Third Year Rotation Information and Affiliates Guide 2019-2020
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Foreword As our first two years of medical school are nearing an end, we can look forward to putting our knowledge and skills to use in the clinical setting. This experience is an exciting time which will give us further insight into our interests and final career decisions. While the core rotations are the same for all of us, each of the sites is distinctive in its own way. We have many options available to us, ranging from small community hospitals to large academic medical centers. As such, we will each have a unique set of clinical experiences from which to draw on for the rest of our careers. This guide was created to provide information about each affiliate hospital and the various rotations they offer. We have tried to make this as helpful and complete as possible. Please keep in mind that while every effort has been made to provide the most accurate information, this guide is not the final word. The Office of the Registrar will provide the official information regarding individual course locations, enrollment limits for each site, and the blocks when each course is offered. We hope the information in this guide will help you select rotation sites to fit your own goals. We wish you all the best of luck next year! Sincerely, Affiliations Committee Representatives Nilanjan Haldar George Titomihelakis nxh047@jefferson.edu gxt024@jefferson.edu
TABLE OF CONTENTS List of Hospitals and Contacts 3 Sidney Kimmel Medical College Contacts 4 Third Year Curriculum Scheduling Procedure 5 Curriculum Overview 6 Phase 2 Block Schedule 7 Longitudinal Integrated Clerkship 8-9 Family Medicine 11 - 16 Internal Medicine 17- 21 Neurology 22 - 24 Obstetrics & Gynecology 25 - 29 Pediatrics 30- 33 Psychiatry 34 - 38 Surgery 39 - 44 Affiliate Hospital Information Abington Memorial Hospital 45 A.I DuPont Hospital for Children 46 Albert Einstein Medical Center 47 Jefferson Health Northeast (ARIA) 48 Bryn Mawr Hospital 49 Christiana Care Health System 50 Crozer-Keystone Health System 51 Excela Health Latrobe Hospital 52 Inspira Medical Center 53 Lankenau Medical Center 54 Methodist Hospital 55 Morristown Medical Center (Atlantic Health) 56 Overlook Medical Center (Atlantic Health) 57 Reading Hospital 58 Thomas Jefferson University Hospital 59 - 60 Virtua Health 61 Wilmington Veterans Affairs Medical Center 62 WellSpan York Hospital 63 Affiliate Security Procedure 64 2
List of Hospitals Offering Junior Electives 2019 - 2020 CONTACT HOSPITAL LOCATION E-MAIL/WEB SITE INFORMATION Abington Memorial David Gary Smith, M.D. dgsmith@abingtonhealth.org Abington, PA Hospital 215-481-2606 www.abingtonhealth.org Alfred I. DuPont Hospital sselbst@nemours.org Wilmington, DE Steve Selbst, M.D. for Children www.nemours.org 302-651-5874 Albert Einstein Douglas McGee, D.O. mcgeed@einstein.edu Philadelphia, PA Medical Center 215-456-7056 www.einstein.edu Jefferson Health Robert Danoff, D.O. rdanoff@ariahealth.org Bensalem, PA Northeast (ARIA) 215-949-5066 www.ariahealth.org Main Line Health Barry Mann, M.D. mannb@mlhs.org Bryn Mawr, PA Bryn Mawr Hospital 484-476-3409 www.mlhs.org Christiana Care Lisa Maxwell, M.D. lmaxwell@christianacare.org Newark, DE Health System 302-733-1039 www.christianacare.org Crozer-Keystone Elise Hogan, M.D. elise.hogan@crozer.org Springfield, PA Health System 610-690-4471 www.crozer.org Excela Health Michael Semelka, D.O. msemelka@excelahealth.org Latrobe, PA Latrobe Hospital 724-537-1485 www.excelahealth.org Aarti Aggarwal, M.D. aggarwala@ihn.org Inspira Medical Center Woodbury, NJ 917-379-0904 http://www.inspirafmwoodbury.org/ Main Line Health Barry Mann, M.D. mannb@mlhs.org Wynnewood, PA Lankenau Medical Ctr. 484-476-3409 www.mlhs.org Martin Koutcher, M.D. martin.koutcher@jefferson.edu Methodist Hospital Philadelphia, PA 215-952-9197 www.jefferson.org James Alexander, MD james.alexander@jefferson.edu Morristown Medical Ctr. Morristown, NJ 973-971-5322 www.atlantichealth.org James Alexander, MD james.alexander@jefferson.edu Overlook Medical Ctr. Summit, NJ 973-971-5322 www.atlantichealth.org Mark Martens, M.D. mark.martens@towerhealth.org Reading Hospital West Reading, PA 484-628-8333 www.readinghealth.org Sidney Kimmel (see page four) Medical College at TJU Mary Campagnolo, M.D. mcampagnolo@virtua.org Virtua Health Voorhees, NJ 856-355-0009 www.virtua.org Veterans Affairs Robert Boucher, M.D. robert.boucher@va.gov Wilmington, DE Medical Ctr. 302-633-5203 www.va.gov David Emrhein demrhein@yorkhospital.edu WellSpan York Hospital York, PA 717-851-2967 www.yorkhospital.edu 3
Sidney Kimmel Medical College Contacts 2019 - 2020 DEPARTMENT CLERKSHIP COORDINATORS DIRECTORS Laura Monroe Education Program Administrator Fred Markham, M.D. 215- 955- 2362 215-955-2350 laura.monroe@jefferson.edu fred.markham@jefferson.edu Family Medicine Amy Levine Marisyl de la Cruz, M.D. Program Coordinator 215-503-3461 215-955-1372 mariasyl.delacruz@jefferson.edu amy.levine@jefferson.edu Amanda White Sarah Rosenberg, M.D. Medicine 215-955-8737 215-955-7795 amanda.white@jefferson.edu amanda.white@jefferson.edu Jasmine King Daniel Kremens, M.D. Neurology 215-955-4967 215-503-2724 Jasmine.d.king@jefferson.edu daniel.kremens@jefferson.edu Diana Brooks Katherine Lackritz, M.D. Obstetrics/Gynecology 215-955-8462 215-955-5000 diana.brooks@jefferson.edu katherine.lackritz@jefferson.edu Alisa LoSasso, M.D. Pediatrics TBD 215-955-6525 alosasso@nemours.org Jaynie Estrada Mitchell Cohen, M.D. Psychiatry 215-955-9823 215-955-6592 Jaynie.estrada@jefferson.edu mitchell.cohen@jefferson.edu Sherry Weitz Gerald Isenberg, M.D. Surgery 215-955-6879 215-955-6879 sherry.weitz@jefferson.edu gerald.isenberg@jefferson.edu 4
Phase 2: Core Clinical Rotations Scheduling Procedures In early November, students will begin to select the rotation and location of clerkships with the Registrar's Office. Specific dates will be emailed from the Registrar’s Office. Approximately on January 15, 2019 the results of the lottery will be available to all second year students. STUDENTS ARE PROHIBITED FROM HOLDING MORE THAN ONE SLOT PER CORE SUBJECT and the Registrar will automatically delete extra slots held thereby jeopardizing a student's first choice. Due to the complex nature of the scheduling process, the schedules received by students are final. If a student desires a change to a different rotation or a different site, they must find someone to switch with them directly. This must be done at least 6 weeks before the start of the rotation in question via standard drop/add form, and will require an approval by the Clerkship Coordinators and/or Directors for both clerkships. In an event of an approval, the Clerkship Coordinator will notify the affiliate site and the Registrar. The major objective is to give each student the highest order of courses and locations preferred, while also meeting Jefferson and affiliated hospital requirements. Determination of final location and sequencing of all rotations is determined by SKMC. If the student's first preference is not available, due to enrollment limitations or other factors, the process will move to the next highest selection depending on the preference selected by the student on the schedule request list. If a student fails to provide alternate choices of time periods and locations, and the first choice is not available, the student will be assigned when and/or where space is available. Phase2: Important Dates 4/15/2019 Phase 2 starts 5/27/2019 Memorial Day: students are off 6/3/2019 Mandatory Interclerkship Session 7/4/2019 Independence Day: students are off 7/15/2019 Mandatory Interclerkship Session 8/26/2019 Mandatory Interclerkship Session 9/2/2019 Labor Day: students are off 10/7/2019 Mandatory Interclerkship Session 11/18/2019 Mandatory Interclerkship Session 11/28-29/2019 Thanksgiving: students are off 12/23/2019-1/3/2020 Winter Vacation 1/13/2020 Mandatory Interclerkship Session 2/24/2020 Mandatory Interclerkship Session 4/6/2020-4/17/2020 Spring Vacation 5
