Education on The Wards: The Firm Structure

Coronary Care Unit (CCU): Rotations in the CCU provide for the care of acutely ill patients with heart disease under careful supervision of an Attending Physician. Here, residents care for patients belonging both to the interventional cardiology service and the heart failure service resulting in a very well-rounded experience under close supervision of an Attending Physician with help from a cardiology fellow. The Director of the Coronary Care Unit is Dr. Joseph Brennan, Associate Professor of Medicine.

Firm Chief: Joseph Brennan, MD, BS

Cardiology (Goodyer): The Goodyer Service was named after Dr. Allan Goodyer who was the Chief of Cardiology at Yale School of Medicine in the 1960s. Dr. Goodyer graduated from Yale School of Medicine and was a resident at YNHH. His chief interests were electrocardiography, left ventricular function and congestive heart failure and he was uniformly recognized as an excellent teacher. The Goodyer Team, consisting of second- and third-year residents as well as physician assistants, cares for patients with acute cardiac complaints and diseases under the supervision of a cardiologist and often a cardiology fellow.

Firm Chief: Lynda Rosenfeld, MD

General Medicine (Fitkin): Fitkin is a general internal medicine service staffed by third-year residents and interns and is named after Mr. Abram Fitkin, a major benefactor of the medical school in the 1930's.

Firm Chief: Lynn E. Fiellin, MD

General Medicine (Generalist): The Generalist Service is a very special service designed specially to provide a unique continuity inpatient-outpatient experience to interns and senior residents and admits patients whose primary physicians are the residents who have their Continuity Clinic at Yale and attendings at the Yale-New Haven Hospital Primary Care Center (PCC) or Yale Internal Medicine Associates (YIMA). For more details see Ambulatory Education.

Firm Chief: Patrick O'Connor, MD, MPH, MACP

Geriatrics (Cooney): Our Geriatrics service is located at Saint Raphael’s Campus, and consists of an attending geriatrician and/or general medicine attending, a geriatrics fellow, a senior resident and intern, and students. This Firm is named after Dr. Leo Cooney, a true “master clinician” who has been a leader in geriatric care at Yale-New Haven Hospital for several decades. This Firm provides an opportunity to focus on the unique needs of elderly patients with acute illnesses as well as the importance of multidisciplinary care and how to collaborate and coordinate outpatient services with various resources in our community.

Firm Chief: Amenuve Bekui, MD, MPH

Hematology (Duffy): The inpatient hematology service provides in-depth exposure to a variety of patients with liquid tumors as well as other acute hematologic diseases, including those with leukemia, lymphoma, neutropenic fever, graft versus host disease, and bone marrow or stem cell transplant. Dr. Stephanie Halene is the interim Chief of Hematology.

Firm Chief: Thomas Prebet, MD, PhD

Hepatology (Klatskin): Dr. Gerald Klatskin, after whom the Klatskin Firm is named, was the father of hepatology in America and a world-renowned pioneer of the subspecialty of liver disease. Dr Klatskin was the recipient of the American Gastroenterological Association’s highest award, the Julius Friedenwald Medal. A master clinician, he maintained detailed records on index cards of the thousands of patients that he saw over the years. His collection of many thousand Kodachromes of liver biopsies of every kind of liver disease known at the time, many of which he had made substantial contributions to, is legendary. It is fitting that the team named after Dr. Klatskin will focus on evaluation and treatment of patients with liver disease. The Klatskin team is staffed by senior residents, interns, and students, with supervision by a liver attending and assistance of a gastroenterology fellow. The team preferentially admits patients with liver disease.

Firm Chief: Michael Nathanson, MD, PhD

HIV/Infectious Diseases (Donaldson): The Donaldson Team, named after Dr. Robert M. Donaldson Jr, admits patients with HIV/AIDS. Interestingly, Dr. Donaldson was not an infectious diseases specialist, but an eminent gastroenterologist, having been an editor of the best known journal on the subject, Gastroenterology, a former President of the American Gastroenterological Association and a recipient of its most prestigious award, the Julius Friedenwald Medal for his seminal research in gut flora and cobalamin absorption. He served the Department of Medicine at Yale in many capacities, as Chief of Medicine at the affiliated Veterans Administration Medical Center, as Vice Chairman and later Acting Chairman of Medicine and then as Acting Dean of the Medical School. Why is it that a team which cares for patients with HIV/AIDS is named after a gastroenterologist? During the latter phase of his professional career, the AIDS epidemic had peaked and resulted in devastation of the lives of those whom it affected and the lives of their loved ones. Dr. Donaldson could not remain on the sidelines and, well into his mid-sixties, he began to attend outpatient clinics that cared for patients with AIDS, learned about the disease from colleagues who were experts on the disease, and became devoted to the cause of patients with AIDS. At any given time, the census of HIV patients on the Donaldson team varies from 40 to 75%. The focus of the learning experience while on this rotation is HIV and AIDS.

Firm Chief: Merceditas Villanueva, MD

Medical Intensive Care Unit (MICU - York Street Campus): The Yale MICU rotation provides for a wide and very well supervised experience with intensive care unit patients in an outstanding learning environment. The MICU admits 3000 patients per year including 350 patients from regional hospitals. The MICU has an average daily census of 34 critically ill patients with a wide range of life-threatening disorders including septic shock, acute respiratory distress syndrome, and acute hepatic failure. The learning extends to beyond the management of these intensely ill patients to exposure to discussions on end of life issues, palliative care and code status. For more information, click here.

Firm Chief: Jonathan Siner, MD

Stepdown Unit (SDU): The medical Stepdown Unit rotation provides an opportunity for second- and third-year residents to provide care to a diverse array of relatively ill patients in conjunction with physician assistants and two attending physicians. The director of the Medical Step-Down Unit is Dr. Peter Marshall, Associate Professor of Medicine, Pulmonary & Critical-Care.

Firm Chief: Mayanka Tickoo

Nephrology (Peters): The Peters Firm is named after a giant in American Medicine, Dr. John Punnett Peters, who joined the Yale faculty in the 1920s. Dr. Peters developed laboratory medicine and contributed greatly to metabolic diseases, from which later emerged the subspecialties of nephrology and endocrinology. He was also a man with a deep sense of social commitment who ruffled many feathers in the political system of his time in the U.S. by being a champion for the poor and complaining bitterly about the quality of health care they received, during the Great Depression and thereafter. His liberal views on this and similar issues landed him in a great deal of trouble in the political climate of the early years of the Cold War. The Peters Team preferentially admits patients with renal disease and is led by outstanding nephrologists.

Firm Chief: Ursula C Brewster, MD

Oncology: The inpatient oncology service provides exposure to a wide variety of cancer patients, focusing on those with solid tumors, including those with oncological emergencies, neutropenic fever and new diagnoses. Pain management and end of life issues are also a focus on this service. Dr. Roy Herbst is the Chief of Medical Oncology.

Firm Chief: Joseph Paul Elder, MD