of diagnostic studies, planning therapy, making arrangements for care after discharge and communicating with patients and their families. Subinterns attend the same conferences as the internal medicine house staff. There are also several conferences specific to the cardiology service.
Student time distribution: Inpatient 90%, Conferences/Lectures 10%; Primary Care 25%, Subspecialty Care 75%
Major teaching responsibility: Attending, chief resident, and resident
Patients seen/weekly: 8-12
On call/weekend responsibility: Yes
M25 823 CLINICAL CARDIOLOGY - VA HOSPITAL
Instructor(s): Wade Martin, MD, 289-6329
Location: John Cochran VA Hospital
Elective Contact: Wade Martin, MD, 289-6329
Other Information: Students should meet in Room B206, 2nd Floor, VA Hospital.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
The major purpose of this elective in clinical cardiology at the John Cochran VA Hospital is to improve evaluation and management skills for diagnosis and treatment of important cardiovascular conditions such as coronary artery disease including acute myocardial infarction, congestive heart failure, hypertension, and valvular heart disease. The rotation is designed to be flexible enough to accommodate a wide variety of course objectives but includes the opportunity to participate in 1-3 outpatient clinics per week; 1-4 weeks of inpatient intensive care, telemetry, or cardiology consultation rounds; and ECG, stress testing, nuclear imaging, or echocardiographic reading sessions, cardiac catheterization and electrophysiologic procedures. The emphasis will be on improvement of the ability to diagnose and treat cardiovascular disease on the basis of information obtained from a thorough history and physical examination that is integrated with data from appropriate highly targeted laboratory studies in a manner that optimizes patient outcome and minimizes risk and costs.
Student time distribution: Inpatient 45%, Outpatient 55%, Conferences/ Lectures 5-10%; Primary Care 25%, Subspecialty Care 75%
Major teaching responsibility: Attendings and fellows
Patients seen/weekly: 20
On call/weekend responsibility: Varies
M25 825 CARDIAC ARRHYTHMIAS AND ELECTROPHYSIOLOGY
Instructor(s): Timothy Smith, PhD, MD, 454-7834
Location: Barnes-Jewish Hospital, North Campus
Elective Contact: Timothy Smith, MD, or Yvonne O’Connell, 454-7834
Other Information: Students meet in the Cardiology Division, 4th Floor Kingshighway Building, Barnes-Jewish Hospital, North Campus, 8:00 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
This elective provides the student with exposure and teaching in the diagnosis and treatment of complex cardiac rhythm disturbances. Specifically, the student is expected to evaluate patients referred for evaluation and treatment of complex or life-threatening rhythm disturbances, unexplained syncope or sudden cardiac death. Rounds are made daily on hospitalized patients, and students are welcome to observe electrophysiologic studies or implantation of pacemakers and defibrillators. This elective also provides an intensive opportunity to learn clinical electrocardiography and the systematic use of anti-arrhythmic drugs. Finally, since patients with chronic, complex rhythm disturbances frequently have organic heart disease, a broad-based exposure to general cardiology is also part of this elective.
Student time distribution: Inpatient 80%, Outpatient 10% (optional), Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attending physician
Patients seen/weekly: 2 new consults/day
On call/weekend responsibility: None
M25 827 HEART FAILURE/CARDIAC TRANSPLANTATION
Instructor(s): Gregory Ewald, MD, 454-7009
Location: Barnes-Jewish Hospital, North Campus, Suite 4455
Elective Contact: Gregory Ewald, MD, 454-7009
Other Information: Students should page the attending physician, 8:00 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
This rotation is intended to provide trainees with a comprehensive experience managing patients with advanced heart failure. In addition to daily rounds, trainees are invited to attend both heart failure and transplant clinics. Further, the curriculum is supplemented by a comprehensive syllabus that contains the critical literature pertinent to this patient population. The trainees will also have experience with the evaluation of patients for operative heart failure therapies and will have the opportunity to observe these surgical procedures.
Student time distribution: Inpatient 70%, Outpatient 20%, Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings
Patients seen/weekly: 30
On call/weekend responsibility: None
M25 830 DERMATOLOGY
Instructor(s): Dermatology staff, 454-8622
Location: 7705 Wohl Hospital
Elective Contact: Rosemarie Brannan, 454-8622
Other Information: Students should contact the Dermatology office
(454-8622) prior to first day for room assignment.
