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M25/801 Honors Medicine- General Medicine

The purpose of the “Honors Medicine” elective (sub-internship) is the development of expertise in the care of hospitalized patients in a well-supervised teaching environment. Sub-interns act as their patients’ interns under the supervision of residents and attending physicians. Sub-interns have the same on-call and admitting schedules as the interns on their teams and are assigned up to two new patients on each admitting day. Sub-interns are not required to spend call nights in the hospital. Except in emergencies, sub-interns are the first individuals to evaluate patients admitted to medical service teams. A diagnostic and therapeutic approach to the patient is planned in consultation with the resident. Sub-interns assume primary responsibility for the daily care of their patients, under the supervision of resident and attending physicians. This includes evaluation on daily rounds, scheduling and obtaining results of diagnostic studies, planning therapy, making arrangements for care after discharge and communicating with patients and their families. Sub-interns attend the same conferences as the house staff.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Primary Care 50%; Subspecialty Care 50%

Major Teaching Responsibility
Attending, chief resident, and resident

Patients Seen/Weekly
8-12

On Call / Weekend Responsibility
Yes

M25/805 Rheumatology

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will be involved in the diagnostic work-up and management of patients with rheumatic illnesses including systemic lupus erythematosus, rheumatoid arthritis, vasculitis (polyarteritis, Wegener’s, temporal arteritis), spondyloarthropathies (ankylosing spondylitis, reactive arthritis), osteoarthritis, gout and regional musculoskeletal problems. By working closely with a faculty member, fellows and medical residents, students become integral and active members of the rheumatology service for inpatient consultations and outpatient clinics at Barnes-Jewish Hospital. An emphasis is placed on the physical examination of joints and the musculoskeletal system, synovial fluid analysis, and interpretation of diagnostic tests and radiographs. Students attend two rheumatology conferences held weekly. A rotation limited to outpatient rheumatology is possible by prior arrangement with Dr. Brasington.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 40%; Outpatient 50%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings

Patients Seen/Weekly
~25 per student

On Call / Weekend Responsibility
None

M25/810  Geriatric Medicine

Valid start weeks for four-week blocks are: Weeks 5, 13, 17, 21, 25, 29, 33, 37, and 41.

The primary goal of this rotation is for students to gain proficiency in the principles of geriatric evaluation and management, including the medical, psychological, social, and functional assessments of older adults. Students are expected to participate in the evaluation of three to five patients per week, in a variety of settings including the outpatient Geriatric Assessment Clinic, in-patient Geriatric Consult service, Parc Provence nursing home, and the Rehabilitation Institute of St. Louis (TRISL). Students will also have the opportunity to participate in hospice and home care visits, interdisciplinary team meetings, and observe an assessment at the WU Alzheimer’s Disease Research Center. Students are expected to attend weekly conferences while on the rotation.

The day normally begins at 8:30 a.m. and is usually finished by 5:30 p.m. There is no night or weekend call. Time is provided to read the detailed syllabus/bibliography. Students will be expected to give an oral presentation on a topic of their choice once during the rotation.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 20%; Outpatient 80%; Primary Care 20%; Subspecialty Care 80%

Major Teaching Responsibility
Attendings

Patients Seen/Weekly
10-15

On Call / Weekend Responsibility
None

M25/811  Clinical Internal Medicine- Hospitalist

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This course allows the student to work one-on-one with hospitalist physicians on a patient care team. The student acts as the intern under the direct supervision of the attending physician. Daily responsibilities include admission history and physicals, daily notes and discharge summaries on assigned patients. S/he also will have the opportunity to perform indicated procedures on patients on this service. Students are encouraged to participate in Department of Medicine conferences.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 95%; Conferences/Lectures 5%; Primary Care 100%

