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  • 4th Year Subinternships & Selectives - Curriculum

    Subinternships & Selectives | Elective

    Fourth Year Subinternships & Selectives

    Med 401: Medicine Inpatient Subinternship Min/Max:  0/3

    Fourth year students function as subinterns under the supervision of a senior medical resident and teaching attending.  Students are responsible for the initial history & physical, assessment, plan and orders on their newly admitted patients.  Students also have ongoing responsibility for the patients they admit, including communication with the attending physician, daily progress notes, orders and follow-up of all lab studies, diagnostic tests and consults ordered on their patients.  Students work as part of a team and are expected to participate fully in morning work rounds, teaching rounds, literature searches and sign-out rounds.

    Students admit one to two patients per day and have ongoing responsibility for three to five patients.  Students take overnight call with their intern every fourth night.  Students are expected to attend curriculum conference, firm conference, and Benjamin Gouley, MD Medical Grand Rounds.


    Ped 401: Ambulatory Pediatrics Subinternship Min/Max:  Max 1

    Note: This course is the same as the elective Ped 401: Ambulatory Pediatrics. Students who take this course as a subinternship should be sure that the Pediatrics Department and Dean’s office are aware of that fact.

    Ped 402: Pediatric Inpatient Subinternship Min/Max:  Max 1

    Note:  This subinternship is on the Einstein Pediatric Service at St. Christopher’s Hospital for Children. Students who select this subinternship must complete application materials that are available in the Pediatrics Office at Jefferson. This subinternship on the Einstein service is considered by Jefferson to be a “home” rotation.

    Students will gain a broad exposure to the care of children hospitalized on a general pediatrics inpatient ward, they will acquire skills in history-taking, physical examination, generation of differential diagnoses, and development of treatment plans.  Students will gain an understanding of the daily care and management of hospitalized children and the appropriate use of ancillary services, including nursing and social services.  Students also will acquire skills in procedures such as venipuncture and intravenous catheter placement.

    The student will be an integral member of the inpatient team and, as experienced is gained, will be given increasing responsibility for patients under supervision of a senior member of the team. The student will attend all work rounds, attending rounds, teaching sessions and X-ray conferences. The student will be on call every fourth to fifth night.

    Emergency Medicine Selective/Elective                Director: Ishrat Khatri, MD

    Students from Jefferson Medical College along with students from other allopathic and osteopathic institutions have the option to rotate through Einstein’s Emergency Department as part of their required Emergency Medicine curriculum, or as an additional elective. Rotations at Einstein are generally four weeks in length.  For those students who are interested in doing research in the field of Emergency Medicine, a four-week elective is offered at Einstein. Optional experiences in toxicology and pre-hospital care also are available to interested students.  

    The Emergency Department at Einstein is a busy Level I Trauma Center, with an annual volume of 77,000 patients. High acuity patients of all ages are treated and the pediatric population comprises approximately 20% of emergency room visits. The Department of Emergency Medicine operates a four-year emergency medicine residency program that encompasses 12 residents at each PGY level.

    Students work approximately 11-14, 8-hour shifts during their rotation. Required weekly conferences are held at Einstein on Wednesdays.  In addition, Jefferson students return to TJUH on Fridays to attend required student conferences.

    Jefferson students who are interested in an Emergency Medicine rotation at Einstein should contact the Division of Emergency Medicine at TJUH directly. All emergency medicine rotations for Jefferson students are coordinated through Jefferson's Emergency Medicine department.  All other students interested in a clinical or research elective should contact Dr. Jordan Spector directly at spectorjo@einstein.edu.

    Neurology Selective/Elective     Director: Rabia Choudry, MD

    Students from Jefferson Medical College have the option to rotate on the neurology service at Einstein as part of their six-week neurology selective in the 3rd or 4th year.  During a student’s six week neurology selective, half the time is spent at TJUH and the other half may be spent at Einstein Medical Center. The time at Einstein is split between Rehab Medicine at Elkins Park (one third) and at the main Einstein campus on Broad and Tabor. The experience at Einstein is split between Inpatient Admission, Inpatient Consults and a series of brief electives and outpatient opportunities. Students interact closely with Einstein residents from Internal Medicine, Emergency Medicine and Psychiatry as well as with a Temple Neurology resident. In 2009, Einstein will begin its own Neurology residency as well.  

