A cutting-edge medical education

Medicine wards

A wards team generally consists of an attending, one senior resident, and two interns. It may also include a sub-intern or a third-year medical student from an affiliated medical school like Penn State. Our call cycle consists of a recurring cycle with two days of “day-call” admitting, two “post-call” days with no admitting. There is no 24-hour call.

Specialty Rotations

Each resident spends a two-week block in each of the core specialties of internal medicine both through our core subspecialty clinics and inpatient consultative services. These rotations are Monday through Friday in the outpatient setting, without weekend call or cross-coverage responsibilities.

Cardiology and CHF

Cardiology Clinic and Consultation will offer an exposure to diverse outpatient and inpatient populations with a variety of cardiac conditions. Residents on this rotation are exposed to interesting cardiology cases, including diagnoses of ischemic heart disease, heart failure, congestive heart failure and cardiomyopathies, valvular/structural heart disease, and common arrhythmias such as SVT, atrial fibrillation, ventricular tachyarrhythmias, and varying degrees of heart block. The rotation includes experience in the Advanced heart failure clinic and participation in cardiology testing and procedures (e.g. echocardiography, stress testing, ambulatory rhythm monitoring).

Pulmonology

The pulmonary rotation will provide residents with the necessary cognitive, technical, ethical, and social skills to manage several pulmonary conditions including: pulmonary medicine prevention, smoking cessation, vaccinations, screening and medication options for latent tuberculosis, evaluation of common pulmonary symptoms, obstructive airway disease, occupational and environmental lung disease, restrictive lung disease, interstitial lung disease, pulmonary hypertension, lower respiratory infections, pulmonary nodule, sleep medicine , positive pressure ventilation, pulmonary complications of HIV infection and opportunistic infections. This will also include pulmonary procedures such as the use of supplemental oxygen, spirometry, ABG, thoracentesis, and the administration of non-invasive positive pressure ventilation.

Nephrology

The nephrology rotation provides in-depth exposure and education for interested residents in areas of acid-base and electrolyte disorders, hypertension, and renal disease. Residents will care for and become adept at caring for outpatients with a variety of clinical conditions to include: hypertension, chronic kidney disease, and glomerular disease. On the inpatient consult service, residents will be exposed to a variety of consultative nephrology questions such as management of acute kidney injury, acid-base and fluid-electrolyte imbalance, and hemodialysis patients hospitalized for a variety of medical conditions.

Neurology

Residents will learn about neurology problems that are frequently seen in the primary care setting, as well as neurological diseases that are more frequently seen by neurology subspecialty services. They will become adept at evaluating a variety of neurological disorders including but not limited to headaches, dizziness/vertigo, stroke, dementia and neurodegenerative disease (like motor neuron diseases), episodic conditions like epilepsy, demyelinating conditions, neuromuscular conditions, movement disorders like Parkinson’s disease, and neuro-oncological conditions. There will be opportunity to observe and participate in neurophysiology (EMG, EEG, Video EEG monitoring), botulinum toxin injections, nerve blocks, lumbar punctures, programming and interrogating vagal nerve stimulators, and deep brain stimulator procedures.

Endocrinology

Residents will be taught to diagnose and manage diabetes mellitus and other major hormonal imbalances and metabolism abnormalities; learn key clinical findings on physical examination of patients with common endocrine problems such as diabetes mellitus, hypogonadism, thyroid disorders, hypercalcemia, and hypoaldosteronism; and provide management for many interesting endocrine cases. They will also participate in procedures such as fine-needle biopsy of the thyroid, and ultrasound evaluation of the thyroid.

Rheumatology

Residents will learn about common and uncommon rheumatologic problems that are seen in the primary care setting. There will be opportunities to participate in injections of joints and bursa. The residents will be trained in the management of fibromyalgia, osteoarthritis, polymyalgia rheumatica, osteoporosis, gout, CPPD, myopathies, and a host of musculoskeletal disorders such as torn rotator cuff, knee internal derangement, cervical and lumbar spine radiculopathies, cauda equina, spondyloarthropathy, joint instability, inflammatory arthritides, and autoimmune conditions.

Gastroenterology

Residents work in the outpatient GI clinic and inpatient Gastroenterology & Hepatology disorders clinic with gastroenterologists. Here they learn the best practice guidelines, indications, risks, and benefits of tests and procedures that are frequently utilized in the diagnosis and management of patients with GI and liver disorders. Residents will assist with gastrointestinal procedures including upper and lower endoscopy, as well as advance endoscopy such as ERCP.

Hematology/Oncology

Residents will care for a diverse patient population with many types of hematologic and oncologic diseases. They will see a combination of new and follow-up patients to address a variety of heme-onc disorders and consultative issues. Residents will have the opportunity to observe and perform bone marrow biopsies, intrathecal delivery of chemotherapy, and accessing ports and PICC lines. Residents will also participate in tumor board discussions and work alongside the hematology/oncology physicians in the infusion center as part of the patient care team.

Away/audition rotations

The Internal Medicine Program and the department of Graduate Medical Education is supportive of away rotations, both at local institutions and institutions across the country.

Research rotations

Research blocks are available beginning PGY-2.

Resident as Teacher Curriculum

Residents have several opportunities to teach medical students who are rotating through Kaiser Permanente in both the inpatient and outpatient settings. On the inpatient ward teaching team, the residents have the opportunity to work with sub-interns and 3rd year medical students from our affiliated institutions, including Penn State School of Medicine and Eastern Virginia Medical School. In the outpatient clinics, the residents work with and take part in teaching medical students from Georgetown and George Washington University