INTERNAL MEDICINE
Contact: Mistie Stewart
Telephone: 691-1094
E-mail: stewar21@marshall.edu
(Students are to contact the Medicine Coordinator prior to arranging electives.
All out-of-town electives must be approved by the Academic Affairs Office prior
to scheduling.)
TABLE OF CONTENTS
COURSE NUMBER
Advanced Skills in Clinical Epidemiology MED 800
Clinical Dermatology MED 803
Clinical Endocrinology and Metabolism MED 805
Research in Endocrinology and the Metabolism MED 806
Clinical Gastroenterology MED 807a
Primary Care Internal Medicine MED 809
Clinical Hematology-Oncology MED 811
Research in Hematology MED 812
Clinical Infectious Diseases MED 813
Research in Infectious Diseases MED 814
Clinical Pulmonary Disease MED 821
Clinical Rheumatology MED 823
Subinternship in Medicine MED 827
Clinical Neurology MED 829
Clinical Geriatrics MED 839
Rural Medicine MED 888
ADVANCED SKILLS IN CLINICAL EPIDEMIOLOGY, MED 800
COURSE DIRECTOR: Todd Gress, MD, MPH
CREDIT: 2 weeks
MODE OF GRADE: Letter Grade
PREREQUISITE(S): Epidemiology as MSII
COURSE DESCRIPTION: This MS IV course will cover necessary skills in
epidemiology used in clinical practice for both interpretation of the medical
literature and application to patient care.
COURSE OBJECTIVES: 1. The fourth year medical student will master
common epidemiologic principles and statistical tests and results by the end of
the course. 2. The fourth year medical student will demonstrate their skills in the
interpretation of the medical literature as measured by faculty in small group
sessions. 3. The fourth year medical student will learn and use epidemiologic
data to guide care in simulated clinical cases.
TEACHING METHODS/ EVALAUTION METHODS:
The daily structure of this course will be 1) Initial introduction via lecture about
an epidemiologic and biostatistical principle 2) Faculty guided reading from the
text 3) Reading and interpretation of a medical article(s) 4) Presentation and
discussion of the article in a faculty lead small group session.
Students will be evaluated using daily faculty evaluation of their small group
presentations and a final exam at the end of the course. The evaluation form will
be based on the learning and institutional objectives.
INSTITUTIONAL GOALS AND OBJECTIVES MET OR ADDRESSED
K10, S3c, S9d and e, S12, A1, A10, A11
TEXT: Epidemiology, Third Edition by Leon Gordis, Elsevier/Saunders
CLINICAL DERMATOLOGY, MED 803
DURATION: Two to Four weeks.
DESCRIPTION: Participate in the management of about 30 patients with skin
disorders each day.
LOCATION: Offices of one of the following:
Dr. Nazeem Abraham, Huntington, WV (523-5100)
Dr. Carol Cooper, Ashland, KY (606) 324-1483
Dr. Jerry Hahn, Petersburg, WV (304) 822-3838
Dr. Jack Ditty, Ashland, KY (606) 836-3111
GOALS: To recognize and treat various skin disorders.
RESPONSIBILITIES OF STUDENT: To assist in diagnostic procedures such as
skin biopsies, KOH preparations for fungus, etc., to compile differential diagnosis
list for selected patients and to become acquainted with formulating
dermatological prescriptions.
OTHER PERTINENT INFORMATION: This elective must be arranged by the
student. After dates are set, the student must inform the Office of
Academic Affairs where and with whom (preceptor name) the elective will
take place. For Dr. Hahn's availability, the student should contact the RHEP Site
Coordinator at (304) 257-5812.
CLINICAL ENDOCRINOLOGY AND METABOLISM, MED 805
DURATION: Two to four weeks.
DESCRIPTION: This elective in Huntington provides an opportunity for medical
students to develop their clinical skills and expertise in diabetes and thyroid
disease and other endocrine diseases. Efforts will be made to "tailor make" this
elective for each student to meet the student's career goals in medicine and
areas other than medicine as well, e.g. Ob/Gyn endocrinology, Pediatric
endocrinology, etc. The student will participate as a member of the team
consisting of full-time faculty endocrinologists, the fellow in Endocrinology, the
resident assigned on the Endocrinology Service, and the medical student on the
elective. The medical student works closely with the faculty endocrinologist who
will make patient rounds daily. The student attends outpatient endocrinology
clinics two half-days a week for training in the management of endocrinology
problems in ambulatory patients. A variety of educational conferences are
scheduled including endocrinology grand rounds, endocrinology lectures, and the
Huntington Hormone Club meetings to which the student is invited. About twenty
percent of the student's time will be spent directly or indirectly in ambulatory care.