    Students interested in rotating at Einstein during their neurology selective should contact the Department of Neurology at TJUH.

    Orthopedics IDPT      Director:  John Handal, MD

    Students from Jefferson Medical College have the option to rotate on the Orthopaedic service at Einstein as part of their six-week selective in the 3rd or 4th year.  During a student's six week selective, three weeks are spent at Einstein Medical Center in the Department of Orthopaedics and the remaining three weeks at TJUH in another specialty field of their choice.
    Students interested in rotating at Einstein for their three week Orthopaedic selective should contact the Department of Orthopaedics at TJUH.  

    While on the Orthopaedics service at Einstein Medical Center, students will rotate through each of the services within the Department of Orthopaedics and gain exposure to most aspects of orthopaedics including hand and wrist surgery, joint replacement, sports medicine and arthroscopic surgery, shoulder, elbow, knee, foot and ankle surgery, neuromuscular disorders, spine and trauma.  

    Under the direct supervision of attending physicians and residents on the service, students will observe and participate in interesting and complex cases in the operating room and trauma cases in the Level One Trauma Center/ emergency room.  In addition, students will see patients in the ambulatory office setting and be involved in the pre- and postoperative management of in house patients and consults.  

    Students attend all departmental educational conferences held during the course of the rotation.

    Subinternships & Selectives | Elective | Top

    Fourth Year Elective

    Emergency Medicine Toxicology Elective                      Director:  Adam Rowden, DO

    The two to four week elective in Medical Toxicology focuses on the care of all poisoned patients including adults, children, and adolescents.  There is a breadth of clinical exposure including acute overdoses, chronic poisonings, and occupational/environmental medicine. The Division of Toxicology has a busy inpatient consultation service, an outpatient clinic, and a 23-hour Observation Unit.  Daily activities include bedside rounds on our inpatients and observation unit, poison center case review, and dedicated lecture time with the faculty.  Through our affiliation with the Poison Control Center at Children’s Hospital of Philadelphia, students can participate in a variety of activities at the center and CHOP.

    Under the supervision of division faculty, students will be able to initially evaluate poisoned patients in the emergency department and participate in the development of a treatment plan.  Admitted patients will be followed by the student where the team will address issues of disposition and appropriate periods of observation, potential complications, antidotal therapy, and eventual medical clearance.  Interested students should contact Adam Rowden, DO directly at rowdena@einstein.edu.

    Med 457:  Cardiology  Director: Vincent Figueredo, MD

    Students are assigned patients on the cardiology consultation service and in the coronary care unit. Daily teaching rounds with cardiology fellows are followed by one hour of conference with a full-time faculty member. Students are exposed to all aspects of acute coronary care including management of arrhythmias, pump failure, acute ischemic syndromes, thrombolytic therapy, primary angioplasty and stenting. Interpretation of history, physical examination and EKG, and management of cardiac patients undergoing non-cardiac surgery; also studies, ablation, open heart surgery, transesophageal echo and stress testing. Two EKG conferences, journal club, cardiology grand rounds, cath conference, morning report and subspecialty conference occur weekly.


    Med 479:  Gastroenterology  Director:  Philip O. Katz, MD

    Medical students are active participants in the GI consultation service. The student evaluates patients on the inpatient consult service as well as the gastroenterology clinic.  The student rounds daily with the consult team and attends endoscopies and conferences.  Students are expected to read texts and primary sources concerning the patients seen. Students gain an understanding of the indications, benefits and risks of endoscopic procedures and learn to function as a consultant in a medical subspecialty.

    Med 481:  Geriatrics  Director: Richard Grant, MD

    Students are exposed to geriatric practices at multiple sites, including inpatient, primary care, consultation service, ambulatory practices, nursing home, hospice and home care.  Students also participate in weekly geriatrics seminars and general medicine conferences. Topics focus on chronic illnesses, functional disability and long-term care.