Major Teaching Responsibility
Hospitalist attendings

Patients Seen/Weekly
10

On Call / Weekend Responsibility
None

M25/821  Inpatient Cardiology

Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will participate as members of the Barnes-Jewish Cardiology at Washington University Consultative Team. They will be part of a team composed of faculty members, fellows, residents, and nurse specialists that sees a large population of cardiac patients and follows them through all aspects of their in-hospital care. Emphasis will be placed on physical examination and the interpretation of modern cardiac diagnostic tests including electrocardiograms, echocardiograms and coronary angiograms and their role in clinical decision making.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Outpatient 0%; Conferences/ Lectures 10%; Primary Care 0%; Subspecialty Care 100%

Major Teaching Responsibility
Attending and fellow

Patients Seen/Weekly
10-15

On Call / Weekend Responsibility
None

M25/822  Honors Medicine- Cardiology

Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The structure and functioning of the “Honors Medicine-Cardiology” elective (sub-internship) is very similar to the general medicine sub-internship (M25 801). The basic purpose is to develop expertise in the care of hospitalized patients in a well-supervised teaching environment. The majority of patients admitted to the service will have a cardiology diagnosis as the main reason for admission. Some general medical problems will also be seen. All attendings on the service are cardiology subspecialists. Cardiology fellows act as the chief resident for the service on a monthly basis. Sub-interns act as their patients’ interns under the supervision of residents and attending physicians. Sub-interns have the same on-call and admitting schedules as the interns on their teams and are assigned up to two new patients on each admitting day. Sub-interns are not required to spend call nights in the hospital. Except in emergencies, sub-interns are the first individuals to evaluate patients admitted to medical service teams. A diagnostic and therapeutic approach to the patient is planned in consultation with the resident. Sub-interns assume primary responsibility for the daily care of their patients, under the supervision of resident and attending physicians. This includes evaluation on daily rounds, scheduling and obtaining results of diagnostic studies, planning therapy, making arrangements for care after discharge and communicating with patients and their families. Sub-interns attend the same conferences as the internal medicine house staff. There are also several conferences specific to the cardiology service.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Primary Care 25%; Subspecialty Care 75%

Major Teaching Responsibility
Attending, chief resident, and resident

Patients Seen/Weekly
8-12

On Call / Weekend Responsibility
Yes

M25/825  Cardiac Arrhythmias And Electrophysiology

Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective provides the student with exposure and teaching in the diagnosis and treatment of complex cardiac rhythm disturbances. Specifically, the student is expected to evaluate patients referred for evaluation and treatment of complex or life-threatening rhythm disturbances, unexplained syncope or sudden cardiac death. Rounds are made daily on hospitalized patients, and students are welcome to observe electrophysiology studies or implantation of pacemakers and defibrillators. This elective also provides an intensive opportunity to learn clinical electrocardiography and the systematic use of anti-arrhythmic drugs. Finally, since patients with chronic, complex rhythm disturbances frequently have organic heart disease, a broad-based exposure to general cardiology is also part of this elective.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 80%; Outpatient 10% (optional); Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attending physician

Patients Seen/Weekly
2 new consults/day

On Call / Weekend Responsibility
None

M25/827  Heart Failure/Cardiac Transplantation

Valid start weeks for 2 or 4-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.

This rotation is intended to provide trainees with a comprehensive experience managing patients with advanced heart failure. In addition to daily rounds, trainees are invited to attend both heart failure and transplant clinics. Further, the curriculum is supplemented by a comprehensive syllabus that contains the critical literature pertinent to this patient population. The trainees will also have experience with the evaluation of patients for operative heart failure therapies and will have the opportunity to observe these surgical procedures.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 70%; Outpatient 20%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings

Patients Seen/Weekly
30

On Call / Weekend Responsibility
None

M25/830 Dermatology

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 29, 33, 37, and 41.

THIS COURSE HAS A STRICT ATTENDANCE POLICY!

The aim of this elective is to provide a guide for the student so that s/he is able to appreciate dermatology within the broader perspectives of medicine and biology. Emphasis will be placed on the dermatologic variations encountered in a normal physical examination of the skin, the identification of common skin diseases, dermatologic clues to systemic disease, as well as those dermatologic conditions that are life threatening. The student will participate in outpatient care in the Barnes-Jewish Hospital and affiliated clinics. Students will attend all clinical teaching rounds and conferences in addition to the basic science and cutaneous histopathology conferences.