Phase 2 Curriculum Overview Phase 2 curriculum consists of 49 weeks of instruction Transition to Clerkships Course (JMD300) 1 week Surgery/Emergency Medicine Block • General Surgery (SURG 350) 6 weeks • Surgical Subspecialty Selective 3 weeks • Emergency Medicine (EMRG350) 3 weeks Internal Medicine/Neurology Block • Internal Medicine (MED 350) 8 weeks o 4 weeks at TJUH o 4 weeks at an Affiliate Hospital • Neurology (NEUR 350) 4 weeks Family Medicine/Psychiatry Block • Family Medicine (FMED 350) 6 weeks • Psychiatry (PSYH350) 6 weeks Obstetrics & Gynecology/Pediatrics Block • Obstetrics & Gynecology (OBGY 350) 6 weeks • Pediatrics (PED 350) 6 weeks You will be automatically enrolled in Transition to Clerkships Course (JMD300) as well as Scholarly Inquiry (JMD350), which will run through the entire Phase 2. Each clerkship block is taken as a pair – i.e. Surgery is always paired with Surgical Subspecialties and Emergency Medicine, Internal Medicine with Neurology, Family Medicine with Psychiatry, and Obstetrics & Gynecology with Pediatrics. Please keep this in mind when you are compiling your request list. Students have a choice of Surgical Subspecialties. They are: • Anesthesia (ANES352) • Neurosurgery (NRSG352) • Ophthalmology (OPHT352) • Orthopedics and Musculoskeletal Disease (ORTH352) • Otolaryngology (OTOL352) • Urology (UROL352) During the first day of each 6 weeks throughout Phase 2 you will return to the main SKMC campus for the Interclerkship Days, during which will focus on interdisciplinary curricular content. Attendance at all 7 Interclerkship Days is mandatory to successfully complete Phase 2. . 6
Phase 2 Block Schedule Start End Phase 2 IM/Neuro Phase 2 Surg/EM Phase 2 FM/Psych/Peds/OB 4/15/19 4/19/19 Trans ition to Clerks hips Cours e 4/22/19 4/26/19 No Interclerkship 4/29/19 5/3/19 Block MY 4 Block MY 1 5/6/2019 5/10/19 Block 18-08 (MY ) 5/13/2019 5/17/19 5/20/2019 5/24/19 Block MY 5 5/27/19 5/31/19 Block MY 2 6/3/19 6/7/19 Interclerkship 6/3/19 6/10/19 6/14/19 Block MZ4 6/17/19 6/21/19 Block 18-09 (MZ) 6/24/19 6/28/19 Block MY 3 7/1/19 7/5/19 Block MZ5 7/8/19 7/12/19 7/15/19 7/19/19 Interclerkship 7/15/19 7/22/19 7/26/19 Block MA4 Block MA1 7/29/19 8/2/19 Block 19-01 (MA) 8/5/19 8/9/19 8/12/19 8/16/19 Block MA5 8/19/19 8/23/19 Block MA2 8/26/19 8/30/19 Interclerkship 8/26/19 9/2/19 9/6/19 Block MB4 9/9/19 9/13/19 Block 19-02 (MB) 9/16/19 9/20/19 Block MA3 9/23/19 9/27/19 Block MB5 9/30/19 10/4/19 10/7/19 10/11/19 Interclerkship 10/7/19 10/14/19 10/18/19 Block MC4 Block MC1 10/21/19 10/25/19 Block 19-03 (MC) 10/28/19 11/1/19 11/4/19 11/8/19 Block MC5 11/11/19 11/15/19 Block MC2 11/18/19 11/22/19 Interclerkship 11/18/2019 11/25/19 11/29/19 Block MX4 12/2/19 12/6/19 Block 19-04 (MX) 12/9/19 12/13/19 Block MC3 Block MX5 12/16/19 12/20/19 12/23/19 12/27/19 VACATION 12/30/19 1/3/20 1/6/20 1/10/20 1/13/20 1/17/20 Interclerkship 1/13/2020 1/20/20 1/24/20 Block MF4 Block MF1 1/27/20 1/31/20 Block 19-05 (MF) 2/3/20 2/7/20 2/10/20 2/14/20 Block MF5 2/17/20 2/21/20 Block MF2 2/24/20 2/28/20 Interclerkship 02/24/2020 3/2/20 3/6/20 Block MG4 3/9/20 3/13/20 Block 19-06 (MG) 3/16/20 3/20/20 Block MF3 3/23/20 3/27/20 Block MG5 3/30/20 4/3/20 4/6/20 4/10/20 VACATION 4/13/20 4/17/20 7
Thomas Jefferson University’s Sidney Kimmel Medical College (SKMC) Longitudinal Integrated Clerkship (LIC) at Atlantic Health System What is a Longitudinal Integrated Clerkship (LIC)? An LIC is an innovative model for the clinical clerkship year founded on the organizing principle of continuity— continuity of care, supervision, curriculum, and of relationships with patients, preceptors, and the health care system. You will have the opportunity to follow patients longitudinally throughout the core disciplines, spanning all phases of diagnosis and treatment. Features of the LIC: • A nine-week clinical inpatient immersion experience followed by 40 weeks of longitudinal care across the core disciplines in the outpatient setting • A preceptor in internal medicine, family medicine, pediatrics, obstetrics and gynecology, surgery, neurology, and psychiatry will be assigned to work with you on a weekly basis • You will gain an understanding of the disease process through involvement of care delivery across all aspects of the health care system • Opportunities to learn from master SKMC educators in Atlantic Health’s state-of-the-art teaching hospitals, as well as Goryeb Children’s Hospital, Gagnon Cardiovascular Institute and Atlantic Neuroscience Institute If I choose to participate in the LIC, will I get the same education? Yes! The LIC delivers an equivalent curriculum to that of the traditional block model, including didactics, patient log requirements, assignments, and NBME exams, longitudinally over the course of the entire clerkship year. What are the benefits of participating in an LIC? • Learn through patient-centered care • Develop longitudinal relationships with faculty preceptors and patients in acute and chronic care settings • Perform equivalent to peers on standardized testing • Experience an increased connection with patients • Foster a greater sense of self-awareness and responsibility for your education To apply, you must: • Be in good academic standing • Submit a brief, 500-word essay describing your interest in the program • Meet with program faculty Notification of acceptance will occur prior to the general clerkship lottery. For more information: Contact deborah.bixler@atlantichealth.org 8
The ½ day specialty sessions occur in the outpatient setting, unless stated otherwise. Self-Directed Time = White Space 9
Important Note!!!!! ALL HOUSING ARRANGEMENTS FOR ROTATIONS MUST BE MADE WITH THE AFFILIATE HOSPITALS DIRECTLY ONCE YOU ARE ASSIGNED TO YOUR ROTATIONS. THE LIST OF CONTACTS IS INCLUDED WITHIN THE GUIDEBOOK. 10