    Med 433:  Hematology/Oncology    Director: William Tester, MD

    This elective exposes students to outpatient and consultative hematology/oncology.  Students participate in the outpatient clinics of faculty hematologists/oncologists, see new consults in the inpatient and outpatient setting and help formulate diagnostic and therapeutic strategies. Conferences on topics pertaining to patients seen by the student are part of the rotation as is regular review of peripheral blood smears and bone marrows.  This elective serves as a contrast to what students may have observed on inpatient oncology services and demonstrates how patients with malignancies can be managed in the outpatient setting.


    Med 478:  Hepatology/Liver Transplantation  Director: Victor Araya, MD

    Students develop skills in the recognition, manifestations, diagnosis and management of patients with the most common hepatic disorders, including chronic viral hepatitis C and B, autoimmune liver diseases and alcoholic liver disease. Students participate in daily conferences of the liver transplant team and learn basic aspects of transplantation medicine and immunosuppression. Students learn the indications for liver biopsy and interpretation of histologic features of liver disease.


    Med 473:  Infectious Disease  Director:  Robert Fischer, MD

    Students are active participants on the infectious disease consultation service.  Under the supervision of the attending physician, students complete new consultations and follow-up rounds. The service includes HIV, transplant, oncology, trauma and surgical patients, as well as exposure to more common problems such as bacteremias, line infections, pneumonia, urinary tract infections, skin and soft tissue infections. Rounds in the radiology and microbiology departments occur daily, and students attend case presentation conferences.


    Med 469:  Medical Intensive Care  Director: Steven Goldberg, MD

    The Medical Intensive Care Unit (MICU) at Einstein is managed by the full-time pulmonary/critical care faculty. The team consists of three to four interns, two senior residents, one pulmonary fellow and the teaching attending.  The student works as a member of the MICU team and has primary responsibility for one to two patients.  Students have the option of staying on call at night. Comprehensive teaching and management rounds are held daily.  Didactic and interdisciplinary lectures also are scheduled regularly.  The student acquires skills in hemodynamic monitoring, ventilator management and the care of patients with life-threatening illnesses.

     

    Med 441:  Nephrology  Director: Eric Bloom, MD

    Students are active participants on the nephrology consult service.  This rotation provides students a general overview of nephrology with special emphasis on management of common clinical problems.  Students are exposed to a wide array of problems in clinical nephrology including hypertension, water-electrolyte and acid-base abnormalities. Students also have limited exposure to hemodialysis and peritoneal dialysis along with renal transplantation.  Students work closely with medical residents, nephrology fellows and nephrology attendings.  They participate in daily teaching rounds, attend daily didactic conferences, weekly journal club and nephrology grand rounds.  Students also participate in weekly clinical nephrology and hypertension clinic.


    Med 467:  Pulmonary   Director: Michael Lippmann, MD

    Students are active participants on the pulmonary consult service, where they work closely with medical residents, pulmonary fellows and full-time faculty.  On this rotation students learn management of respirators, hemodynamic monitoring and indications for bronchoscopy. Students also learn to do pulmonary consultations with an appropriate history and physical, differential diagnosis and treatment plan.  Experience is gained in the work-up of patients with COPD, cancer, interstitial lung disease, severe asthma, pleural effusions and infections. Students attend three weekly conferences (intake, pulmonary seminar and pulmonary grand rounds).


    Med 489:  Rheumatology   Director: Lawrence Brent, MD

    Students on the rheumatology service are involved in outpatient and inpatient evaluation and treatment of patients with a wide spectrum of rheumatic diseases. Students attend rheumatology clinic four to five half days per week and participate in the evaluation and treatment of primary rheumatology inpatients and consults at AEMC and MossRehab.  Students develop an understanding of the use and interpretation of rheumatologic laboratory tests. There is ample opportunity to learn procedures including joint aspiration and soft tissue injection. Students attend weekly rheumatology conference as well as journal club/case conference.