Enrollment limit per period: 4
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
The aim of this elective is to provide a guide for the student so that s/he is able to appreciate dermatology within the broader perspectives of medicine and biology. Emphasis will be placed on the dermatologic variations encountered in a normal physical examination of the skin, the identification of common skin diseases, dermatologic clues to systemic disease, as well as those dermatologic conditions that are life threatening. The student will participate in outpatient care in the Barnes-Jewish Hospital and affiliated clinics. Students will attend all clinical teaching rounds and conferences in addition to the basic science and cutaneous histopathology conferences. M25 830 is essentially the same as the 3rd-Year Dermatology Clerkship. Students are limited to taking either one or the other—NOT BOTH. Students are also limited to taking either M25 830/Dermatology or M25 831/Pediatric Dermatology 4th year electives-NOT BOTH.
Student time distribution: Inpatient 25%, Outpatient 50%, Conferences/ Lectures 25%; Specialty Care 100%
Major teaching responsibility: Course Master for rotation, private attending and senior resident
Patients seen/weekly: 25-50
On call/weekend responsibility: None
M25 831 PEDIATRIC DERMATOLOGY
Instructor(s): Susan J. Bayliss, MD, 454-2714
Location: 3N48 Children’s Hospital
Elective Contact: Rosemarie Brannan, 454-8622
Other Information: Call 454-2714 prior to first day of elective. Reporting time is 7:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
This clinical rotation will be available to students interested in dermatology, pediatrics or both. Students will follow the dermatology rotation (M25 830) with an emphasis on pediatric dermatology by attending pediatric dermatology clinics, seeing consults, etc. Enthusiastic students will have an opportunity to write up a case report if they wish, but need to notify Dr. Bayliss before the course. Students can take either this elective or M25 830/Dermatology— NOT BOTH.
Student time distribution: Inpatient 1%, Outpatient 74%, Conferences/ Lectures 25%; Subspecialty Care 100%
Major teaching responsibility: Single attending
Patients seen/weekly: 50-100
On call/weekend responsibility: None
M25 836 CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
Instructor(s): Mauricio Lisker-Melman, MD, 454-8141
Location: Barnes-Jewish Hospital, East Pavilion
Elective Contact: Mauricio Lisker-Melman, MD, 454-8141
Other Information: Students meet in the Digestive Disease Clinical Center, street level East Pavilion, Barnes-Jewish Hospital, 8:00 a.m. first day of elective.
Enrollment limit per period: 4
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
The GI Hepatology elective is integrated into a very active inpatient/outpatient and endoscopy service at Barnes-Jewish Hospital. Students will participate in the evaluation of inpatients and outpatients with a spectrum of gut and liver disorders, will make patient rounds with the faculty and fellows, and have responsibility for patients on whom consultations have been requested. In addition, they will observe biopsy, endoscopic, and intubation techniques and participate in outpatient clinic and GI conferences.
Student time distribution: Inpatient 65%, Outpatient 25%, Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attending and fellows
Patients seen/weekly: 12 new
On call/weekend responsibility: None
M25 838 MEDICINE CONSULT SERVICE
Instructor(s): Christopher Gutjahr, MD, 362-1707
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Mary Russell, 362-1707
Other Information: Students should meet in the Division of Hospital Medicine office, Room 16-420, 8:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41. Two week rotations are also available.
The focus of the Medicine Consult Service elective is the evaluation and management of medically complex patients admitted to the hospital on non-medicine services. The issues involved with perioperative management are particularly stressed. The student will function as a member of the consult service team. Duties will include performing initial consultations and follow-up care under the supervision of a Hospital Medicine attending and a senior medical resident. Attendance at Department of Medicine and division conferences is encouraged.
Student time distribution: Inpatient 90%, Conferences/Lectures 10%; Primary Care 100%
Major teaching responsibility: Consult Service attending (from the Division of Hospital Medicine)
Patients seen/weekly: 10-15
On call/weekend responsibility: None
M25 839 DOCTORS ON FILM: THEMES RELEVANT TO POM
Instructor(s): Thomas M. De Fer, MD, 747-4366
Location: 6604 Wohl Hospital
Elective Contact: Thomas M. De Fer, MD, 747-4366
Other Information: Location and time to report on first day of elective to be arranged with course master.
Enrollment limit per period: 6
Valid start weeks for 4-week blocks are: Weeks 29 and 37.