LOCATION: Inpatient activities at Cabell Huntington Hospital, St. Mary's Hospital
or Huntington VA Medical Center. Outpatient activities at the practice offices of
the Department of Medicine at the Marshall University Medical Center.
GOALS: The goals of the elective are to learn to recognize common endocrine
syndromes, to understand the approach to diagnosis and management, and to
understand basic tests and procedures used in the evaluation of endocrine
disorders. Major emphasis is on how to manage patients with diabetes, thyroid
disease, and osteoporosis, and interpretation of tests.
RESPONSIBILITIES OF STUDENT: The student will be responsible for daily
rounds on patients; evaluating and presenting patients to attending
endocrinologists; reviewing literature relevant to patient cases; reading endocrine
handouts; attendance at outpatient endocrinology clinics and endocrinology
conferences.
RESEARCH IN ENDOCRINOLOGY AND THE METABOLISM, MED 806
DURATION: Two to four weeks.
DESCRIPTION: This elective provides an opportunity for medical students to
conduct a research project under the preceptorship of faculty of the Section of
Endocrinology, Department of Medicine. The student will gain experience in
scientific methods and design of experiments. He/she will select a well defined
project which is in a research area of one of the faculty. The student will work
under the guidance of either Drs. Leidy, Driscoll or Chertow. Research will be
conducted in the research laboratories at the Marshall University School of
Medicine. The student will be able to complete his/her research activities within a
period of twelve weeks and usually will have collected sufficient data for
publication. Ongoing research activities include studies relevant to insulin and
somatostatin secretion in health and in diabetes and to hypothalamic-pituitary
hormone secretion in health and in a variety of pituitary disorders including
pituitary tumors.
LOCATION: Endocrine Research Laboratories, Building 5, Huntington VA
Medical Center.
GOALS: To understand methods of research in the laboratory, to provide the
student with insight into laboratory investigation and its relevance to clinical
problems; to allow the student to become comfortable in the laboratory so that
the student may develop a good idea as to whether he/she has any serious
interest in pursuing research activities in his/her future career.
RESPONSIBILITIES OF STUDENT: To conduct research activities full-time
during the twelve week elective.
CLINICAL GASTROENTEROLOGY, MED 807. 201
DURATION: Two to four weeks.
DESCRIPTION: The student will be part of the clinical GI consultation service at
downtown hospitals. He/she will gain experience in the assessment and
management of patients with GI diseases, and will have the opportunity to
become familiar with endoscopic and other diagnostic procedures. The student
will be expected to become familiar with the literature on the management of
patients with specific gastrointestinal disorders.
LOCATION: Cabell Huntington Hospital and St. Mary's Hospital and the practice
offices of the Department of Medicine at the Marshall University Medical Center.
GOALS: To: (1) Increase the students knowledge of gastrointestinal
pathophysiology, patient management and GI procedures. (2) Provide an
opportunity to increase these skills of students in presentation and discussion of
cases. (3) Provide practice in working up patients in-depth, with appropriate
literature research.
RESPONSIBILITIES OF STUDENT: The student may attend educational
conferences as time allows, and will see approximately one consultation per day.
He/she will obtain the patient's history, including information on previous
admissions, examine the patient, and review the laboratory data. After the
discussion with the Attending Physician, the student will formulate plans for
patient management, and communicate them to the patient, his family, and the
house staff. The student may perform simple procedures under supervision, and
will observe flexible endoscopic procedures, and will follow these patients during
their hospitalization. The student also will have the opportunity to participate in
the outpatient management of patients with gastrointestinal illnesses.
OTHER PERTINENT INFORMATION: Limited to one student.
PRIMARY CARE INTERNAL MEDICINE, MED 809
DURATION: Two to four weeks.
DESCRIPTION: The student participates in the primary care practice of internal
medicine as carried on by members of the Section of General Internal Medicine.
There may be opportunities for both office and hospital experience in primary
care, depending upon the faculty preceptor, but the emphasis will be on
ambulatory medicine. The student will be exposed to a variety of experiences in
the clinical setting which illustrate the concepts of quality primary and ambulatory
care, including record-keeping in the problem oriented fashion, office
management and chart auditing. Students treat patients with a wide variety of
problems and obtain a great deal of "hands-on" experience in patient care.