    OBGY 405: OB/GYN Inpatient Clerkship  Director: David Jaspan, DO

    This elective is designed to expose the student in detail to all facets of women’s health care.  The student will function as subintern with increased responsibilities for patient management, treatment plans, and surgical procedures.  The student will spend time on the labor and delivery unit, in the ambulatory care office, and in the operating room.  In addition to the clinical education, the rotation includes daily rounds, morning report and conferences, along with weekly grand rounds.


    OBGY 402:  Outpatient Subinternship          Director:  Charles Beckmann, MD

    Students participate in the ambulatory care provided in the various office sessions in the resident obgyn practice.  A primary emphasis is placed on primary women’s health care and health promotion/disease prevention and routine gynecologic care appropriate to a woman’s age.  In addition, students participate in the care provided in specialty areas such as high-risk obstetrics, colposcopy, and so forth.  Students also attend the didactic programs offered (grand rounds, lectures, case presentations, morbidity and mortality conference, etc.) and Morning Report.

    OBGY 409:  Maternal-Fetal Medicine   Director:  Carlene Quashie, MD

    This elective is designed to provide an introduction and familiarization with high-risk obstetrics including preventive, diagnostic, and therapeutic measures.  The student participates in the evaluation and management of high-risk obstetrical patients, such as those with diabetes, hypertension, and preterm labor.  In addition, he/she becomes familiar with modern diagnostic procedures including antenatal testing, ultrasonography, amniocentesis, color flow Doppler, CVS and fetal echocardiography.  The opportunities for practical experience are supplemented by clinical case reviews and conferences on maternal fetal medicine and neonatology.


    Orth 401:  Orthopedics   Director:  John Handal, MD

    The Orthopaedic Surgery elective is designed for students interested in the specialty field of orthopaedics.  Students rotate through each of the services within the Department of Orthopaedics and gain exposure to various aspects of orthopaedics including hand and wrist surgery, joint replacement, sports medicine and arthroscopic surgery, shoulder, elbow, knee, foot and ankle surgery, neuromuscular disorders, spine and trauma.  

    Working closely with and under the direct supervision of attending physicians and residents on the orthopaedic services, students will observe and participate in interesting and complex cases in the operating room and trauma cases in the Level One Trauma Center/ emergency room.  In addition, students will see patients in the ambulatory office setting and be involved in the pre- and postoperative management of in house patients and consults.  

    Students attend all resident and departmental educational conferences held during the course of the rotation.  Students will be assigned to approximately 5 nights on call with the orthopaedic residents during the elective rotation.  Meals tickets are provided for students on call.


    Ped 401:  Ambulatory Pediatrics   Director:  Alan Schindler, MD

    This elective is designed to provide the student with an in-depth experience in ambulatory pediatrics and to expose the student to all aspects of the ambulatory care of children, with emphasis on well child care and the evaluation and follow-up of sick children.  The student will become competent in obtaining histories, performing physical examinations, and diagnosing and treating common childhood problems such as iron deficiency anemia, lead poisoning, asthma, sexually transmitted diseases, and psychosocial issues.

    The student will participate in a busy pediatric and adolescent ambulatory center. The student will be precepted by attending physicians and senior pediatric residents, be given specific reading assignments, and participate in Pediatrics conferences. There may be opportunities to learn how to perform some procedures, such as venipunctures and bladder catheterizations, under the supervision of the pediatric staff.

    Ped  403: Intensive Care Nursery   Director: David Schutzman, MD

    This elective provides the student with a broad exposure to the care of the newborn infant in the delivery room and the Neonatal Intensive Care Unit.  Students will gain an understanding of the daily care and management of critically ill and very low-birth-weight babies and acquire skills such as placing umbilical catheters and intubating infants.

    The student will be an integral member of the NICU team and, as experience is gained, will be given responsibility for patients under the supervision of a senior member of the team. The student will attend all work rounds, attending rounds, teaching sessions, x-ray conferences and perinatal rounds. During a four-week rotation the student will be on call 5 or 6 times with the senior resident on the team.