Jefferson FAMILY Abington Health Bryn Mawr Christiana Crozier Latrobe/ Northeast MEDICINE (ARIA) Excela Min/Max Number of 1-2 1-2 2 5-8 1-2 3-4 Students Morristown Medical Ctr./ FAMILY Inspira Overlook Reading TJUH WellSpan Atlantic Virtua York MEDICINE Health Health Hospital System Min/Max Number of 1 4 1 6-12 1 1 Students FAMED 350 FAMILY MEDICINE The Family Medicine Clerkship is a five-six week rotation with sites around greater Philadelphia. As a 3rd year medical student, you are now an integral part of the team providing patient care. Your focus should be on gathering information through the history and physical exam, accurately reporting that information, providing a differential diagnosis, and prioritizing problems. Caring for patients in an outpatient setting is a central component of Family Medicine. At all clerkship sites, you will spend a significant portion of your time in an outpatient practice. Some sessions may be supplemented by didactics and community-based experiences in order to expose you to other areas of Family Medicine. These vary from site to site. Students will be supervised by Family Medicine faculty and upper-year residents at all sites. Abington Memorial Hospital As a family medicine teaching program, we have a strong commitment to teaching medical students. Third year students from many local medical schools rotate with our residents on the Family Medicine Inpatient Service and in the Family Medicine Center. We also offer four week and two week fourth year elective rotations for interested medical students. Students are incorporated into all aspects of the Family Medicine Residency during their rotations with us. The majority of student time is spent caring for patients in the outpatient setting but also may include activities such as rounding in the hospital with the family medicine residents and attending’s, geriatric facility visits, and home visits. Medical students are involve in all conferences and didactic programs at the Abington Family Medicine during their rotations and participate in a series of lectures on the top 20 diagnoses in primary care specifically designed for the students. There is also the opportunity for interested students to work with our residents in other activities such as preparticipation sports physicals, outpatient office procedures and research projects and publications. 11
FAMED 350 FAMILY MEDICINE Jefferson Health Northeast (ARIA) Aria Jefferson has a long standing tradition of working with medical students, residents, and allied medical professionals in training. This is our mission and we enjoy working with the future physicians and advanced practice professionals who will serve their patients in the future. Our family medicine rotation is integrated into our family medicine residency program. As such, the students work directly with community faculty in their office settings. In this way the real "feel" of being a family physician engaged in their community is experienced. Acute, chronic, preventive and episodic care is part of the daily professional life of family physicians, and medical students are immediately included as part of the office team. There will be one-one preceptor experience, sometimes including a family medicine resident as well. Additionally, once per week there will be teaching rounds at an extended care facility, working with seniors for a geriatric component of the family medicine rotation. We also offer medical students the option to round with the inpatient teaching service if that would be an interest. Also, each Thursday morning the students will join us at our Family Medicine conference from 7 - noon at the Aria Jefferson Bucks campus. Thank you for considering the Family Medicine rotation at Aria Jefferson. We look forward to working together. Bryn Mawr Hospital The goal of this six-week rotation is for the student to practice and improve his/her interviewing and physical examination skills and to begin integrating patient data with basic science to make relevant clinical decisions. This Family Practice rotation is intended to provide the third-year student with a broad clinical experience. There is ample time spent in the hospital-based residency practice and in the office of a community-based family practitioner. The array of exposures will include the family practitioner in the office, making home visits and nursing home visits. In addition, the students meet with faculty for seminars on clinical problem solving and interviewing skills. Students are responsible for reading necessary information to appropriately learn about the patients they have seen. An evaluation will be made by the preceptor with whom the students work and the faculty and residents at Bryn Mawr Family Practice. 12
FAMED 350 FAMILY MEDICINE Christiana Care Health Services Students will be exposed to a wide range of clinical experiences and settings. Students spend two weeks in a private family physician’s office, at least one week in our residency practice, several sessions in an urgent care setting, as well as several varied experiences in community medicine, including HIV Clinic, nursing home and home visits. As part of the rotation, all students participate in a practice OSCe session in our Virtual Education and Simulation Center. Lectures also include interactive didactic sessions on common outpatient topics as well as an introduction to evidence-based medicine. Students are evaluated by the course director outside preceptors, faculty, residents and staff. Mid-rotation meetings are informal due to the wide range of assigned locations. The clerkship director meets with all students for several sessions of orientation and most Fridays thereafter. Due to the varied locations to which the students must travel, an automobile is required for this rotation. Crozer-Keystone Health System At the Crozer-Keystone Center for Family Health in Springfield, we offer 2 and 4-week fourth year electives and a 6-week third year clerkship for interested medical students. During your rotation, you will spend the majority of the time caring for patients in the outpatient setting which is located in Delaware County (20 minutes outside of Philadelphia.) Our Springfield office recently received Level 3 recognition from the National Committee for Quality Assurance for our Patient Centered Medical Home. Patient care activities will routinely include exposure to global health, office procedures, cosmetic medicine, sports medicine activities, medical informatics, inpatient service and behavioral science sessions. In addition, students will also be involved the community through school physicals, home visits and nursing home visits. Students participate in the weekly didactic sessions with our residents as well as dedicated weekly medical student teaching sessions. If you are interested in doing a rotation in Family Medicine at Crozer, please contact our Student Coordinator at (610) 690-4471 or via email at FMResidency@crozer.org. We greatly look forward to participating in your medical education and exposing you to the dynamic specialty of Family Medicine! For more information, please visit our website at fammed.crozer.org. Excela Health Latrobe Hospital Students get to interview and examine patients first at Latrobe. The student takes an active role in care/management of patients, and students participate in clinical analysis processes. Students are supervised by board-certified family practice attendings. There is probably no other site within the Jefferson system at which the students get this opportunity to act as clinicians and to contribute so directly to the care of actual patients. Students receive informal feedback from every preceptor with whom they work. Preceptors relay information verbally or in writing to the clerkship coordinator, who has a formal face to face discussion with the students in mid-course and at the end of the rotation. The clerkship coordinator compiles the evaluations and writes the narrative grade report to send back to Jefferson. Students are evaluated compared to the theoretical expectations for a student at their level of training and experience. Knowledge, professionalism, personal skills, and ability to think in clinical terms are all important grading factors. 13