OPEN TO WUSM STUDENTS ONLY. This course will explore the relevant social themes of films in which physicians and/or the medical profession are the main focus. There are countless portrayals of physicians in the cinema. There are also many films that deal extensively with various features of health care delivery. For good or for bad, viewers of these films outside our profession are influenced by these portrayals. Common stereotypes are perpetuated—“If it’s in the movies there must be some truth to it.” Depictions of physicians and major themes have evolved with time and under the influence of social and scientific developments. The course will investigate these depictions and themes using a selection of films to provoke thought and discussion. Each student will select a film from a list provided and preview it. They will introduce the film to the group and lead the discussion after the group viewing. Each student will complete an approximate 1,000-word essay regarding the relevant themes in the film and how they relate to the medical profession. All meetings will be arranged with the course master.
Student time distribution: Conferences/Lectures 100%
Major teaching responsibility: Thomas M. De Fer, MD
Patients seen/weekly: N/A
On call/weekend responsibility: None
M25 841 CARE OF THE HIV-INFECTED PATIENT
Instructor(s): Kristin Mondy, MD, 747-1725
Location: St. Louis Children’s Hospital, Barnes-Jewish Hospital, plus other ambulatory sites.
Elective Contact: Kristin Mondy, MD, 747-1725
Other Information: Students should contact Dr. Mondy one week prior to the start of rotation. Students report to the ID Clinic/ACTU, Storz Building, 4570 Children's Place, 9:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41..
This elective is designed to introduce students to the care of HIV-infected individuals (adults, adolescents, and children) and of HIV-exposed infants. Care of the HIV-infected patient encompasses not only the medical aspects, but also the psychosocial aspects of care. The elective will involve rotation through several clinics including the maternal-HIV clinic, pediatric and adolescent HIV clinics, and several adult HIV clinics, along with participation in community-wide social service meetings, home visits, and exposure to the Retrovirus laboratory and the AIDS Clinical Trials unit. In addition, the student will spend part of his/her time rotating in the general ambulatory infectious diseases clinics (pediatric and adult ID).
Student time distribution: Outpatient 65%, Conferences/Lectures 15%, Other 20%; Subspecialty Care 100%
Major teaching responsibility: Attendings listed above as course instructors
Patients seen/weekly: 20
On call/weekend responsibility: None
M25 844 HEMATOLOGY AND HEMOSTASIS
Instructor(s): Philip Majerus, MD, Morey Blinder, MD, and Stuart Kornfeld, MD, 362-8801
Location: 8441 Clinical Sciences Research Building
Elective Contact: Morey Blinder, MD, 362-8857
Other Information: Students meet in Barnes-Jewish Hospital North, 7900 Nursing Division, 8:00 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Activities planned include work-up of patients at Barnes-Jewish Hospital under the supervision of the hematology fellow and his staff consultant; attendance at clinical rounds three to five hours weekly; participation in out-patient clinics; experience in various procedures, especially blood and bone marrow morphology and in interpretation of coagulation tests. Weekly student rounds with a senior staff person.
Student time distribution: Inpatient 80%, Outpatient 10%, Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attending and fellow
Patients seen/weekly: 3-5
On call/weekend responsibility: None
M25 847 BONE AND MINERAL DISEASES
Instructor(s): Michael Whyte, MD; Kathryn Diemer, MD; Roberto Civitelli, MD; Reina Villareal, MD; and
Dwight Towler, MD, PhD
Location: Barnes-Jewish Hospital
Elective Contact: Michael Whyte, MD, 314-872-8305
Other Information: Please contact Dr. Whyte a week before elective for instruction and meeting location.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
The course is designed to acquaint the student with the clinical, radiological and pathological manifestations of disorders of bone and mineral metabolism, their etiology and pathogenesis, and to expose him/her to current concepts of therapy. The student will see patients at Barnes-Jewish Hospital, St. Louis Children’s Hospital and Shriners Hospital for Children.
Acquired and heritable bone diseases will be studied in the context of derangements of mineral homeostasis with emphasis on vitamin D and peptide hormone metabolism and skeletal formation and remodeling. The role of non-invasive methods for measuring bone mass in the diagnosis and management of skeletal diseases also will be stressed.
While students rotate through the Division of Bone and Mineral Metabolism, they will be asked to participate in the weekly divisional conferences. Faculty and medical students will present interesting cases for discussion or the students can present a pertinent topic they have researched during their rotation presenting the recent medical literature on topics related to bone metabolism, bone densitometry, and patient care issues involving osteoporosis, metabolic bone disease, Paget’s disease, congenital bone diseases or other topics encountered during their clinical experience.