    Ped 404:  Neuro Developmental Pediatrics   Director:  Wendy Ross, MD

    This elective provides intensive exposure to developmental/behavioral pediatrics for the fourth-year medical student interested in a career in pediatrics or child psychiatry.  The student will gain competency in the skills required for history taking, physical examination and review of psychometric testing results of children with suspected developmental difficulties such as attention deficit hyperactivity disorder, learning disabilities, autism, and global developmental delay. Approaches to children with behavioral difficulties will also be explored.

    Each week, under the supervision of a developmental pediatrician, the student will evaluate patients with developmental problems and participate in their ongoing care. The student will also have learn to advocate in the community at large in order to meet the needs of these patients by communicating with schools and various agencies in the community. The student will have the opportunity to present a conference to members of the team on pertinent topics.

    Ped 427:  Adolescent Medicine    Director:  Alexis Lieberman, MD

    This elective is designed to provide the student with an in-depth experience in Adolescent Medicine and to expose the student to all aspects of the care of adolescents.  The student will spend eight sessions per week in the Teen Health Center, becoming competent in obtaining histories from adolescents, in performing physical examinations on adolescents, including pelvic examinations, in diagnosing and treating sexually transmitted diseases, and in addressing adolescent psychosocial issues.

    During the remaining two sessions each week, the student will have the opportunity to participate in some of the many aspects of adolescent health care that take place outside of the physician’s office.  These may include working on quality improvement projects in the Teen Health Center, with the very real potential of improving the care of adolescents in the Teen Health Center.


    Ped 428:  Clinical Genetics    Director:  Adele Schneider, MD

    NOTE: This elective must be scheduled with the Program Director after July 1st.

    This elective provides exposure to all aspects of clinical genetics for fourth-year students interested in clinical genetics, pediatrics, or obstetrics (including perinatology).  The student will become familiar with the detailed process of a genetics evaluation, including learning how to draw a three-generation pedigree and how to obtain a developmental history and detailed genetics examination.

    Under the supervision of the clinical geneticist and/or board-certified genetic counselors the student will see pediatric patients both at Einstein and at satellite offices. Other opportunities include participating in prenatal genetic counseling, maternal-fetal medicine evaluations for genetic conditions, breast cancer genetic counseling and observation of level II ultrasound, amniocentesis and CVS procedures in the antenatal testing unit. Periodically there are activities related to the Ashkenazi Jewish Genetic Disease screening program or the anophthalmia research program in which the student may participate.

    Ped 473: Infectious Disease  Director: Allan Arbeter, MD

    NOTE: This elective is not offered in July or January

    Students will become familiar with the investigative processes involved in evaluating the patient who may have an infectious disease. The student will be a member of the infectious disease team. The student will see new consults, obtain histories, perform physical examinations, review laboratory and imaging studies and generate a differential diagnosis.  The student will participate in rounds at both Einstein and Jefferson Hospital and as a speaker in one of the weekly ID conferences.

    Psyh 436:  Child & Adolescent Inpatient Psychiatry  Director:  Fayez El-Gabalawi, MD

    Medical students will become familiar with the diagnostic and evaluation process of adolescent disorders.  Students will learn basic dynamics of family therapy, and the paradigms for normal adolescent development

    Medical students will become an integral part of the treatment team approach that is used on the Adolescent Psychiatry Unit at Belmont.  Students will be assigned two patients to follow throughout the rotation and will be familiarized with the family approach to the treatment of adolescent disorders.
     
    Students will be assigned appropriate reading material to gain an understanding of normal adolescent development.  Students will be expected to participate in all case conferences and family therapy conferences.  Students will also meet with their individual supervisor once a week to review their cases.

    Psych 437:  Co-Occurring Disorder Unit   Director:  Tom Richardson, MD

    Students will learn various regimens of detoxification and will become familiar with the 12-step recovery model and the dual diagnosis program.  Students also will learn about the method and theories of Addiction Psychiatry.

