Student sub-internship and Electives

The Department of Internal Medicine will accept Subinternship Applications after the Annual Yale Medical Student Subinternship Meeting which is scheduled anywhere from late January to mid-February. Yale Medical Students should call the Office of Student Affairs for the Annual Sub-Internship Meeting details. Internal Medicine Subinternship Rotations will be scheduled by the Department of Internal Medicine at the VA Medical Center (West Haven), Yale-New Haven Hospital and Waterbury Hospital.

Requirements

Currently the Yale Department of Internal Medicine only schedules Yale Medical Students for Internal Medicine Subinternship Rotations. Yale Medical Students must complete two (2) Inpatient Internal Medicine Clerkships before their Internal Medicine Subinternship Rotation.

How to Apply for an Internal Medicine Subinternship for the Next Academic Year

Yale Medical Students are asked to complete and submit an Internal Medicine Subinternship Application Form to Barbara Wanciak approximately 2 weeks after the Annual Sub-Internship Meeting (information, forms and deadline dates are provided at the meeting and are available through the Office of Student Affairs or by emailing Barbara at barbara.wanciak@yale.edu). Completed applications may be faxed to Barbara Wanciak at 203-785-7258 or delivered to her office (101 FMP) by the deadline date provided at the meeting. Once the Internal Medicine SubInternship Schedule is drafted, students who applied by the deadline date will be emailed a draft copy of the Internal Medicine Subinternship Schedule to consider and a contract to sign if they accept their assigned rotation. Signed contracts are returned to Barbara Wanciak by the provided deadline date (no exceptions). Finalized Internal Medicine Subinternship Schedules for the upcoming academic year will be emailed to every contracted Yale Medical Student by the end of March. Dr. Cyrus Kapadia is the Internal Medicine Subinternship Director and Dr. John Moriarty is the Internal Medicine Subinternship Associate Director. The staff contact for scheduling Internal Medicine Subinternships and submitting applications and signed contracts is Barbara Wanciak, 203-785-6963. The staff contact for the Internal Medicine Subinternship Entrance/ Orientation Meetings is Tatianna Hilton, 203-785-7113.

Details about Internal Medicine Subinternship Rotations

Internal Medicine Subinternship Rotations are approximately 4 weeks in length and begin on Mondays. All Internal Medicine Subinternship Rotations end on Fridays unless you are scheduled for “On-Call” Friday night, in which case your last day will be Saturday. Internal Medicine Chief Residents determine who is “On-Call” and the call schedule is not available prior to the end of June each year. There is a mandatory Internal Medicine Subinternship Entrance/Orientation Meeting the Friday prior to the start of the Internal Medicine Subinternship Rotation. Tatianna Hilton will email students approximately 1 week before the start of their rotation with the time and location of the meeting. You may reach Tatianna Hilton at 203-785-7113. Internal Medicine Subinternship Entrance/ Orientation Meetings are approximately one-hour long and hosted by Dr. Kapadia. During this meeting, Dr. Kapadia will provide you with the goals and objectives of the Internal Medicine Sub-Internship Rotation, attending schedules, “Survival Guide”, resident pager cards and other important information you will need for your rotation. Initial academic year attending schedules are not available prior to July 1. Internal Medicine Subinternship Rotations will be scheduled at the VA Medical Center, Yale-New Haven Hospital and Waterbury Hospital only by the Yale Department of Internal Medicine.

How do I Apply for a Medicine Subinternship during the Current Academic Year?

After Internal Medicine Subinternship Schedules are finalized at the end of March each year, Yale Medical Students interested in scheduling a rotation later in the academic year (after October) may email Barbara Wanciak at barbara.wanciak@yale.edu to make inquiries about availability. We usually fill the first four or five blocks (mid-June through early November) by March of the previous academic year. Scheduling Yale Medical Students later in the academic year is based on available slots and approval by the Internal Medicine Chief Residents, Dr. Cyrus Kapadia - Internal Medicine Subinternship Director and Dr. John Moriarty - Internal Medicine Subinternship Associate Director. Once an inquiry has been made through Barbara Wanciak about scheduling an Internal Medicine SubInternship Rotation, approval may take 1 to 2 weeks before being finalized with the student.

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This elective offers experience in the MICU at Y-NHH. Students are on call every fourth night with an intern and resident pair, assisting them in the admission of patients. Students follow patients in the MICU and assist in their care with their intern and resident. It provides the opportunity for participating in the acute management of common medical emergencies. The elective is offered for a period of two or four weeks.