Responsibilities: Shriners Hospital Wednesday a.m./p.m. (Dr. Whyte); CAM BMD teaching service, Thursday; Bone Research Conference Friday 9 a.m. Brown Room; Bone Health Case Conference, 7101 Steinberg conference room, North Campus, Friday 11 a.m. or 3 p.m.
Student time distribution: Inpatient 5%, Outpatient 80%, Conferences/ Lectures 15%; Subspecialty Care 100%
Major teaching responsibility: Attendings
Patients seen/weekly: ~20
On call/weekend responsibility: None
M25 850 HEMATOLOGY AND ONCOLOGY IV
Instructor(s): Scot Hickman, MD; Vorachart Auethavekiat, MD; David Kuperman, MD; and
Daniel Morgensztern, MD, 289-6308
Location: John Cochran VA Hospital
Elective Contact: Scot Hickman, MD, 289-6308
Other Information: Students should contact Dr. Hickman prior to first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
The student will have major inpatient and outpatient exposure to the management of the following: non-small cell and small cell lung cancer, carcinoma of the colon, prostate cancer, anemia, lymphoma, and leukemia. A wide variety of more esoteric tumors and hematological pathology may be encountered. In addition to diagnosis, staging, and management, general oncological topics such as pain management, hypercalcemia of malignancy and malignant effusions will be discussed. The weekly schedule includes morphology sessions, multidisciplinary conferences and tutorial sessions with the student alone, which will require prior literature review.
Student time distribution: Inpatient 25%, Outpatient 70%, Conferences/Lectures 5%; Primary Care 25%, Subspecialty Care 75%
Major teaching responsibility: Attendings and some fellow teaching input as well
Patients seen/weekly: 25
On call/weekend responsibility: None
M25 855 CLINICAL INFECTIOUS DISEASES
Instructor(s): Victoria Fraser, MD, 454-8214
Location: Barnes-Jewish Hospital, North Campus
Elective Contact: Cindy Waterman, 454-8214
Other Information: Students should contact Cindy Waterman at 454-8214 first morning of elective.
Enrollment limit per period: 6
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Study of patients with infectious diseases. The elective is designed to teach students the fundamentals of evaluating clinical problems in infection and formulating plans for workup and therapy. Students see consultations in infectious diseases in every part of Barnes-Jewish Hospital under the supervision of a faculty member who rounds with them every day. They work closely with medical residents and infectious disease fellows, follow their own patients and play an important role in their management. They are expected to read the literature about their patients and participate in clinical conferences. They attend teaching rounds and conferences and lectures in infectious diseases. They also learn appropriate use of antibiotics, antifungal and antiviral agents. A wide distribution of infectious diseases are covered including opportunistic infections, community acquired acute and chronic infections, and hospital acquired infections.
Student time distribution: Inpatient 90%, Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Single attending and fellow
Patients seen/weekly: 15 new consults
On call/weekend responsibility: None
M25 861 ONCOLOGY-INPATIENT
Instructor(s): Alex Denes, MD, 362-4803
Location: Division 7900, 7th Floor CAM
Elective Contact: Helen Black, 747-7509
Other Information: Students meet on the 7th Floor CAM, POD B, Medical Oncology Outpatient Area, 8:00 a.m. first day of elective.
Enrollment limit per period: 6 students per block, on average one per attending
Valid start weeks for 4-weeks blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Medical Oncology is a complex subspecialty that is undergoing a rapid evolution as a result of new systemic treatment approaches that stem from biological insights into the nature of cancer. During the course of the elective, medical students will be able to interact with attending physicians and patients for bed side teaching and attend tumor boards and lectures focused on the care of patients with solid tumors. At the end of the rotation the students will appreciate the principles of our approach to cancer patients and should have gained insights into the pharmacological basis for systemic cancer treatment. The ethical and medical challenges of caring for patients with advanced incurable malignancies will also be an important theme, as well as the conduct of clinical research in this patient population. Students will learn to care for hospitalized patients suffering from complications from their cancer or from toxicities due to treatments. Oncologic emergencies will be covered. Issues such as palliative care treatment options and end-of-life decision making will be explored as well.