FAMED 350 FAMILY MEDICINE Inspira Medical Center Woodbury Our faculty has training in Women’s Health and Wound Care in addition to a focus on Geriatrics. We have our own prenatal clinic, which is supervised by staff obstetricians. Mid rotation evaluations occurs at 3 weeks, and are in the form of verbal feedback. We evaluate students based on composite scores collected from all physicians that worked with the student. Our forms mirror the criteria present on the final evaluation forms sent from Jefferson. All subjective comments are incorporated in the evaluations. Morristown Medical Center (part of Atlantic Health System) We are a family medicine teaching program, and as such we teach medical students from several medical schools along with our residents. Students will work with both residents and attendings in our outpatient office in Summit, NJ. Students will meet patients from a variety of backgrounds, take histories, conduct physicals, develop differentials and present to attendings and senior residents. They will also spent time on geriatric rounds in our nursing home facility and in our prenatal clinic. There is also opportunity for interested students to round with the family medicine inpatient team. Medical students are involved in all conferences/ didactic sessions along with the residents. These periodically might include procedure conferences such as suturing, GYN procedures or joint injections. Additionally, there are medical student behavioral science sessions. Overlook Medical Center (part of Atlantic Health System) We are a family medicine teaching program, and as such we teach medical students from several medical schools along with our residents. Students will work with both residents and attendings in our outpatient office in Summit, NJ. Students will meet patients from a variety of backgrounds, take histories, conduct physicals, develop differentials and present to attendings and senior residents. They will also spent time on geriatric rounds in our nursing home facility and in our prenatal clinic. There is also opportunity for interested students to round with the family medicine inpatient team. Medical students are involved in all conferences/ didactic sessions along with the residents. These periodically might include procedure conferences such as suturing, GYN procedures or joint injections. Additionally, there are medical student behavioral science sessions. 14
FAMED 350 FAMILY MEDICINE Reading Hospital and Medical Center The Reading Hospital is a large, community based hospital with many resources. Students have the opportunity the opportunity to customize parts of the rotation, depending upon their particular interest. Students “formally” stay within the residency program, but have the opportunity to work with specialists along with the Family Medicine Residents. Students typically work with 8-10 residents and 8 faculty members throughout their rotation. The mid-rotation and final evaluations are a composite of input from those who worked with the student. For each office hour session, the student will complete a SOAP note which is critiqued and returned to the student. Students will have the opportunity to do home visits with Berks Visiting Nurses 1 day per rotation, Alvernia University Student Health Clinic 1 afternoon per rotation, Wound care one ½ day per rotation, palliative care 1 day per rotation, and other procedure and subspecialty clinics throughout the rotation. Special features of your clerkship include a required Biopsychosocial project which involves interviewing a long-term patient and writing a 3-page paper with a genogram (time built into your schedule to complete). You will have the opportunity to work with skilled nurses and gain hands-on experience as well as document directly in Epic. Thomas Jefferson University Hospital For clerkship students rotating at Jefferson, the bulk of clinical time is spent in the Jefferson Family Medicine Associates practice. There, students typically meet patients, take the history, conduct the physical exam, and present patients to precepting faculty. Students are responsible for formulating a differential diagnosis, developing an assessment and therapeutic plan, and performing health maintenance activities. Students may be responsible for labs, follow-up, notes, and referrals as needed. The patient population in the Family Practice Center is largely urban, and students encounter a rich mix of personalities, backgrounds, and health issues. Student may also be assigned to a community preceptor and will be expected to travel by car. 15
FAMED 350 FAMILY MEDICINE Virtua Health Students who rotate at Virtua Health will be considered a part of our Family Medicine Residency during their 6 week rotation with us. As a teaching program with over 30 years of experience training residents, we are dedicated to ensuring that students get an excellent experience in seeing what Family Medicine is all about. Students will spend the majority of their time at our outpatient facility, the Virtua-Tatem Brown Family Practice Center, and also spend 1 week on inpatient rounds on our family medicine service at Virtua Voorhees. We are about 30 minutes from Center City Philadelphia, making access for Jefferson students quite easy. Our practice has a very diverse patient population, with a broad demographic mix including 30% pediatrics. In the office, students will work with residents and 1 on 1 with an attending, and will see a wide variety of patients that encompass everything from well child and preventive health visits to the most complex chronic disease management cases, as well as office procedures. Our practice is recognized by the NCQA as a level 3 medical home, and students will gain experience learning in an environment that emphasizes patient satisfaction, patient safety and continuous quality improvement. Students will also be involved in participating in nursing home rounds and home visits, in addition to opportunities with school health and other outreach activities as they arise. Our goal is to expose you to the exciting specialty of Family Medicine and all it has to offer! We also offer 4th year rotations for those interested in Family Medicine as a career choice. Please contact our coordinators at (856) 325-3737 and visit our website to learn more about Virtua Family Medicine Residency. WellSpan York Hospital Students see patients at the Thomas Hart Family Practice Center which is part of the family medicine residency program founded in 1968. The family practice center is connected to the hospital and has 24 exam rooms, two procedure rooms, a lab, and a conference room as well as offices for the faculty and residents. The average number of outpatient visits per year is approximately 23,000. These visits include well-child care, maternity care, adult care, and numerous outpatient procedures. The family practice center has been using an electronic health record since September 2006. Students will spend most of their time at the Thomas Hart Family Practice Center but will also spend two half-days per week at a private family medicine office in the community. Students will also spend two weeks on the family medicine inpatient service. There are didactics held on Thursday mornings which all students participate in as well as weekly visits to the York Hospital Simulation Lab. Students are supervised by Stacey Robert, MD and the Program Coordinator for the student rotations, Christie Colon. 16