Emphasis will focus on clinical application utilizing the appropriate literature to
broaden the knowledge base of the student.
LOCATION: The practice offices of the Department of Medicine at the Marshall
University Medical Center. By special arrangement, it may be possible for
selected students to be located in offices in Cabell County or other counties
within the state.
GOALS: The goals of this elective allow students to thoroughly explore the
following aspects of comprehensive primary care: philosophical and practical
aspects of ambulatory care; how a defined system of care can provide quality
assurance to the patient and continual education for the provider; specifically, the
application of the problem-oriented system to ambulatory care; appreciation that
the care of hospitalized patients is only one aspect of the practitioner's
responsibility and that one goal of an efficient practice is to minimize frequency
and duration of hospitalization.
RESPONSIBILITIES OF STUDENT: The student will be expected to interview,
examine, collect appropriate data, and propose possible diagnoses and therapies
on selected patients under a preceptor's guidance. The student should be able to
master the concepts of the problem-oriented medical record as applied to
ambulatory care. Each student may be asked to research a special topic interest
for presentation during the elective.
OTHER PERTINENT INFORMATION: Limited to one student per preceptor time.
CLINICAL HEMATOLOGY-ONCOLOGY, MED 811
DURATION: Two to four weeks, which may be extended by arrangement to 8
weeks.
DESCRIPTION: This elective provides the student with experience in the
diagnosis and management of hematological and oncological problems both in
the inpatient and clinic setting. These include anemia, coagulation disorders, and
hematological and solid neoplasms. Special instruction includes the focused
physical examination techniques appropriate to blood disorders and neoplasia,
bone marrow aspiration under supervision, the microscopic evaluation of
peripheral blood and bone marrow, and treatment planning. For students electing
a longer rotation, emphasis will be on continuity of care and modalities of support
appropriate to on-going disorders. Ambulatory experiences will comprise
approximately 30% of the course.
LOCATION: St. Mary's Hospital, and Cabell Huntington Hospital and the
Hematology/Oncology Section practice offices of the Department of Medicine at
the Marshall Medical Center.
GOALS: To familiarize students with the presentation and the techniques of
evaluation appropriate to patients with blood disorders and neoplastic diseases
and to understand the role of the physician in the detection, analysis and
management of these conditions.
RESPONSIBILITIES OF STUDENT: The student will be responsible for the initial
assessment of selected cases, assembling of data for the solution of clinical
problems, and elements of the management of the patient depending on the
student's individual educational intentions and experience. The student will be
responsible for mastering selected elements of the hematological literature under
guidance of the preceptor, and will undertake library research appropriate to
patients under care.
RESEARCH IN HEMATOLOGY, MED 812
DURATION: Twelve weeks. Under special circumstances, a shorter elective can
be arranged if a student wishes to continue the research started in a summer
position.
DESCRIPTION: This elective offers the opportunity to conduct research in the
Hematology Laboratories at Marshall University School of Medicine. The student
will conduct a laboratory project of mutual interest to the student and the
hematology faculty. A faculty member will assist the student in selecting a project
which will provide a broad exposure to differing laboratory methods and which
can be completed in the time of the elective. The project may be in diagnostic
hematology or in conjunction with one of the ongoing research projects in
hematology or oncology. The student will have an inside view of the methods
used in red cell studies and rheology. The student will become proficient in these
areas. It is expected that the student will collect sufficient data to publish at least
one paper based on the research done in this twelve-week elective, and the
student will be responsible for preparing the manuscript. The faculty will assist in
this task.
LOCATION: Hematology Research Laboratory, Medical Education Building.
GOALS: Develop understanding of research methodology in hematology and of
the scientific method of investigation in general; become critical of data; interpret
current literature, and conduct research in one aspect of hematology.
RESPONSIBILITIES OF STUDENT: To conduct a research project in
hematology and to prepare the results for publication.
CLINICAL INFECTIOUS DISEASES, MED 813
DURATION: Two to four weeks.
DESCRIPTION: The student will examine patients requiring consultations in
Infectious Diseases with an Infectious Diseases attending physician at the
affiliated hospitals. A scientific approach to the diagnosis of infectious diseases
will be stressed. Interpretations of cultures, Gram's stains and other appropriate
laboratory data will be taught. Whenever possible, the student will examine each
patient daily, enter a note on the chart and discuss the patient directly with the
attending physician in Infectious Diseases. The student will supplement bedside
teaching by reading about common infectious diseases seen in the United States
today, by attending journal club and preparing presentations concerning topics
related to the patients being examined on consultation. The student will
participate in the weekly journal club and ID Conference.