Student time distribution: Inpatient 90%, Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: All Medical Oncology Attendings
Patients seen/weekly: 50
On call/weekend responsibility: None
M25 865 INTENSIVE CARE MEDICINE - BARNES-JEWISH NORTH
Instructor(s): Warren Isakow, MD, and staff, 454-8762
Location: Barnes-Jewish Hospital, North Campus
Elective Contact: Lisa Wetzel, 454-8762
Other Information: Students meet at the MICU (8th Floor Barnes-Jewish Hospital, North Campus), 9:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
This elective in intensive care is offered in the Intensive Care Unit at Barnes-Jewish Hospital, North Campus. This unit has 10 intensive care beds providing intensive nursing care and life-support technology. The patients represent a mixture of patients with primarily medical problems. Patient care responsibility includes night call. In addition to patient responsibility, there are regularly scheduled conferences and attending rounds.
Student time distribution: Inpatient 100%; Subspecialty Care 100%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: 8
On call/weekend responsibility: Every third night
M25 867 MEDICAL INTENSIVE CARE
Instructor(s): Marin Kollef, MD, 454-8764
Location: Barnes-Jewish Hospital, South Campus
Elective Contact: Rebecca Light, 454-8764
Other Information: Students report to the Medical Intensive Care Unit, 8300 Barnes-Jewish Hospital, South Campus, 7:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
This elective is offered as an opportunity to gain additional experience in acute, primary care medicine. The elective is an advanced course in patient care involving complex medical problems. Responsibilities involve working up new patients with the MICU team, case presentations and attendance at conferences. Conferences consist of attending rounds Monday through Saturday, radiology rounds Monday through Saturday, pulmonary conference and medical grand rounds on Thursday, and critical care conference once each month. Call schedule is every third night.
Student time distribution: Inpatient 90%, Conferences/Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Attendings and residents
Patients seen/weekly: 3
On call/weekend responsibility: Yes
M25 869 PALLIATIVE MEDICINE
Instructor(s): Jane Loitman, MD, 747-4780
Location: West Pavilion, Barnes-Jewish Hospital
Elective Contact: Jane Loitman, MD, 747-4780
Other Information: Please contact course master at least one week before start of elective. Reporting time is 9:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
The Palliative Medicine elective will focus on the care of patients with life-threatening or debilitating illness throughout the course of their care. Skills in symptom management, communication, and interdisciplinary team-based care will be the focus. Students will spend the majority of their time on the BJH Palliative Care Service. Based on the individual student’s interest, there will also be opportunities to work with the BJC Hospice Team and the St. Louis Children’s Hospital WINGS program.
Students will learn to assess and treat refractory symptoms, participate in complicated advanced care planning, and gain an understanding of rational polypharmacy through consultation on end-of-life issues and symptom management. While in the hospital, students will be responsible for seeing patients upon initial assessment as well as delivering follow up care with the team. Patients will be seen for both end-of-life care as well as symptom management. Students will participate in conversations with patients regarding goals of care, delivering bad news, and withholding/withdrawing care. Students will attend interdisciplinary team meetings and make home visits with hospice care providers. Emphasis will also be placed on observing and understanding the psychosocial and spiritual needs of the patients, as well as the impact of the burden on caregivers.
Student time distribution: Inpatient 75%, Outpatient 15%, Conferences/Lectures 10%; Subspeciality Care 100%
Major teaching responsibility: Attendings (Jane Loitman, MD; Bernie Shore, MD; Elliot Gellman, MD)
Patients seen/weekly: 10
On call/weekend responsibility: None
M25 870 ENDOCRINONOLOGY, DIABETES AND METABOLISM
Instructor(s): Clay F. Semenkovich, MD, and staff, 362-7617
Location: 8th Floor SW Tower, Barnes-Jewish South Campus
Elective Contact: Karen Muehlhauser, 362-7617
Other Information: Students meet on 8th Floor SW Tower, Barnes-Jewish South Campus, 8:15 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
In general, the 4-week rotation will be divided into 2 weeks general endocrinology and 2 weeks diabetes. Students taking this elective sees patients with endocrine and metabolic diseases in the Outpatient Consultation offices and inpatients at Barnes-Jewish Hospital They will present these cases at formal rounds. They will also participate in informal rounds with the division and at divisional seminars. Extensive interaction with patients with diabetes and a diabetes education program are included, as is involvement with patients with thyroid, pituitary, adrenal, gonad, metabolic bone disease, and lipid disorders. Ample opportunities will be provided for discussions of patient problems with the members of the division.