M25 830 is essentially the same as the 3rd Year Dermatology Clerkship. Students are limited to taking either one or the other – NOT BOTH.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 25%; Outpatient 50%; Conferences/ Lectures 25%; Specialty Care 100%

Major Teaching Responsibility
Course Master for rotation and senior resident

Patients Seen/Weekly
25-50

On Call / Weekend Responsibility
None

M25/831  Pediatric Dermatology

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This clinical rotation will be available to students interested in dermatology, pediatrics or both. Students will follow the dermatology rotation (M25 830) with an emphasis on pediatric dermatology by attending pediatric dermatology clinics, seeing consults, etc. Enthusiastic students will have an opportunity to write up a case report if they wish, but need to notify the instructor before the course.

Students can take either this elective or M25 830/Dermatology — NOT BOTH.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 1%; Outpatient 74%; Conferences/ Lectures 25%; Subspecialty Care 100%

Major Teaching Responsibility
Two attendings

Patients Seen/Weekly
50-100

On Call / Weekend Responsibility
None

M25/836 Clinical Gastroenterology and Hepatology

Valid start weeks for four-week blocks are: Weeks 5, 13, 17, 21, 25, 29, 33, 37, and 41.

The GI Hepatology elective is integrated into a very active inpatient/outpatient and endoscopy service at Barnes-Jewish Hospital. Students will participate in the evaluation of inpatients and outpatients with a spectrum of gut and liver disorders, will make patient rounds with the faculty and fellows, and have responsibility for patients on whom consultations have been requested. In addition, they will observe biopsy, endoscopic, and intubation techniques and participate in outpatient clinic and GI conferences.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 65%; Outpatient 25%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attending and fellows

Patients Seen/Weekly
12 new

On Call / Weekend Responsibility
None

M25/838  Medicine Consult Service

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41. Two week rotations are also available.

The focus of the Medicine Consult Service elective is the evaluation and management of medically complex patients admitted to the hospital on non-medicine services. The issues involved with perioperative management are particularly stressed. The student will function as a member of the consult service team. Duties will include performing initial consultations and follow-up care under the supervision of a Hospital Medicine attending and a senior medical resident. Attendance at Department of Medicine and division conferences is encouraged.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Primary Care 100%

Major Teaching Responsibility
Consult Service attending (from the Division of Hospital Medicine)

Patients Seen/Weekly
10-15

On Call / Weekend Responsibility
None

M25/844  Hematology and Hemostasis

Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Activities planned include work-up of patients at Barnes-Jewish Hospital under the supervision of the hematology fellow and his staff consultant; attendance at clinical rounds three to five hours weekly; participation in out-patient clinics; experience in various procedures, especially blood and bone marrow morphology and in interpretation of coagulation tests. Daily student rounds with a senior staff person.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 80%; Outpatient 10%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attending and fellow

Patients Seen/Weekly
3-5

On Call / Weekend Responsibility
None

M25/847  Bone and Mineral Diseases

Valid start weeks for 4-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The course is designed to acquaint the student with the clinical, radiological and pathological manifestations and treatment of disorders of bone and mineral metabolism, including osteoporosis, Paget’s disease of bone, hyperparathyroidism, osteomalacia, and more rare disorders of bone development and homeostasis. The student will rotate through clinics of the Division of Bone and Mineral Diseases, and see patients at Barnes-Jewish Hospital, Barnes-Jewish West County Hospital and Shriners Hospital for Children.

Acquired and heritable bone diseases will be studied in the context of derangements of mineral homeostasis with emphasis on vitamin D and peptide hormone metabolism and skeletal formation and remodeling. The role of non-invasive methods for measuring bone mass in the diagnosis and management of skeletal diseases also will be stressed. Faculty and medical students will be present interesting cases for discussion or the students can present a pertinent topic related to bone metabolism they have researched during their rotation.