INTERNAL Abington Albert Christiana Lankenau Methodist Einstein MEDICINE 6/6 – blocks 10,11, 12 Min/Max Number of Students 0/4 5/5 0/6 4/4 7/7 – Blocks 13-21 Morristown INTERNAL Medical Ctr. Reading TJUH WellSpan York MEDICINE /Atlantic Health System Hospital Min/Max Number of Students 4/4 2/2 0/24 2/2 MED 350 INTERNAL MEDICINE For the 2018-19 academic year, all students will start the Internal Medicine Clerkship with a mandatory “Academic Week” during which they will participate in a variety of educational activities that will give them foundation in Internal Medicine and Neurology. After that, students will spend 3 weeks at the Thomas Jefferson University Hospital, and 3 weeks at one of the academic affiliate hospitals. Christiana Branch Campus students spend entire 6 weeks at Christiana Care Health System. Each site offers unique learning opportunities, but ultimately adheres to the unified set of educational objectives. At all sites, students will receive education at bedside and in the classroom, and will be exposed to a wide variety of educational methods. All students will participate in a variety of projects that will expose them to incorporating evidence-based medicine and foundational science concepts into clinical practice, as well as introduce them to aspects of cost-conscious care. Students will be evaluated by both faculty and housestaff based on their clinical performance, receiving a single grade that reflects their performance at both Thomas Jefferson University Hospital and an academic affiliate. A shelf exam is taken at the end of the clerkship. 17
MED 350 INTERNAL MEDICINE Abington Memorial Hospital/Jefferson Health Abington Hospital/ Jefferson Health is a tertiary care facility located in Montgomery County, 30 minutes from Center City. It is a 660 bed Hospital with over 90,000 ER visits per year and offers patients a comprehensive care experience. Abington Hospital has a long and rich tradition of student training in Internal Medicine. We excel in our ability to provide a comprehensive clinical experience while also maintaining a personal concern for each student. The clerkship offers a scholarly and effective approach to the provision of medical care for learners alongside our internal medical residency program. Our environment promotes a culture of safety and respect for all members of the health care team and for our patients. The key elements of Abington’s successful training and educational programs are the broad clinical mix, the well-prepared and dedicated medical staff and the progressive increments in patient management responsibility delegated to our trainees. Albert Einstein Medical Center Einstein Medical Center Philadelphia is located in an urban, socio-economically disadvantaged area in North Philadelphia. It is a very large, multidisciplinary tertiary-care hospital with 600 acute care beds, caring for a diverse patient population with a large scope of complex medical illnesses. During Internal Medicine at Einstein, students will rotate on either general medicine or subspecialty services. The robust didactic program includes core conference series, EKG workshops, radiology rounds, subspecialty rounds, noon student reports, and a Jeopardy-style review session. Physical diagnosis rounds are held both at bedside and in a simulated setting. During the simulation sessions, students learn IV placement, venous blood draws, and basic review of ACLS algorithms. Students also have a chance to round with the phlebotomy and IV teams to acquire and practice these skills. Christiana Care Health System – Christiana Hospital Students interact with consultants from all subspecialty Internal Medicine services. These include Cardiology, Infectious Disease, Gastroenterology, Hematology, Nephrology, Pulmonary and Rheumatology. On the internal medicine service, students are evaluated by the intern and resident with whom they worked most closely. Depending on the service, an attending hospitalist evaluates them as well. These individuals complete the Sidney Kimmel Medical College evaluation in New Innovations. A workshop in IV insertion is provided for students and is schedule each month. Students are also required to prepare a one- page response to an evidence-based question assigned to them. Several literature references are expected. A bedside physical examination session is carried out usually with two students. This may involve performance of an entire physical examination or sections based on student needs. Mandatory sessions include Medical Grand Rounds and student core lectures. 18
MED 350 INTERNAL MEDICINE Lankenau Hospital Lankenau Hospital has over 100 years of experience in training medical students and residents. Indeed, educating students is a core value at Lankenau Hospital where medical students are considered valued members of the health care team. We pride ourselves on providing a university-level academic experience in a warm, supportive community environment. Straddling the city of Philadelphia and its “Main Line” suburbs, Lankenau provides a fascinating diversity of patients and pathology. At Lankenau, third year students rotate on one of our eight core teaching teams. Each team is led by either an Academic Hospitalist or an Academic General Internist who is focused on providing excellent patient care and an excellent educational experience for residents and students on their team. In addition to our core student Didactic conferences, students attend and present at a weekly student case conference that is led by core teaching faculty. Students will spend time in our simulation lab practicing their clinical skills. Students also attend regularly scheduled Lankenau conferences such as Noon Conference, Morbidity and Mortality Conference, and Grand Rounds. Bedside, didactic, and multidisciplinary rounds take place daily and informal bedside teaching experiences with subspecialty consultants take place daily. Students have the opportunity to learn and practice bedside procedures such as phlebotomy, IV placement, and the drawing of arterial blood gases. All students are strongly encouraged to attend and