Student time distribution: Inpatient 20%, Outpatient 70%, Conferences/ Lectures 10%; Subspecialty Care 100%
Major teaching responsibility: Faculty consultant for inpatients, individual faculty one-on-one for outpatients, and program director for both
Patients seen/weekly: 8-10
On call/weekend responsibility: Elective for students
M25 871 ONCOLOGY-OUTPATIENT
Instructor(s): Steven Sorscher, MD, 362-9319
Location: Siteman Cancer Center, CAM Building
Elective Contact: Michael McKenzie, 362-5654, mmckenzi@im.wustl.edu.
Other Information: Students meet on the 7th Floor, Siteman Cancer Center, CAM Building, 4921 Parkview Place, 8:30 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Students will gain experience in the initial treatment of newly diagnosed malignancies and the outpatient management of oncology patients. Participation in multidisciplinary tumor conferences will stress a combined-modality approach to management, incorporating chemotherapy, radiotherapy and surgery. Students will see patients with a variety of malignancies, including lymphoma, myeloma, and tumors of the lung, breast, and colon. Management of hypercalcemia and other paraneoplastic syndromes, as well as cancer pain management will be covered. Students will have the opportunity to see how most oncologists spend 90% of their workday. They will observe different styles that oncologists have in presenting news about prognosis, treatment options and other information to patients while they also learn about the molecular basis for cancer, the mechanisms of action for our therapies (particularly the newer agents which target specific molecular abnormalities) and the key studies that justify the use of therapies (e.g., randomized studies showing that after surgery, chemotherapy will reduce the risk of recurrence from a particular cancer with a particular regimen). By spending time with clinicians, students will learn how to identify hereditary syndromes, use drugs for symptom relief and also learn how radiographic and laboratory tests allow oncologists to care for patients.
Student time distribution: Outpatient 85%, Conferences/Lectures 15%; Subspecialty Care 100%
Major teaching responsibility: Oncology attendings and occasionally fellows
Patients seen/weekly: 30-50
On call/weekend responsibility: None
M25 880 PULMONARY MEDICINE - BARNES-JEWISH HOSPITAL
Instructor(s): Daniel Rosenbluth, MD, and staff, 454-8762
Location: 5th Floor Kingshighway Building, North Campus
Elective Contact: Lisa Wetzel, 454-8762
Other Information: Students should page Pulmonary Consult Fellow, 7:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Students will acquire skills in the evaluation and management of patients with pulmonary diseases and in the interpretation of pulmonary function tests. They will gain experience in outpatient Lung Center and attend regular pulmonary and critical care medicine conferences.
Student time distribution: Inpatient 60%, Outpatient 20%, Conferences/ Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Multiple attendings, fellows and residents
Patients seen/weekly: 20
On call/weekend responsibility: None
M25 882 PULMONARY MEDICINE - VA HOSPITAL
Instructor(s): Carlos Daughaday, MD, 289-6306
Location: John Cochran VA Hospital
Elective Contact: Carlos Daughaday, MD, 289-6306
Other Information: Students meet in 6C-MICU John Cochran VA Hospital, 7:30 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Students will participate in several ambulatory care activities of the Pulmonary Section, including outpatient consultations of common respiratory disorders such as COPD, obstructive sleep apnea, lung cancer and tuberculosis, and follow-up of primary care patients with pulmonary disease. In addition, students will round in medical intensive care units, interpret pulmonary function tests, participate in bronchoscopy and attend scheduled teaching conferences of the Pulmonary Division.
Student time distribution: Inpatient 30%, Outpatient 50%, Conferences/ Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Several attendings
Patients seen/weekly: 6-10 (by student)
On call/weekend responsibility: None
M25 883 TRANSFUSION MEDICINE
Instructor(s): Douglas Lublin, MD, PhD, 747-0687
Location: Barnes-Jewish Hospital
Elective Contact: Mary Madden, 747-0687
Other Information: Students should discuss their rotation with Dr. Lublin and staff in advance. Students should meet the team on 5900 Pheresis Unit at 9:30 a.m. first day of the elective. Contact resident on beeper 424-1154 if you have questions.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
This elective is designed to introduce the student to the clinical aspects of blood banking and transfusion medicine. The four-week elective will consist of didactic sessions with senior staff, teaching conferences, participation in daily clinical rounds. The student will develop clinical skills in areas related to transfusion practice, blood conservation and evaluation of transfusion reactions. Complex hematologic diseases such as the coagulopathies and diseases that require apheresis will serve to instruct in current clinical practice along with evolving applications of transfusion medicine, such as photopheresis and peripheral stem cell harvest for marrow transplantation.