Responsibilities: Shriners Hospital Wednesday a.m. (Dr. Whyte); CAM, 2nd and 3rd Monday (a.m.), and 4th Thursday (p.m.) of each month; Barnes-Jewish West County Prof. Building 2; Tuesdays or Wednesdays, p.m. Metabolic Bone Disease Case Conference, Fridays 8:00 a.m., BJC Institute of Health Building, 11th Floor, Conference Room AB; Avioli Musculoskeletal Research Seminars, Fridays 9:00 a.m., BJC Institute of Health Building, 11th Floor, Conference Room AB.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017
Student Time Distribution
Outpatient 85%; Conferences/ Lectures 15%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings

Patients Seen/Weekly
~20

On Call / Weekend Responsibility
None

M25/853  Bone and Joint Infectious Disease Consult

Valid start weeks for two-week blocks are: Weeks 3, 7, 11, 15, 19, 23, 27, 31, 35, 39, and 43. Must be done in conjunction with 2 weeks of General Infectious Disease

Study of infectious diseases of the bones and joints, including infections in both native and prosthetic joints. The elective is designed to teach students the fundamentals of evaluating clinical orthopedic infections and formulating plans for workup and therapy. Students see consultations in infectious diseases in every part of Barnes-Jewish Hospital under the supervision of a faculty member who rounds with them every day. They work closely with the infectious diseases attending and nurse practitioner, follow their own patients and play an important role in their management. They are expected to read the literature about their patients and participate in clinical conferences. They attend teaching rounds and conferences and lectures in infectious diseases. They also learn appropriate use of antibiotics and antifungal agents. The role of surgical and medical management is discussed, and the students will interact with surgical staff in understanding the risks and outcomes of these common infections. Two weeks of General Infectious Disease are a prerequisite to this course.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Single Attendings

Patients Seen/Weekly
20

On Call / Weekend Responsibility
None

M25/854  Transplant Infectious Disease

Valid start weeks for two-week blocks are: Weeks 3, 7, 11, 15, 19, 23, 27, 31, 35, 39, and 43. Must be done in conjunction with 2 weeks of General Infectious Disease

Study of infectious diseases in patients who have had bone marrow or solid organ transplants, or who have a hematologic malignancy. The elective is designed to teach students the fundamentals of evaluating clinical infections in these complex and interesting patients and formulating plans for workup and therapy. Students see consultations in every part of Barnes-Jewish Hospital under the supervision of a faculty member who rounds with them every day. They work closely with infectious disease fellows, follow their own patients and play an important role in their management. They are expected to read the literature about their patients and participate in clinical conferences. They attend teaching rounds and conferences and lectures in infectious diseases. They also learn appropriate use of antibiotics, antifungal and antiviral agents in this highly immune suppressed population. A wide distribution of infectious diseases is covered including management of neutropenic fever, invasive fungal infections in the transplant population, acute and chronic infections, infection prophylaxis and monitoring and interactions between immunosuppressive agents and antibiotics.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Single Attending and Fellow

Patients Seen/Weekly
6

On Call / Weekend Responsibility
None

M25/858  Ambulatory Infectious Disease-Outpatient

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The elective is designed to teach students the fundamentals of evaluating clinical infections in the outpatient setting. Students see patients under the supervision of a faculty member. Students will participate in the care of HIV infected or otherwise immunosuppressed patients as well as general infectious disease and travel patients. The clinic is the primary provider for HIV infected patients, and students will learn the pathogenesis of HIV, become familiar with most antiretroviral medications, and have the opportunity to learn about opportunistic infections and their prophylaxis. They will also have the opportunity to see patients with bone and joint infections, endovascular infections, endemic and opportunistic mycoses, sexually transmitted diseases and travel plans. Patients seen will have a wide range of acute and chronic infections with a heavy emphasis on HIV/AIDS, including indigent and insured patients, of both sexes and a wide range of ages. The students will play an important role in the management of these patients. They are expected to read the literature about their patients and participate in clinical conferences.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Outpatient 90%; Conferences/Lectures 10%;
Primary Care 20%; Subspecialty Care 80%