observe any procedures their patients are undergoing such as cardiac catheterizations, endoscopies, and surgeries. Students are evaluated in face-to-face sessions with their floor attendings and residents at both the midpoint of the block and at the end of each block. End of block evaluations are completed by the student’s Attending, their resident, and occasionally their intern, if desired. Our medicine Clerkship Director Jonathan Doroshow, MD, is always available to students for assistance with patient presentations, notes, or assistance with shelf-exam study plans. Methodist Hospital The Medicine clerkship is a four-week rotation located on the campus of Methodist Hospital Division of Thomas Jefferson University. It is a community teaching hospital with 120 beds, caring for a diverse patient population with a large scope of complex medical issues. During the rotation, students will rotate on general internal medicine services. This course emphasizes the integration and application of pathophysiology to the diagnosis and management of patients in addition to the skills of history-taking, physical examination, and case presentation. The course is an apprenticeship focusing on the bedside care of patients. Students work closely with house staff members and attendings - making daily rounds, admitting new patients, and caring for them with the team. 19
MED 350 INTERNAL MEDICINE Morristown Medical Center (part of Atlantic Health System) Morristown Medical Center (MMC) is the flagship teaching hospital for Atlantic Health System in northern New Jersey. We function as a tertiary referral center for the region with over 680 beds providing students excellent clinical exposure to patients from diverse socioeconomic backgrounds. Third year medical students are assigned to one of the Department of Medicine general medicine teaching teams which are led by an academic hospitalist. Daily teaching rounds are conducted with the attending. In addition to morning report and noon conference, there is a “student report”, a core didactic series of lectures including a weekly cardiac auscultation conference and meetings with the clerkship directors to review notes. Reading Hospital Reading Hospital is a 695-bed acute care hospital located in West Reading, PA, which is approximately a 90- minute commute from Philadelphia. Medical patients are admitted primarily to hospitalist services, with subspecialties serving mainly in a consultant role. Students on Internal Medicine are assigned to the general internal medicine teaching teams, providing care for a broad scope of medical illnesses in a diverse patient population. Students perform histories and physicals, gain experience writing notes and orders in EPIC EMR, refine presentation skills, and accompany patients to diagnostic procedures. Arrangements are made with respiratory therapy to provide experience drawing ABGs. Students attend morning report, grand rounds, and either mid-day resident conferences or small group faculty-led student conferences. Free on-campus housing and parking are available, as well as a daily meal stipend. Additional information about the health system and local area can be found at https://www.readinghealth.org/education-and- research/academic-affairs/students/ . Thomas Jefferson University Hospital Thomas Jefferson University Hospital is located on campus of Thomas Jefferson University. It is a very large multidisciplinary tertiary-care hospital with 950 acute care beds, caring for a diverse patient population with a large scope of complex medial illnesses. During Internal Medicine at Jefferson, students will rotate on either general medicine or subspecialty services. The robust didactic program includes core conference series, small group EKG workshops, and a Jeopardy-style review session. Physical diagnosis rounds are held both at bedside and in a simulated setting. During the simulation sessions, students will learn arterial puncture technique, EKG lead placement, and will have a chance to practice finger stick glucose monitoring and a subcutaneous injection. 20
MED 350 INTERNAL MEDICINE WellSpan York Hospital As an integral part of the leading health care delivery system in South Central Pennsylvania, York hospital is a 580 bed community teaching hospital serving 520,000 plus people in South Central Pennsylvania. Third year clerkship in Internal Medicine at York provides the student with excellent exposure to a broad range of diagnoses and multiple complex medical problems. Students are an integral and valued part of the team. Students take call with the team, admit patients in conjunction with their interns and residents, present and follow their patients. Students get a hands on experience caring for patient with congestive heart failure, acute coronary syndrome, gastrointestinal bleeds, delirium, stroke and COPD just to mention a few. Students participate in a core lecture series, advanced diagnosis sessions, a weekly student report with the Clerkship Director, opportunities for SIM sessions and to work with ancillary staff to sharpen skills on venipuncture, IV placement, urinalysis and peripheral blood smear interpretation. 21
NEUROLOGY Albert Einstein Christiana Lankenau Min/Max Number of Students 4/4 2 1/1 NEURO 350 NEUROLOGY Introduction: The Neurology Clerkship provides a foundational experience in the field of Adult Neurology. The main goals of the Clerkship are for the student to be exposed to and learn about conditions typically seen by neurologists; to acquire core knowledge on the pathophysiology, clinical presentation, diagnostic processes, and assessments of the different neurological conditions observed during the Clerkship; to understand the relevant information required to perform a detailed neurological history; and to achieve proficiency in performing a neurological examination. Structure: The Clerkship at TJUH includes two rotations: one on the General Neurology Wards or Neurology Consultation services, and one on the Stroke or Neurocritical Care services. A half-day of outpatient experience is included during the rotations. Rotations in affiliated hospitals include a combination of inpatient and outpatient experiences. The students will be supervised by Resident House officers and/or Attending Neurologists. Didactics during the Clerkship include lectures, conferences, and case presentations at the different Clerkship sites. These didactics are complemented by an academic week, a joint Neurology and Internal Medicine educational initiative that includes topics related to various neurological topics and subspecialties (hosted at TJUH and attended by all students on the Clerkship). Evaluations are based on summative and formative assessments. A shelf exam is taken at the end of the clerkship. Locations: Thomas Jefferson University Hospital (TJUH) Albert Einstein Medical Center Christiana Care Health Services Lankenau Hospital 22