Student time distribution: For July, November and March: Inpatient 30%, Outpatient 30%, Conferences/Lectures 40%; For remainder of year: Inpatient 40%, Outpatient 40%, Conferences/Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Attendings
Patients seen/weekly: 20-25
On call/weekend responsibility: None
M25 884 BONE MARROW TRANSPLANTATION AND STEM CELL BIOLOGY
Instructor(s): John F. DiPersio, MD, PhD, 362-9339
Location: Bone Marrow Transplant Unit 13-100
Elective Contact: John F. DiPersio, MD, PhD, or Angela Hess, 454-8306
Other Information: Students meet in the Bone Marrow Transplant Unit, 8:30 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Intense four-week clinical rotation exposing interested fourth-year medical students to the clinical world of bone marrow transplantation and to the basic science of hematopoiesis, leukemia, and stem cell biology. Students will be primarily responsible for the care of autologous and allogeneic BMT recipients and those patients being treated for a variety of hematologic malignancies such as AML, ALL, multiple myeloma and Non-Hodgkin’s Lymphoma. In addition they will be exposed to methods of stem cell harvest, cryopreservation, and immunophenotyping. This rotation plans to provide motivated students with an ideal mix of clinical medicine and basic science.
Student time distribution: Inpatient 60%, Outpatient 20%, Conferences/ Lectures 20%; Subspecialty Care 100%
Major teaching responsibility: Attending on service as well as all BMT physicians
Patients seen/weekly: 10-20
On call/weekend responsibility: None
M25 885 OCCUPATIONAL/ENVIRONMENTAL MEDICINE
Instructor(s): Bradley Evanoff, MD, MPH, 454-8638
Location: 1st Floor, Wohl Hospital
Elective Contact: Bradley Evanoff, MD, MPH, 454-8638
Other Information: Students should meet at 1st Floor, Wohl Hospital, 9:00 a.m. first day of elective.
Enrollment limit per period: 1 (2, by special arrangement)
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41. (Students may take this elective for up to 12 weeks.)
This elective is designed to introduce students to both the clinical treatment and the prevention of work-related injuries and illnesses. Clinical activities will include the diagnosis and treatment of workers with illnesses due to chemical exposure and repetitive motion, as well as acute injuries. Preventive activities will include work site visits and intervention projects, as well as involvement with work site health promotion and policy making. Specific activities are flexible depending on the students’ interests. Students are also urged to contact Dr. Evanoff if they wish to participate in research projects concerning the epidemiology of work-related diseases.
Students may elect to participate in the Interdisciplinary Environmental Clinic at Washington University. Based in the law school, the clinic involves interdisciplinary teams of students (law, engineering, environmental science) taking principal responsibility, under faculty supervision, for cases and projects on behalf of environmental and community organizations. The medical student(s) would assist clinic students by evaluating the human health impacts involved in one or more of the clinic's cases, and presenting such information to the client organization(s) and others. Among the cases on which medical students might participate are: (1) air pollution associated with proposed cement plant upwind of the St Louis metropolitan area; (2) lead poisoning of children in the City of St. Louis; (3) lead poisoning of children and long-term exposure of adults to lead and possibly other metals in Herculaneum, Missouri; (4) air and water pollution caused by concentrated animal feeding operations (factory farms) in northern Missouri. Students choosing this option will work with the Environmental Clinic staff and with Dr. Evanoff to evaluate and present evaluations of human health impacts of environmental exposures.
Student time distribution: Outpatient 20%, Conferences/Lectures 10%, Reading/Research 70%; Subspecialty Care 100%
Major teaching responsibility: Attending
Patients seen/weekly: 10
On call/weekend responsibility: None
M25 887 CLINICAL CARDIOVASCULAR MEDICINE
Instructor(s): Thomas F. Martin, MD, 573-308-1301
Location: Phelps County Regional Medical Center, Rolla, MO
Elective Contact: Annette Wells,
573-308-1301; awells@im.wustl.edu
Other Information: Students should meet at Phelps County Regional Medical Center, 1000 W. 10th Street, Rolla, MO, 8:00 a.m. first day of elective. Ask Intensive Care Unit secretary to page Dr. Martin.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 25, 29, 33, and 37.