    Students will be involved in the assessment and treatment of patients with co-occurring substance and psychiatric disorders.   They will have the opportunity to follow several patients in a “team” model with the attending, nursing staff, counselors and social workers.  Students will participate in treatment team meetings and all case conferences and will be supervised by the attending physician.

    Psyh 401:  Inpatient Psych (Belmont)      Director:  Richard Jaffe, MD
                         Inpatient Psych (AEMC)            Director:  Marc Zisselman, MD

    During these inpatient electives, students will learn skills in diagnostic interviewing, diagnostic psychiatry, and develop a basic knowledge of psychopharmacology and supportive psychotherapy.

    The senior student will function at the first year resident level with considerable responsibility for a few patients under his/her direct care.  The senior student will be an integral part of a multi-disciplinary team and will participate in team meetings and case conferences.  Richard Jaffe, MD or Marc Zisselman, MD will provide supervision.

    Psyh XXX:  Psychiatric Subspecialties

    Medical students have the opportunity to gain focused experience in psychiatry by selecting one of a number of psychiatric subspecialty units for a fourth year rotation. Students will collect specialized psychiatric histories, conduct mental status exams, and learn the diagnoses and treatments associated with the chosen subspecialty.  Students will work closely with a faculty member, who will provide bedside instruction and recommend readings.  Students will gain experience in working with the teams associated with each subspecialty.  Available subspecialty rotations include Child and Adolescent Emergency Psychiatry, Adult Emergency Psychiatry, Consultation and Liaison Psychiatry, Child and Adolescent Inpatient Psychiatry, Adult Inpatient Psychiatry, Addictions Psychiatry, Geriatric Psychiatry, Eating Disorders, HIV Psychiatry, and Care of Persistent Illness in a Long Term Structured Residence.  Subspecialty availability will vary throughout the year due to variations in faculty schedules.  Contact the Education Coordinator at 215-456-9015 to discuss interest and availability of rotations.


    RAD 401:  Radiology  Director:  Susan Summerton, MD

    This four-week elective is designed to equip medical students with a foundation in radiology, regardless of specialty.  They will acquire fundamental skills in image interpretation covering a wide range of modalities. The month is divided into 1-week segments that emphasize the following subspecialties: Chest Imaging, Abdominal Imaging, Musculoskeletal Imaging and Neuroradiology.  

    Students will rotate through different sections in the department, join our attending and resident radiologists during imaging review sessions and observe interventional procedures. There will also be small group learning sessions with radiology attendings and residents. The students will attend daily 8:00 a.m. and Noon Radiology Conferences that stress observation, pathophysiology and differential diagnosis. Additional educational materials are available in the form of a DVD lecture series and online using www.LearningRadiology.com.

    Surg 452:  General Surgery
    Surg 453:  Thoracic and Cardiovascular
    Surg 454:  Transplant
    Surg 458:  Diseases of the Breast
    Surg 459:  Colon & Rectal Surgery
    Surg 480:  Trauma/Critical Care    Director: Robert Somers, MD

    Students may choose to become familiar with the many aspects of general surgery (transplant, urology, ENT, neurosurgery, CT Surgery, colon and rectal surgery and diseases of the breast) or to focus on the specifics of a particular surgical subspecialty. The hospital is designated as a Level 1
    Trauma Center so there is ample opportunity for exposure to a wide variety of cases.

    Students will attend all conferences associated with the specific surgical service and will work with the residents and attending assigned to a particular service.  


    Surg 485:  Surgical Intensive Care   Director: Mark J. Kaplan, MD

    Students rotating in the Surgical Intensive Care Unit will be exposed to the complex problems of surgical/trauma patients in critical condition, and to the management of these problems. Basic concepts learned during the first two years of medical school, especially those of cardiopulmonary physiology and pharmacology, need to be reviewed and integrated with the understanding of disease processes and treatment modalities learned in the clinical years. By the end of the rotation, students should feel comfortable walking onto a unit, learning the history of and assessing a patient, delineating a patient’s current monitoring and treatment modalities, and discussing current issues and potential changes that should be made therein.