LOCATION: St. Mary's Hospital, and Cabell Huntington Hospital and the
practice offices of the Department of Medicine at the Marshall University Medical
Center.
GOALS: Develop broad background in the common infectious diseases,
including diagnostic evaluation, use and interpretation of microbiologic laboratory
tests, treatment and especially appropriate antibiotic usage.
RESPONSIBILITIES OF STUDENT: The student will be responsible for
conducting examinations of patients with infectious diseases, recommending
appropriate diagnostic microbiologic tests, and interpretation of the results, and
outlining a treatment plan with the guidance of the attending physician in
Infectious Diseases. The student will work closely with the faculty in Infectious
Diseases and residents on the Infectious Diseases Service as an integral
member of the consultant team.
OTHER PERTINENT INFORMATION: Limited to one student.
RESEARCH IN INFECTIOUS DISEASES, MED 814
DURATION: Two to four weeks.
DESCRIPTION: This elective offers the opportunity to conduct research in the
Infectious Diseases Laboratories at Marshall University School of Medicine.
Faculty will assist the student in selecting a project which will provide a broad
exposure to differing laboratory methods and which can be completed in the time
of the elective. The student will have an inside view of the methods used in
antibody detection, cultivating viruses and bacteria. The student will become
proficient in these areas. It is expected that the student will collect sufficient data
to publish one paper based on the research done in this elective; the student will
be responsible for preparing the manuscript. The faculty will assist in this task.
LOCATION: Infectious Diseases Research Laboratories.
GOALS: Develop understanding of research methodology in infectious disease
and of the scientific method of investigation in general; become critical of data;
interpret current literature in infectious diseases; and conduct research in one
aspect of infectious diseases.
RESPONSIBILITIES OF STUDENT: To conduct a research project in infectious
diseases and to prepare the results for publication.
CLINICAL PULMONARY DISEASE, MED 821
DURATION: Two to four weeks (or up to 8 weeks, by permission).
DESCRIPTION: The student will be introduced to the clinical practice of
pulmonary medicine in this elective, with an emphasis on the history and physical
examination in a variety of patients with lung disease. The student will make
assessments and recommendations on patients under the guidance of the
faculty. Participation in procedures such as thoracentesis, pleural biopsy, and
bronchoscopy will be encouraged. The student will learn interpretation of
pulmonary function testing, be guided by a faculty member in reading and
evaluating the literature of pulmonary diseases and respiratory physiology. The
student will participate in pulmonary clinic at the VA Medical Center.
LOCATION: VA Medical Center, St. Mary's Hospital and Cabell Huntington
Hospital, Huntington, WV.
GOALS: To develop a base of knowledge in evaluating and diagnosing
pulmonary disease and in applied respiratory physiology.
RESPONSIBILITIES OF STUDENT: The student will be responsible for
performing history and physical examinations and forming an assessment,
differential diagnosis, and tentative plans for work-up. They will be responsible
for participating in the academic activities of the pulmonary division.
OTHER PERTINENT INFORMATION: Limited to one student at a time.
CLINICAL RHEUMATOLOGY, MED 823
DURATION. Two to four weeks.
DESCRIPTION: The student will examine office patients in a rheumatology
practice and learn differential diagnosis of localized arthritic conditions and
systemic disease with joint involvement, their clinical characteristics and
management. He/she will examine patients at the rheumatology clinics of the
affiliated hospitals and a limited number of consultations for inpatients will be
conducted each week.
LOCATION: VA Medical Center and the practice offices of the Department of
Medicine at the Marshall University Medical Center.
GOALS: To teach a core curriculum of the common diseases of the joints and
the understanding of their pathogenesis, diagnosis and therapy.
RESPONSIBILITIES OF STUDENT: Daily attendance of office hours and visits
to hospital clinics and inpatient consultations as scheduled. Examination and
evaluation of patients with rheumatic diseases, including ordering of appropriate
laboratory tests and interpretation of results.
SUBINTERNSHIP IN MEDICINE, MED 827
DURATION: Two to four weeks.
DESCRIPTION: The student will serve as a "subintern" involved with the
patient's care from the time the patient is admitted until the time of discharge.