Major Teaching Responsibility
Clinic Attendings

Patients Seen/Weekly
15

On Call / Weekend Responsibility
None

M25/859  General Inpatient Infectious Disease

Valid start weeks for two- or four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41. Two week blocks must be done in conjunction with Transplant Infectious Disease or Bone and Joint Infectious Disease.
Study of patients with infectious diseases, including inpatient care of HIV infected patients and general infectious disease consults. The elective is designed to teach students the fundamentals of evaluating clinical problems in infection and formulating plans for workup and therapy. Students see consultations in infectious diseases in every part of Barnes-Jewish Hospital under the supervision of a faculty member who rounds with them every day. They work closely with medical residents and infectious disease fellows, follow their own patients and play an important role in their management. They are expected to read the literature about their patients and participate in clinical conferences. They attend teaching rounds and conferences and lectures in infectious diseases. They also learn appropriate use of antibiotics, antifungal and antiviral agents. A wide distribution of infectious diseases is covered including community acquired acute and chronic infections, opportunistic infections in HIV infected patients, hospital acquired infections, and basic infection control practices. This is a four-week rotation. Two-week rotations are allowed, but must be done in conjunction with two weeks of Transplant Infectious Disease or Bone and Joint Infectious Disease.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%. Students must be present at 75% of the elective to receive a passing grade.

Major Teaching Responsibility
Single attending and fellow

Patients Seen/Weekly
7 new consults, 15 total

On Call / Weekend Responsibility
None

M25/861  Oncology-Inpatient

Valid start weeks for four-weeks blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Medical Oncology is a complex subspecialty that is undergoing a rapid evolution as a result of new systemic treatment approaches that stem from biological insights into the nature of cancer. During the course of the elective medical students will be able to interact with attending physicians and patients for bed side teaching and attend tumor boards and lectures focused on the care of patients with solid tumors. At the end of the rotation the students will appreciate the principles of our approach to cancer patients and should have gained insights into the pharmacological basis for systemic cancer treatment. The ethical and medical challenges of caring for patients with advanced incurable malignancies will also be an important theme, as well as the conduct of clinical research in this patient population. Students will learn to care for hospitalized patients suffering from complications from their cancer or from toxicities due to treatments. Oncologic emergencies will be covered. Issues such as palliative care treatment options and end-of-life decision making will be explored as well.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
All Medical Oncology Attendings

Patients Seen/Weekly
50

On Call / Weekend Responsibility
None

M25/862  Inpatient Internal Medicine/Oncology-Firm

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Medical Oncology is a complex subspecialty that is undergoing a rapid evolution as a result of new systemic treatment approaches that stem from biological insights into the nature of cancer. During the course of the elective medical students will be able to interact with attending physicians and patients for bed side teaching and attend tumor boards and lectures focused on the care of patients with solid tumors and lymphoma. At the end of the rotation the students will appreciate the principles of our approach to cancer patients and should have gained insights into the pharmacological basis for systemic cancer treatment. The ethical and medical challenges of caring for patients with advanced incurable malignancies will also be an important theme, as well as the conduct of clinical research in this patient population. Students will learn to care for hospitalized patients suffering from complications from their cancer or from toxicities due to treatments. Oncologic emergencies will be covered. Issues such as palliative care treatment options and end-of-life decision making will be explored as well. Major learning goals:
(1) Become familiar with frequent complications of cancer treatment such as neutropenic fever, nausea/vomiting, diarrhea, infectious complications and their management.
(2) Become familiar with oncologic emergencies (spinal cord compression, hypercalcemia, neutropenic sepsis) and their management.
(3) Become more comfortable interacting with patients and families requiring difficult psychosocial and end-of-life discussions.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017
Student Time Distribution
Inpatient 100%; Subspecialty Care 100%

Major Teaching Responsibility
All Oncology attendings

Patients Seen/Weekly
50

On Call / Weekend Responsibility
One-in-four call, with their assignjed inpatient team.