Clinical cardiology with some internal medicine in a rural setting. Room and board provided.
Student time distribution: Inpatient 50%, Outpatient 50%; Subspecialty Care 100%
Major teaching responsibility: Attending
Patients seen/weekly: 80
On call/weekend responsibility: None
M25 890 CLINICAL NEPHROLOGY
Instructor(s): Aubrey R. Morrison, MBBS
Location: Chromalloy American Kidney Center, Barnes-Jewish Hospital
Elective Contact: Ene Stubenrouch, 362-7211
Other Information: Students meet in the Acute Dialysis Center, Division 14300, Barnes-Jewish Hospital, 8:00 a.m. first day of elective. Ask for the Renal Fellow on the Consult Service.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Students assist in both the inpatient and outpatient areas to diagnose patients with acute and chronic renal failure, glomerulonephritis, and electrolyte disorders. The student is a full member of the inpatient renal consult service, diagnosing and treating patients with acute and chronic renal disease and electrolyte disorders. Students will learn electrolyte management, drug dosing, dialysis procedures and complications, kidney biopsy reading, and the management of acute and chronic renal failure. Students are also encouraged to spend two or three half-days in the outpatient center rotating to the General Renal Clinics and the Transplant Clinic. Throughout the rotation, students work closely with two attendings and two renal fellows.
Student time distribution: Inpatient 80%, Outpatient 10%, Conferences/Lectures 10%; Primary Care 20%, Subspecialty Care 80%
Major teaching responsibility: Two attendings and three renal fellows
Patients seen/weekly: Four consults per week
On call/weekend responsibility: Saturday a.m. rounds desirable but not required
M25 893 ADULT ALLERGY AND CLINICAL IMMUNOLOGY
Instructor(s): H. James Wedner, MD, 454-7377
Location: 15th Floor, Northwest Tower
Elective Contact: Kristy Smith, 454-7377
Other Information: Students meet Kristy Smith in the Allergy and Immunology division office, 15th Floor, Northwest Tower, 8:00 a.m. first day of elective.
Enrollment limit per period: 2
Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.
Students will participate in the allergy consult service at Barnes-Jewish Hospital, North and South Campus. The student will serve as the primary allergy consult for inpatient and Emergency Room consultation and present each patient to the allergy fellows on call and the attending physician. Students will attend The Adult Allergy Clinic, Pediatric Allergy Clinic, and the outpatient clinics at The Asthma & Allergy Center at Barnes-Jewish West County Hospital. Conferences on selected topics in allergy and clinical immunology will be held with the attending staff two to three afternoons a week.
Student time distribution: Inpatient 10%, Outpatient 75%, Conferences/ Lectures 15%; Subspecialty Care 100%
Major teaching responsibility: Attending and staff
Patients seen/weekly: 12
On call/weekend responsibility: Optional
M80 809 AMBULATORY CARE - JACQUELINE MARITZ LUNG CTR
Instructor(s): Daniel Rosenbluth, MD, 454-8762
Location: Barnes-Jewish Hospital, North Campus, Lung Center, 8th Floor CAM
Elective Contact: Lisa Wetzel, 454-8762
Other Information: Students meet in the Lung Center, 8th Floor CAM, Barnes-Jewish Hospital, North Campus, 8:00 a.m. first day of elective.
Enrollment limit per period: 1
Valid start weeks for 4-week blocks are: Weeks 17, 21, 25, 29, 33, 37, and 41.
The Jacqueline Maritz Lung Center houses the ambulatory care activities of the Divisions of Pulmonary Medicine, Thoracic Surgery, and Allergy/Immunology, as well as the pulmonary function laboratory. The student will rotate through (1) both general pulmonary and subspecialty clinics in Pulmonary Medicine (cystic fibrosis, transplantation, emphysema, etc.), (2) Thoracic Surgery clinic, (3) Allergy/ Immunology clinic, and (4) interpretation of pulmonary function tests. Chest imaging is also emphasized in the evaluation process. The rotation can be streamlined to meet areas of emphasis desired by individual students.
Student time distribution: Outpatient 100%, Conferences/Lectures 3-5 wk; Primary Care 15%, Subspecialty Care: 85%
Major teaching responsibility: Multiple attendings
Patients seen/weekly: >20
On call/weekend responsibility: None
Last Modification: 07/10/2008 | |