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The two to four week rotation emphasizes a rigorous history and physical exam to develop a differential diagnosis to guide the care of patients in the hospital and clinic. Supplementary reading on topics arising from the management of the patients is an important component of the experience. Interested students should discuss their goals prior to the rotation.

A maximum of one student can spend a minimum of two weeks on this rotation and share time between a private practice in New Haven, Connecticut and Yale-New Haven Hospital. This elective will not be offered in the summer months but will be available for students from September – May. Students interested in signing up for this elective should contact Linda Limauro in Student Affairs.

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The student will participate in the daily activities of the cardiology service, including rounds, consultations, conferences, and special procedures such as cardiac catheterization, echocardiography and electrocardiography. The training experience will emphasize the physiologic basis for clinical manifestations and therapy of cardiovascular diseases. The rotation is limited to two students every four weeks throughout the year at Yale-New Haven Hospital or the West Haven V.A.M.C. Dr. M. Remetz (Yale); Dr. Steven Pfau (V.A.M.C.)

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Students electing this course will attend the weekly arthritis Clinic at the West Haven VA Medical Center on Tuesday afternoons, and at Yale-New Haven Hospital on Thursday afternoons, preceded by a Rheumatology Teaching Conference. Additionally, students will attend the weekly Allergy and Clinical Immunology Clinic for Adults held at Yale-New Haven Hospital, on Tuesday mornings, followed by a one-hour conference at 10:00 a.m. Also, if they choose to, students can attend the Friday morning Pediatric Allergy Clinic from 8:30 - 9:30 a.m., Allergy/Clinical Immunology Journal Club Wednesday at 1:00 p.m. and a seminar Friday at 8:30 a.m. Students may also join in consultations with the Rheumatology and/or Allergy/Clinical Immunology Services at both the West Haven VA Medical Center and Yale-New Haven Hospital. This elective is limited to one student. Dr. P. W. Askenase

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This is an opportunity for students to see a wide variety of gastrointestinal problems and patients, with an opportunity for discussion and review. The student will be an integral part of the inpatient GI consult service, primarily working in an inpatient setting. The student should plan to attend this rotation on a full-time basis. It is offered to two students throughout the year every four weeks. This elective is recommended for 4th year students. Dr. D. Proctor

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This 52-bed inpatient program at the nation’s first hospice provides intensive palliative care for patients with terminal illness. The medical, psychological and spiritual needs of these patients and their families are met through the coordinated efforts of an Interdisciplinary Team (IDT) of physicians, nurses, social workers, pharmacists, clergy, art therapists and volunteers.

Students work one-on-one with an attending physician caring for patients approaching the end of life and their families. They participate fully in admissions, morning rounds, family conferences and IDT conferences. This elective offers students an opportunity to acquire advanced knowledge and skills in the management of symptoms (pain, anxiety, insomnia, etc.), which will benefit them in their future care of all patients, both those approaching the end of life as well as those who are acutely or chronically ill. It is the only elective in which symptom management receives a major focus.

We offer two- or four-week rotations. The four-week rotation allows for optional time spent with allied services and/or home care. The goal of this rotation for students are to learn to provide optimal symptom management and, as members of the IDT, to learn to care for patients approaching the end of life and to give support to their families. Contact: Louis Gonzalez, MA, MPH at (203) 315-7502.

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The student will participate as an active member of the endocrine training program, making daily rounds with the metabolism fellows and residents and attending physicians. He or she will see inpatient consultations, participate in the endocrine clinics and participate in the regularly scheduled metabolism-endocrine conferences. The assignment will require students full-time for four weeks. Limited to one student per block throughout the year. Dr. Silvio Inzucchi

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This clerkship is designed to provide intensive exposure to clinical hematology by direct participation in the activities of a regular clinical hematology service. Students will work up new patients and consults in rotation with the fellows and residents and will attend outpatient clinics. They will participate in daily hematology ward rounds and bone marrow readings and weekly inpatient/outpatient clinical reviews and clinical research conferences. The rotation is limited to one student for four weeks. Dr. T. Duffy

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This is an advanced clerkship offered to students who have completed the general in-patient medical clerkship. The elective is limited to three students for four weeks on a full-time basis throughout the year. Dr. Edward Chu