M25/865  Intensive Care Medicine, Barnes-Jewish 8300

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective in intensive care is offered in the Intensive Care Unit at Barnes-Jewish Hospital, South Campus. This unit has 16 intensive care beds providing intensive nursing care and life-support technology. The patients represent a mixture of patients with primarily medical problems. Patient care responsibility includes night call. In addition to patient responsibility, there are regularly scheduled conferences and attending rounds.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 100%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings and residents

Patients Seen/Weekly
8

On Call / Weekend Responsibility
Every third night

M25/867  Medical Intensive Care

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

This elective is offered as an opportunity to gain additional experience in acute, primary care medicine. The elective is an advanced course in patient care involving complex medical problems. Responsibilities involve working up new patients with the MICU team, case presentations and attendance at conferences. Conferences consist of attending rounds Monday through Saturday, radiology rounds Monday through Saturday, pulmonary conference and medical grand rounds on Thursday, and critical care conference once each month. Call schedule is every third night.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 90%; Conferences/Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Attendings and residents

Patients Seen/Weekly
3

On Call / Weekend Responsibility
Yes

M25/869  Palliative Medicine

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

The Palliative Medicine elective will focus on the care of patients with life-threatening or debilitating illness throughout the course of their care. Skills in symptom management, communication, and interdisciplinary team-based care will be the focus. Students will spend the majority of their time on the BJH Palliative Care Service. Based on the individual student’s interest, there may also be opportunities to work with the BJC Hospice Team and the St. Louis Children’s Hospital Palliative Care Service.

While in the hospital, students will be responsible for seeing patients upon initial assessment as well as delivering follow-up care with the team. Patients will be seen for both end-of-life care as well as symptom management. Students will learn to assess and treat refractory symptoms and participate in complicated advanced care planning. Students will attend interdisciplinary team meetings, and may participate in conversations about goals of care and coping with bad news. They may also make home visits with hospice care providers, if desired. Emphasis will be placed on observing and understanding the psychosocial and spiritual needs of the patients, as well as the impact of the burden on caregivers. In addition, students will be expected to lead bi-weekly presentations/group discussions on selected aspects of Palliative Medicine with the BJH Palliative Care team.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 85%; Conferences/Lectures 15%; Subspeciality Care 100%

Major Teaching Responsibility
BJH Palliative Care Attendings (Maria Dans, MD; Mike Koller, MD; and Anna Roshal, MD; BJH Palliative Care Team Members; BJC Hospice Medical Director (Bernard Shore, MD); SLCH Palliative Care Service Medical Director (Joan Rosenbaum, MD)

Patients Seen/Weekly
10

On Call / Weekend Responsibility
None

M25/870  Endocrinology, Diabetes and Metabolism

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

In general, the four-week rotation will be divided into 2 weeks of general endocrinology and 2 weeks of diabetes. Students taking this elective will perform consultations with fellows and faculty on the inpatient services at Barnes-Jewish Hospital and will also see patients with endocrine and metabolic diseases in the Outpatient Consultation. They will present these cases daily on teaching rounds. They will also participate in case conferences and seminars on a weekly basis. Extensive interaction with patients with diabetes and a diabetes education program are included, as is involvement with patients with thyroid, pituitary, adrenal, gonad, metabolic bone disease, and lipid disorders. Ample opportunities will be provided for discussions of patient problems with the members of the division. A variety of outpatient clinics are offered in the division and interested students should speak with the fellows and faculty members to customize the learning experience to match his or her career goals.At the end of the rotation, it is expected that students will have the ability to initiate inpatient and outpatient management of diabetes including insulin dosing and glucose monitoring, as well as evaluate and treat of a variety of endocrine disorders including but not limited to thyroid, pituitary, and adrenal disease. Students will learn to perform effective inpatient and outpatient consultations.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 60%; Outpatient 30%; Conferences/ Lectures 10%; Subspecialty Care 100%

Major Teaching Responsibility
Faculty consultant for inpatients, individual faculty one-on-one for outpatients and division chief for both

Patients Seen/Weekly
8-10

On Call / Weekend Responsibility
Elective for students

M25/871  Oncology-Outpatient

Valid start weeks for four-week blocks are: Weeks 1, 5, 9, 13, 17, 21, 25, 29, 33, 37, and 41.