NEURO 350 NEUROLOGY Albert Einstein Medical Center During this rotation, students will have acquire the following: a. A sound foundation for principles of neurologic diagnosis; b. Introduction to common neurological syndromes and diseases, focusing on pathophysiology, common presentations, and principles of management. For each patient assigned, students will perform a thorough H&P with special attention to neurological symptoms and signs. All patients will be presented to an Attending and most will be discussed with a Neurology resident beforehand. We expect you to propose a neurological localization and differential diagnosis on every patient. This will increase your facility in “thinking neurologically.” Rotations during the Clerkship: 1. Inpatient Admitting Service 2. Inpatient Consult Service 3. Outpatient Clinics/ Neuroradiology/ Neuropathology 4. ICU Other Clerkship Requirements: 1. Neuropathology slide review and assignment 2. Patient education handout assignment for “Neurology Patient Library” 3. Attend neurology trainee conferences and student centered conferences, unless excused for other duties. Christiana Care Health Services – Christiana Hospital Students are paired with an attending neurologist. They work with the attending directly in terms of performing consultations, seeing follow-up patients and learning to further their skills in the neurological examination. There is close attention to helping develop a through differential dx and plan. Students are encouraged to review and discuss the medical literature with the neurologist with whom they are working. Opportunities to work with inpatient neurology attendings in the ICU and floors settings are under development. 23
NEURO 350 NEUROLOGY Lankenau Hospital The Lankenau Jefferson student neurology rotation is a mentor/mentee driven model that is singular in the medical school experience at Jefferson. The student who selects Lankenau will be assigned to a specific neurology attending; there are no neurology residents here. All of our attendings have substantial subspecialty experience and several of our staff members are nationally recognized in their respective fields. The student will work intensively with their assigned attending who will also direct their clinical and learning experience such that it will be diversified across the spectrum of neurological disorders and their treatment, predominantly in the outpatient setting where most neurologic disease is treated, as well as on the inpatient service and in the emergency room. 24
OBSTETRICS & Abington Albert Bryn Mawr Christiana Lankenau Einstein GYNECOLOGY Min/Max Number of Students 1/2 3/4 1/2 1/6 3/4 Morristown OBSTETRICS & Medical Ctr. /Atlantic Reading TJUH Virtua WellSpan York GYNECOLOGY Health Hospital System Min/Max Number of Students 2/4 3/3 4/6 4/7 2/3 OB/GYN 350 OBSTETRICS AND GYNECOLOGY Abington Jefferson Health As an OB/GYN teaching program, we have a strong commitment to teaching medical students. Third year students from many local medical schools rotate with our residents and faculty on several services. These services include: gynecologic oncology, night float, gynecology, and obstetrics. Students also get the chance to rotate in our OB/GYN Center for the underserved. Didactic sessions and are held weekly for both residents and students, and weekly morbidity and mortality (M&M) conferences are also held. Morning conferences are held daily. Students are incorporated into all aspects of the OB/GYN residency during their rotations with us. Students receive training both on the inpatient and outpatient EMR in the hospital. EMR write access is available to students during the gynecology service. The hospital is accessible by public transportation when students are scheduled for inpatient duties; however some specialties or outpatient clinics may be in other locations. Albert Einstein Medical Center The clerkship in women’s health, obstetrics & gynecology in the Department of Obstetrics and Gynecology, Albert Einstein Medical Center, is a six-week learning experience designed to provide the basic information about women’s health, obstetrics and gynecology needed by medical students to successfully complete their clerkships and pass national standardized examinations. Students are assigned to rotations in general obstetrics, gynecology, and night float teams, providing ample opportunity to learn the basic knowledge and skills while experiencing hands-on training in deliveries and surgery. Students are included as active members of the ObGyn care teams and are allowed and encouraged to do as much as their knowledge and skills permit. 25
OB/GYN 350 OBSTETRICS AND GYNECOLOGY Albert Einstein Medical Center (Cont’d) In Obstetrics, students are involved in labor and delivery activities, the antepartum and postpartum floor and in clinical scenarios such as normal labor and delivery and high-risk pregnancies (i.e., preterm labor, multiple gestation, premature rupture of membranes). In Gynecology, students participate in both general and oncologic Gyn surgery and coverage for Gyn consultations requested by the emergency department, inpatient service, and in pre-operative clinic one half-day each week. During the outpatient experience, students participate in ambulatory care clinics, which range in focus from colposcopy clinic, to high-risk obstetrics, to new obstetrics and to routine continuity care GYN clinic. During the six-week rotation, students attend weekly didactic activities of the department that include Grand Rounds, daily lectures for the residents and perinatology/neonatology conferences. Specific student lectures are provided throughout the rotation by the Clerkship Director on site. Students return to Jefferson on Friday afternoons for lectures. Evaluations include both the mid-rotation evaluation, and the final evaluation. Both evaluations are gone over with the student by the Clerkship Director in one-on-one meeting midway and at the end of the rotation. 5 consecutive weeknights are scheduled (Night Float) in lieu of traditional (Q4) call on the Labor & Delivery unit. On call facilities, lockers and meal tickets are provided for students during the rotation. Students return to Jefferson on Friday afternoons for lectures Bryn Mawr Hospital The OB/GYN students train at Bryn Mawr Hospital for six weeks. Students will have exposure to a variety of surgical and obstetric techniques along with subspecialty services in perinatal medicine and reproductive endocrine. Written evaluations from attending staff are compiled by the medical student clerkship director. Evaluators consider the student’s attitude, conscientiousness, motivation, history taking, patient interaction, medical knowledge, case presentation and problem analysis. Verbal feedback is provided on a daily basis by the attending the student works with. Each student will have a formal mid-rotation meeting with the Clerkship Director to evaluate the student’s progress, opportunities to improve, strengths, etc. Communication skills and team participation are important. The students work with residents from the specialties of Family Practice and Radiology, but are directly supervised by their attending physicians. Located in the western suburbs of Philadelphia, Bryn Mawr is a full service acute-care teaching hospital. Our patients know us for our high level of personalized care by exceptional physicians, surgeons and nursing staff in both inpatient and outpatient settings. Students return to Jefferson on Tuesday afternoons for PBL and small group sessions and on Friday afternoons for lectures. Students return to Jefferson on Friday afternoons for lectures. 26
