Elective Rotations

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

Ambulatory clinic: As an immersion experience in the principles of ambulatory medicine in the setting of a Patient Centered Medical Home, this rotation focuses on in-depth essential skills in ambulatory general medicine, management of chronic disease states, and learning the different team member roles (nurses, medical assistants, case managers, and pharmacists) and how a patient navigates within the Patient Centered Medical Home.

Cardiology consults: Cardiology consults provides in-depth encounters with cardiovascular diseases. Attendance at all cardiology conferences is required. Some inpatient cardiology consultative work will be done, but the majority of time will be spent in the outpatient cardiology clinic.

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

Essential skills in internal medicine (ESIM): This rotation, completed early in the internship year, focuses on topics not often found elsewhere in the residency curriculum. Topics addressed include fundamental clinical skills with a focus on history taking, physical examination, laboratory interpretation, communication and procedural skills; a comprehensive evidence-based medicine and quality improvement curriculum; and involvement in a research immersion project under direct mentorship.

Gastroenterology clinic/consults: Inpatient gastrointestinal (GI) consults are combined with outpatient management. Common conditions include peptic ulcer disease, hepatobiliary disease, liver transplantation, and diverticular diseases. Various endoscopic procedures are also done.

General medicine consults: Upper-level residents focus on the intricacies of inpatient consult medicine including preoperative evaluation, perioperative management of VTE prophylaxis or treatment, perioperative management of chronic diseases, and acute decompensation of chronic medical conditions.

Geriatrics: This rotation emphasizes care delivery and health management of elderly patients. In-depth patient-centered experiences include inpatient consults, Center for Senior Independence (an outpatient alternative to nursing home care for frail, elderly patients), resident nursing home, inpatient Palliative Care, and time spent with the Henry Ford Hospice team.

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

Infectious diseases: Inpatient consultation on the Infectious Diseases service is combined with some time spent in the outpatient clinic. Henry Ford Hospital has a substantial HIV population, both inpatient and outpatient, allowing for adequate learning about this illness. As Henry Ford Hospital is a major transplantation center, residents can also learn about infectious disorders of the transplant patient. The entire spectrum of infectious diseases is seen at Henry Ford Hospital.

Nephrology consults: Consults and inpatient nephrology, inpatient renal consultation, and renal dialysis will be studied. Discussions on fluid and electrolyte balance and management of acute renal failure are stressed. This experience is meant to complement the inpatient rotation of Nephrology.

Neurology: During the Neurology consultative elective, internal medicine residents will learn basic clinical neurology while providing aid to consulting services. Residents will learn anatomy, physiology, clinical presentation, and management of common nervous system disorders.

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

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

Rheumatology: Not often encountered in the inpatient service, this month-rotation offers exposure to rheumatology, orthopedics and sports medicine, connective tissue disorders, joint problems, back pain, and some sport injuries.

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

Transitions of care: Within the Patient Centered Medical Home model, residents participate in multiple integrated activities designed to improve knowledge and utilization of resources to optimize the outpatient management of patients with acute illness, progression of chronic disease, and exacerbation of chronic disease. Residents also learn about transitions of care between inpatient, ER, Observation Unit, and outpatient care teams.

Additional electives: At the discretion of the program director, interested residents are able to propose and design other elective rotations in their fields of interest. Some examples are anesthesiology (for intubations), cardiac electrophysiology, heart failure service, hepatology consults and inflammatory bowel diseases, renal transplant service, HIV clinic, transplant infectious diseases, tropical medicine, office gynecology, ambulatory medicine, quality improvement, etc.

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