Students will gain experience in the initial treatment of newly diagnosed malignancies and the outpatient management of oncology patients. Participation in multidisciplinary tumor conferences will stress a combined-modality approach to management, incorporating chemotherapy, radiotherapy and surgery. Students will see patients with a variety of malignancies, including lymphoma, myeloma, and tumors of the lung, breast, and colon. Management of hypercalcemia and other paraneoplastic syndromes, as well as cancer pain management will be covered. Students will have the opportunity to see how most oncologists spend 90% of their workday. They will observe different styles that oncologists have in presenting news about prognosis, treatment options and other information to patients while they also learn about the molecular basis for cancer, the mechanisms of action for our therapies (particularly the newer agents which target specific molecular abnormalities) and the key studies that justify the use of therapies (e.g. randomized studies showing that after surgery, chemotherapy will reduce the risk of recurrence from a particular cancer with a particular regimen). By spending time with clinicians, students will learn how to identify hereditary syndromes, use drugs for symptom relief and also learn how radiographic and laboratory tests allow oncologists to care for patients.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Outpatient 85%; Conferences/Lectures 15%; Subspecialty Care 100%

Major Teaching Responsibility
Oncology attendings and occasionally fellows

Patients Seen/Weekly
30-50

On Call / Weekend Responsibility
None

M25/877  Intensive ECG Interpretation

Valid start weeks for two-week blocks are: Weeks 1, 5, 11, 17, 19, 27, 29, 31, 33, 35, 37, 39, 41, and 43.

The student, during the two-week elective, will read 20-25 ECGs obtained from the Barnes-Jewish Heart Station and then over read by an experienced electrocardiographer. There will also be didactic sessions covering infarction, ventricular hypertrophy, heart block, arrhythmias, and aberrant conduction.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Inpatient 0%; Outpatient 0%; Conferences/ Lectures 100%; Subspecialty Care 100%

Major Teaching Responsibility
Attending

Patients Seen/Weekly
N/A

On Call / Weekend Responsibility
None

M25/879  Pulmonary Clinic For The Underserved

Valid start weeks for two-week blocks are: Weeks 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, and 43.Clinical setting: Outpatient Clinic dedicated to providing pulmonary specialty care to patients who are predominantly uninsured or who rely upon public assistance such as Medicaid.

Student role: Students independently interview and examine patients and present findings to the attending, tests and imaging are reviewed, and provider and attending develop plan.

Common problems/diseases: Asthma, COPD, sarcoidosis, lung cancer, and obstructive sleep apnea are commonly seen. Also, patients are referred for evaluation of abnormal x-rays and for symptoms such as dyspnea.

Primary learning objectives:

to understand and practice important history and exam skills in pulmonary medicine: symptoms, smoking history, work and environmental exposures, and important pulmonary physical exam findings.
to understand the basics of pulmonary function tests, chest imaging, and methods for tissue sampling.
to understand the basis of treatment of common pulmonary disorders.

Conferences: There is no conference associated with this clinic, but students may attend the usual Thursday morning Medicine Grand Rounds at 8:00 a.m. and the Pulmonary Grand Rounds at 11:00 a.m. if the subject matter is appropriate.

Schedule of Elective Intervals
Weeks 1-4: June 20, 2016 -July 17, 2016
5-8: July 18, 2016 – August 14, 2016
9-12: August 15, 2016 – September 11, 2016
13-16: September 12, 2016 – October 9, 2016
17-20: October 10, 2016 – November 6, 2016
21-24: November 7, 2016 – December 4, 2016
25-28: December 5, 2016 – January 15, 2017
29-32: January 16, 2017 – February 12, 2017
33-36: February 13, 2017 – March 12, 2017
37-40: March 13, 2017 – April 9, 2017
41-44: April 10, 2017 – May 7, 2017

Student Time Distribution
Outpatient 100%; Conferences/Lectures Vary; Subspecialty Care 100%

Major Teaching Responsibility
Barbara Ann Lutey, MD

Patients Seen/Weekly
12-20

On Call / Weekend Responsibility
None