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department of medicineInternal Medicine Residency ProgramSubspecialty Programs
The Internal Medicine Residency Program does not mandate experience in specific subspecialty areas of medicine; rather, it provides ample opportunity for elective experience in any of the subspecialty sections of the Department of Medicine. Additional elective rotations are available under the auspices of other Temple departments such as Neurology or Obstetrics, Gynecology and Reproductive Sciences.
In addition to our general medicine floor services, we also have 4 teams that are led by subspecialists and see patients with a more narrow range of disease. For example, on the heart failure service, there is one teaching attending, who is able to provide the residents with more exposure and specialty teaching in this particular field. There is also one service each of nephrology, cardiology, and pulmonary patients. Finally, the infectious disease attendings also cover one of the general medicine teams. This variety of teaching attendings helps to provide residents with exposure to multiple approaches to the practice of medicine.
The Section of Cardiology offers full service in invasive cardiology including cardiac catheterization, endomyocardial biopsy, PTCA, balloon valvuloplasty, atherectomy, stents, and electrophysiology procedures, including implantation of pacemakers and devices, and radiofrequency catheter ablation. In addition, the section has a full echocardiography service including transesophageal, exercise and contrast echo, a nuclear cardiology program, Other services include a cardiac rehabilitation program, an outpatient clinical practice, an inpatient hospital service, a heart failure and transplantation program, and a cardiac intensive care unit.
Temple University Emergency Medical Services provides a walk-in care center as well as one of the busiest emergency departments in Philadelphia. Temple University Medical Services is a Level I Regional Trauma Center. This affords the house staff an opportunity to see a wide spectrum of clinical problems with around-the-clock back-up by attending physicians. Teaching activities include individualized bedside rounding, a weekly emergency medicine conference and radiology conferences. In addition, Temple University Hospital has a formal residency training program in Emergency Medicine.
The Section of Endocrinology and Metabolism operates ambulatory diabetes, thyroid and hypertension clinics and maintains an active inpatient consultation service. Regular teaching conferences include weekly journal clubs, endocrine/metabolic conferences, seminars and patient walk-rounds. The Section of Endocrinology and Metabolism is responsible for operating an eight-bed Clinical Research Center. Current research interests include pathogenesis of non-insulin dependent diabetes (anti-insulin receptor antibodies, insulin receptor gene abnormalities, effects of metabolic fuels on insulin sensitivity), mechanisms and treatment of autonomic neuropathy, low renin hypertension, and autoimmune thyroid disease.
The Section of Gastroenterology provides a varied clinical and laboratory experience. The clinical service includes state-of-the-art diagnostic and therapeutic endoscopic procedures and innovative motility studies. The Section of Gastroenterology is internationally known for its expertise in gastrointestinal motility disorders and functional gastrointestinal diseases. Research is conducted in the areas of dysfunction caused by drugs and viruses. New areas of investigation include hepatic drug metabolism and small intestinal adaptation. Clinical therapeutic projects include acid/peptic disorders of the esophagus, stomach and duodenum, gastroparesis, irritable colon syndrome, functional dyspepsia, ulcerative protosigmoiditis and colitis, Crohn's disease, and cancer of the colon. Rounds are made daily on gastroenterology and hepatology services. The teaching program includes weekly GI rounds, case discussions, pathophysiology, endoscopy, radiology and pathology conferences, and a journal club.
The Section of General Internal Medicine is extensively involved in the residency program in both clinical care and educational activities. The Section provides care to several thousand patients who are fee-for-service, commercial and Medicaid-HMO members. In addition, the Section of General Internal Medicine provides attendings for the active Medical Consultation Service, the weekly residents' continuity clinics and the Ambulatory Care rotation. There are weekly ambulatory care conferences that provide a strong focus for resident education in multiple topics of primary and specialty care. In addition, the Section of General Internal Medicine directs the Comprehensive HIV program. Research areas include national clinical trials in HIV medicine and a CDC-sponsored HIV outpatient data base.
The Hematology and Oncology Sections are divided into three services:
Members of the Section of Hematology direct the Clinical Coagulation Laboratory, the Special Hematology Laboratory, and the Blood Bank. The Sol Sherry Thrombosis Research Center is staffed by Section of Hematology investigators. Research activities include cellular and molecular biology of platelets, megakaryocytes and endothelial cells, biochemistry of coagulation proteins, regulation of hematopoiesis, and studies of the therapeutic potential of monoclonal antibodies and biologic response modifiers.
Oncology research involves clinical trials oriented toward drug development and bone marrow transplantation and studies on the cell biology of hematopoietic stem cells and the immunohematology of bone marrow transplantation.
The Section of Infectious Diseases conducts one of the busiest consultation and teaching services at Temple University Hospital. Residents have the opportunity to see and discuss a wide range of adult infectious disease problems. Conferences are held within the Section four days each week and residents on the elective attend Clinical Microbiology Rounds in the laboratory three days a week. The Section of Infectious Diseases also operates a travel and immunization clinic. Research interest include alterations of drug protein binding in disease states, novel mechanisms of antimicrobial resistance, clinical epidemiology, clinical applications of new antimicrobial agents, and infections complicating cancer. Two of the Section members are also in the Section of HIV Medicine and participate in the HIV ambulatory clinic. All Section members care for hospitalized patients with HIV and a wide spectrum of infections related to organ transplantation, cancer, substance abuse, and altered immunity.
The Section of Nephrology and Kidney Transplantation provides an active consultation and fellowship program covering the broad range of renal-electrolyte medicine. Participation in the weekly nephrology grand rounds, journal clubs and pathology conferences is an integral part of the elective. The end-stage renal disease program provides exposure to patients undergoing hemodialysis, peritoneal dialysis and renal transplantation. Faculty research interests include mechanisms and hormonal modulation of ion transport, mechanisms of hypertension and clinical studies on progression of renal disease and fluid, electrolyte and acid-base metabolism.
Clinical and research programs in the Section of Pulmonary Diseases and Critical Care Medicine reflect an interest in obstructive airways disease (asthma and COPD), sarcoidosis, respiratory muscle function and disturbances in the control of breathing. The Pulmonary Section directs and operates an twenty-six bed respiratory intensive care unit, a large ventilator rehabilitation unit, and a multidisciplinary pulmonary rehabilitation program. The Section of Pulmonary and Critical Care Medicine has an innovative procedure service which performs many diagnostic studies including bronchoscopy and pleural and transthoracic needle biopsies. A multidisciplinary sleep lab is jointly managed by the Section of Pulmonary and Critical Care Medicine and Department of Neurology.
The Section of Rheumatology maintains active ambulatory care and inpatient consultation services in the broad range of rheumatic and connective tissue disorders. Residents participate in daily office hours with faculty and attend the weekly rheumatology clinic. They are encouraged to learn various procedures essential to the practice of rheumatology such as arthrocentesis and joint fluid analysis. Formal educational programs include weekly journal club, rheumatology grand rounds, and a patient management conference.
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