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Students desiring an intensive, more advanced in patient experience with the care of HIV infected persons may spend one month as a sub-intern on the Donaldson/Atkins Firm. The Firm offers a combined general internal medicine/HIV ward experience. Previously, Donaldson/Atkins admitted only HIV positive persons. However, with the advent of highly active antiretroviral therapy and effective opportunistic infection (OI) prophylaxis, the HIV inpatient census has decreased and both HIV positive and general medical patients are cared for. The firm practices a multidisciplinary HIV care approach. There are two teams, each comprised of an attending, two residents, two interns, and one third-year medical student. On average, 30-50 percent of the patients are HIV-positive. Students who elect an externship on Donaldson/Atkins function as an integral member of one of the two teams. However, the student does not substitute for, but works in tandem with one of the interns, essentially as a second intern. Activities include supervised initial evaluation and daily management of patients with HIV disease; daily rounds with the team; case presentations to the attending physician; and attendance of tri-weekly attending rounds, and weekly firm conference, during which various HIV related infections and non-infectious problems are discussed.

In addition, the students work closely with members from social work, nursing, pastoral care, and discharge planning to better appreciate the multidisciplinary nature of HIV care. Students can also attend one outpatient HIV clinic per week in the Nathan Smith Clinic (NSC) in order to supplement their inpatient experience with the ambulatory aspects of HIV disease. This elective accommodates one student per month and offers a unique opportunity to participate in comprehensive HIV care in the AIDS Care Program, preferably upon completion of all basic clinical clerkships. A previous medical or surgical sub-internship is useful preparation. Dr. G. Friedland

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Students participate as active members of the consultative and training program in Infectious Diseases at Yale-New Haven Hospital and the West Haven V.A. Medical Center. This includes daily work rounds, daily attending rounds, microbiology rounds four times a week, two weekly clinical conferences and one didactic conference. In addition, residents may have the opportunity to evaluate patients in the outpatient HIV clinics. Dr. V. Quagliarellocollapse
This clerkship in clinical nephrology offers the student an opportunity for in-depth learning regarding problems in fluid and electrolyte disturbances, acute renal failure, chronic renal failure, and hypertension. Emphasis is placed on problem recognition, pathophysiologic diagnosis, evidence-based clinical judgment, and management based on pathophysiologic principles. The primary activity involves the inpatient consultation service in which the student works up and follows several patients per week, and participates in daily rounds with the attending physicians, postdoctoral fellows, and residents on service. An introduction to hemodialysis, peritoneal dialysis, renal transplantation, and renal biopsy histology is also provided. This elective requires full-time participation for four weeks and is limited to two students per block at Yale New Haven Hospital and one student per block at the West Haven V.A.M.C. Dr. Ursula Brewstercollapse
This rotation is designed to provide senior students with an introduction to the principals and practice of occupational environmental medicine. The hope is to fill in gaps missing in most basic medical school curricula and to encourage especially interested students of opportunities for careers in this discipline. The experience is centered around the diagnostic clinic at 135 College Street, New Haven, CT. In addition, students will have an opportunity to participate in ongoing didactic and research conferences as well as to visit factories and other environmentally contaminated sites which are being evaluated for their role in disease causation. The elective is limited to two students for a four-week block. It is available throughout the year. Drs. M. Cullen, C. Redlich, M. Russi, P. Rabinowitz, M. Gulati, O. Taiwo and staffcollapse
Students will work closely with faculty and staff in the Pulmonary Section and participate in daily consulting and intensive care rounds. Students will assist in the examination and treatment of patients with various cardiopulmonary diseases, including tuberculosis, chronic obstructive airway disease, asthma, lung cancer, bacterial and fungal lung infection and other diagnostic problems. They will receive practical instruction in interpreting chest images and pulmonary function tests, clinical and laboratory methods in diagnosis and management, including intensive respiratory care and respiratory therapy, and an opportunity to observe fiberoptic bronchoscopy. Students will receive didactic lectures in a number of areas relating to airway pharmacology, lung cell biology and lung immunology (respiratory cells, immunologic reactions, etc). In addition, students may select one or more of five clinical sessions held weekly. A separate experience is available in intensive care medicine. Dr. R. Matthaycollapse
Students taking this elective will actively participate in the rheumatology service both in the inpatient and outpatient settings and will work closely with the attending and fellow assigned for the month. They will work closely with the faculty member and fellow assigned to the inpatient consultative service at both Yale-New Haven Hospital and the West Haven VA Medical Center. They are expected to attend rounds and evaluate patients with rheumatic conditions and other diseases with rheumatic manifestations. In addition they will participate in outpatient clinics including twoVA Hospital arthritis clinics, and two general Rheumatology clinics at Yale-New Haven Hospital. They are expected to attend two weekly conferences sponsored by the Section of Rheumatology. The elective is limited to one student every four weeks throughout the year. Dr. Insoo Kangcollapse