OB/GYN 350 OBSTETRICS AND GYNECOLOGY Christiana Care Health Services (CCHS) The OB/GYN students all train at Christiana Hospital and Wilmington Hospital. Christiana care health system delivers approximately 7000 babies performs 6000 gynecologic surgical procedures annually. All of the obstetrical care and the majority of the gynecologic surgical care is provided at Christiana Hospital in Newark Delaware. Christiana Hospital is a full service, community based, tertiary care, academic Hospital. Wilmington Hospital is an urban community Hospital and is the location of the clinic experience for students rotating and OB/GYN. Students will be exposed to the subspecialty some maternal fetal medicine, reproductive endocrinology, family planning, urogynecology, and gynecologic oncology. Students are expected to perform or assist with patient admissions, preoperative and postoperative checks, inpatient evaluations and consultations, outpatient care, labor and delivery, surgical assistants, fetal monitoring, and OB/GYN triage. Students are involved in continuity clinics with residents. Students are expected to participate in Wednesday didactics including noontime Grand Rounds and resident and student lectures on Wednesday afternoons. Students return to Jefferson on Friday afternoon for require didactics. Students will spend one week working nights. Local housing may be provided per Christiana policies. Students are assessed based upon evaluation of work done in the clinic, on obstetrical inpatients, on surgical patient services in number to sedation and group discussions. Emphasis is placed on clinical aspects of patient care and the ability to interact with patients and staff. Students are evaluated by the residents, full-time attendings, private attendings, and the medical student coordinator (see Dr. Matthew Fagan). The standard evaluation form for the rotation is provided by Sidney Kimmel Medical College. Lankenau Hospital The OB/GYN students train at Lankenau Hospital for 6 weeks. During this rotation, the student is expected to perform or assist with labor and delivery, postpartum care, gynecological surgery, post-operative care, admission, H & P's, medical and surgical gynecological oncology, and pre-operative work-ups. Students will have exposure to a variety of surgical and obstetric techniques including those pertaining to high risk pregnancies. Subspecialty services to which the students are exposed during the OB/GYN rotation include Gynecologic Oncology, Maternal-Fetal Medicine, and Reproductive Endocrinology. Written evaluations from attending staff and residents are compiled by the physician coordinator of the medical student program. Evaluators consider cognitive skills, clinical skills, professionalism and house staff potential. Mid- rotation evaluation is a private meeting with the student director to discuss progress, opportunities to improve, strengths, etc. Residents complete final evaluations as a group, which are then reviewed and approved by the student director. Academically, Lankenau provides the students with over 9 hours of formal lecturing exclusively for students. These lectures attempt to compliment the lecture series at JMC. Additionally, students attend department and resident conferences. Breakfast and dinner meal tickets are provided to students on call. Students return to Jefferson on Friday afternoons for lectures. 27
OB/GYN 350 OBSTETRICS AND GYNECOLOGY Morristown Medical Center – (part of Atlantic Health System) The OB/GYN students train at Morristown Medical Center for six weeks. During the six-week rotation, students work with residents and faculty in all subspecialties. In Obstetrics, students are involved in labor and delivery activities, the antepartum and post-partum floor and in clinical scenarios such as normal labor and delivery and high-risk pregnancies. In Gynecology, students participate in both general and Gyn Oncology surgery and coverage for Gyn consultations requested by the ER, inpatient service and in pre- operative clinic one half-day each week. During the outpatient experience, students participate in ambulatory care clinic, which range in focus from colposcopy clinic, to high-risk obstetrics, to new obstetrics and to routine continuity care GYN Clinic. Students also spend 1 half day with an Attending Faculty at Planned Parenthood. This location is accessible by public transportation when returning to Jefferson for Friday lectures. Housing is provided; it is very far to commute from Jefferson. Reading Hospital and Medical Center The Reading Hospital is a 600 bed community teaching hospital, which performs over 3,000 deliveries and over 3,500 major gynecologic procedures per year. The third year OB/GYN student is quickly assimilated into the health care team. The student OB experience includes six weeks of inpatient/outpatient experience including one week of OB night float and one week of elective. Students will attend regular prenatal clinic and generally perform at least one supervised delivery during the rotation. One complete workday is devoted to Maternal Fetal Medicine and Genetic counseling. The GYN experience consists of one week of routine gynecology and one week of GYN Oncology. Students participate in a wide range of gynecologic operative procedures including oncologic, pelviscopy, and pelvic reconstructive surgery. There are at least seven hours of protected teaching/lectures per week including 3 weekly lectures with attendings. Students receive mid-rotation evaluations (assessing professionalism, communication skills, and skill sets such as History and Physicals) and final grade recommendations are issued by resident consensus opinion with input from the Clerkship Director. In the last week of rotation, students will give a 20-question written exam on Monday and return to Jefferson on Wednesday. Housing is provided, students will be back to Jefferson every Friday for lectures. Thomas Jefferson University Hospital Subspecialties to which the student will have exposure include Gynecologic Oncology, Maternal-Fetal Medicine, Reproductive Endocrinology, Infertility, and Urogynecology. Students are evaluated by both residents and attendings. Students rotating at TJUH are expected to be professional, well-read, and clinically skilled. Students who are able to work independently will find this site very rewarding. Each student has a mid-rotation meeting with the Clerkship Director to discuss the student’s progress. Students will meet with the Director again at the end of the rotation to review their performance. At TJUH, students are exposed to a wide variety of patients and clinical scenarios and have the opportunity to actively participate in patient care. Students attend Wednesday small group sessions and Friday afternoon lectures at Jefferson. 28
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