The student will be assigned to a medical service and will be given independent
patient care responsibilities consonant with the student's ability to accept such
responsibilities. The student will be on call approximately every sixth night
together with a supervising medical resident and intern. This elective is aimed at
students who want to acquire a strong background in internal medicine. The
elective is available for four, six or eight weeks; students who spend eight weeks
on this elective gain major capabilities in the care of patients with common
medical problems. The student will have close supervision by a clinical faculty
member of the Department of Medicine. The student will be required to attend all
teaching conferences of the Department of Medicine. The Beckley site elective
qualifies as a Rural Elective.
GOALS: To provide training in Internal Medicine, with a solid foundation in the
diagnosis, therapy and management of illnesses encountered in an adult
population.
RESPONSIBILITIES OF STUDENT: The student will be responsible for
performing the history and physical examination, ordering laboratory studies,
interpretation of data, management and treatment of assigned patients. The
student will attend medical conferences and basic science conferences and
make regular ward rounds with the medical residents and faculty attendings in
the Department of Medicine.
CLINICAL NEUROLOGY, MED 829
DURATION: Two to four weeks.
DESCRIPTION: This elective in Huntington provides the student with experience
in the diagnosis and management of neurological problems both in the inpatient
and clinical setting.
LOCATION: The practice offices of Dr. McComas, 2860 3rd Avenue,
Huntington.
GOALS: To familiarize the student with the presentation and techniques of
evaluation appropriate to patients with neurological disorders.
RESPONSIBILITIES OF STUDENT: The student will be responsible for
attending clinic office hours and hospital consultations. The student will be
responsible for the initial assessment of selected cases, the assembling of data
for solving clinical problems, and elements of the management of the patient
depending upon the student's individual educational intentions and experience.
OTHER PERTINENT INFORMATION: Limited to one student.
CLINICAL GERIATRICS, MED 839
DURATION: Two to four weeks.
DESCRIPTION: This elective offers students interested in Geriatrics or General
Internal Medicine an opportunity for an in-depth experience in caring for elderly
persons. The elective encompasses care of patients in acute, convalescent and
rehabilitative stage of illness, and emphasizes an outpatient experience at the
Hanshaw Geriatric Center, the comprehensive geriatric outpatient evaluation
facility of the School of Medicine. Experience in nursing home medicine and
other aspects of long-term care of chronic illness are part of this elective.
LOCATION: Hanshaw Geriatric Center of the Department of Medicine at the
Marshall University Medical Center inpatient services, and Heritage Center
Nursing Home.
GOALS: To develop proficiency in care of elderly patients, with emphasis on
Geriatric Evaluation and Management, care of chronic illness, and rehabilitation.
RESPONSIBILITIES OF STUDENT: Students are assigned to a geriatric
attending physician and will follow the physician's schedule for the month. The
student is responsible for presenting to the Hanshaw Geriatric Center Team one
short discussion each week on a topic in clinical geriatrics or gerontologic basic
science. Alternatively, the student may choose to complete one brief clinical
research project during the month, or a comprehensive literature review of a
topic.
The student attends Geriatric Center Team meetings, and will be required to
attend Medical Grand Rounds, the Journal Club, and other Internal Medicine
conferences as deemed appropriate by the faculty. The student will attend
several half-day visits to the affiliated nursing home. Students with particular
interest will be able to follow several patients there through the entire rotation or
may elect to do a clinical research project in long-term care.
OTHER PERTINENT INFORMATION: Limited to one student.
RURAL MEDICINE, MED 888
DURATION: Two to four weeks.
DESCRIPTION: Introduction to primary care with particular focus on wellness,
maintenance and disease prevention. The experience will demonstrate team
health care provision, case management for functionality and quality. The
experience will include community service such as participation in health fairs,
health education projects in schools. Patient care will be examined in terms of
continuity management and community support as opposed to anecdotal disease
management.
LOCATION: Rural Health Education Partnership Sites and other rural sites as
negotiated.
GOALS: To acquaint students with the issues of community health and
wellness. To provide the students opportunity to practice health education skills.
To equip students with the knowledge, attitudes and skills to participate in a
changing health care environment.
RESPONSIBILITIES OF STUDENTS: Students will participate in health care on
site and in the community. The team will incorporate experiences with midlevel
providers. Students may participate in on-going community health projects,
initiated new projects, or in on-going community health research or initiate such
as approved by the site coordinator.