Internal Medicine

This two- or four-week elective will teach students the essentials of identification of at-risk substance use and substance use disorder as well as a variety of treatment options in both the outpatient and inpatient settings. The primary outpatient site for this rotation is the APT Foundation Central Medical Unit (CMU). The CMU is a primary care medical clinic providing medical care to all persons registered in the APT Foundation Opioid Treatment Program, patients with state sponsored health insurance, and patients needing opioid, alcohol, or benzodiazepine detoxification. We also care for the medical conditions resulting from substance use including HIV, Hepatitis C, and skin/soft tissue infections. Additionally, we actively screen for and treat tuberculosis, hepatitis B, hepatitis C, HIV, and sexually transmitted infections. Residents rotating at the CMU will gain experience performing methadone treatment admissions, buprenorphine inductions and follow-ups, alcohol detoxifications, screening and brief intervention for at-risk substance use, primary medical care of patients with substance use disorders, treatment of co-morbid psychiatric disease and ongoing treatment of medical conditions resulting from substance use. Additionally, residents will gain experience in screening, educating patients and families, evaluation, and treatment of chronic hepatitis C (using new Direct Acting Antivirals) in patients with substance use disorders. The primary inpatient setting for this rotation is the Yale Addiction Medicine Consult Service (YAMCS) at both the YSC and SRC campuses. YAMCS is a hospital-based service started in October 2018 and currently includes a physician who is board-certified in Internal Medicine and Addiction Medicine, an Addiction Medicine Fellow, an APRN, and 2 health promotion advocates. YAMCS provides addiction assessment and treatment to patients who are hospitalized at Yale New Haven Hospital (YNHH) for a range of medical conditions including substance use disorder (SUD) and other relevant medical disorders, such as chronic pain and infective endocarditis. Patients seen by YAMCS are offered evidence-based treatment during hospitalization and connected to ongoing addiction care in the community after hospital discharge.

Length of Rotation: 2 or 4 weeks (maximum-1 students)

Scheduling Restriction: open on case-by-case basis

Student's Class Level: 3rd, 4th, 5th year

Prerequisite:

Accept Visiting Students: no

Learning Objectives

Students electing this course will attend the Allergy & Immunology Clinic for Adults held at the Yale Allergy & Immunology Center at 6 Devine Street, in North Haven; and occasionally at the YNH Old Saybrook Medical Center, 633 Middlesex Turnpike in Old Saybrook. Clinics are held Monday through Friday, with morning and afternoon sessions on most days. Clinic sessions at the Pediatric Allergy & Immunology Clinic at 1 Long Wharf in New Haven may be requested, pending availability. Students will also attend Allergy & Immunology Grand Rounds held on Friday mornings at the Anlyan Center (300 Cedar St, New Haven), followed by case discussions and/or Journal Club. Students may also join in consultations with the Allergy & Immunology service at the YNHH York St campus. Please note that there is no direct shuttle service to the clinic locations; commuting by car is recommended.

Length of Rotation: 2 or 4 weeks (maximum-1 students)

Scheduling Restriction: Not offered June-September

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: Immunobiology course

Accept Visiting Students: yes - departmental approval

Learning Objectives

The 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 may 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.

Length of Rotation: 2 weeks (maximum-1 student)

Scheduling Restriction(s): Only Offered 8/28/23, 11/6/23, 3/11/24 and 5/20/24 blocks.

Student's Class Level: 4th, 5th year

Prerequisite: Successful completion of EL Internal Medicine Cardiology (inpatient) Elective at VA or YSC (minimum 2 weeks)

Accept Visiting Students: yes

Learning Objectives

The student will work directly with the attending faculty, cardiology fellows, physician assistant, nurses, and imaging technologists within the imaging laboratories. Students will be involved with interviewing and examining patients referred for cardiac stress testing under the direct supervision of stress laboratory staff, and learn about the appropriate use of multi modality cardiovascular imaging. They will also gain direct training and supervision in the performance and interpretation of these studies. They will participate in the performance of both exercise and pharmacological stress imaging studies, as well other targeted molecular imaging. An assessment of the history taking, limited cardiovascular examining skills, and problem assessment as relevant to screening patients for stress testing and those with cardiomyopathy is performed by the attending faculty and/or physician assistant with each student. An evaluation of the student’s performance is provided with the input of all attending faculty and imaging staff. Along with the clinical training and exposure, students will learn related cardiovascular physiology and gain exposure to other advanced imaging technology for the evaluation of cardiac and skeletal muscle perfusion and function in patients with suspected cardiovascular and peripheral vascular disease.

Students may speak with the elective director to pursue learning in additional areas of special interest in cardiovascular imaging.

Length of Rotation: 2 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year

Prerequisite: Internal Medicine Cardiology Rotation (YNHH or VA)

Accept Visiting Students: Yes

Learning Objectives

At the conclusion of this activity, participants will be able to define the appropriate use of cardiac stress testing with and without imaging in evaluation of chest pain, and understand the risks involved with stress testing. They will be able to compare the relative advantages and disadvantages of each type of stressor (exercise and pharmacological) and the different adjunctive imaging approaches.

At the conclusion of this elective, the student will be able to complete a pertinent screening history and physical examination for the evaluation of a patient referred for stress testing. The student should demonstrate the ability to perform the pertinent physical examination and direct both a pharmacological and exercise stress test while being observed by an attending, cardiology fellow, or physician assistant.

At the conclusion of this elective, participants will be able to safely perform and monitor a patient undergoing a cardiac stress test with imaging, and be able to interpret the stress electrocardiogram and identify high risk features of the imaging study.

At the conclusion of this elective, participants will have gained exposure to the methods of nuclear imaging and cardiac CT imaging along with reconstruction and analysis of the images.

The student will participate in the daily activities of the inpatient cardiology consult service, including rounds and new consultations under the supervision of a fellow and attending. Students will be participating in clinical case conferences and gain exposure to procedures such as cardiac catheterization, stress testing, echocardiography, nuclear imaging, and electrocardiography. The training experience will emphasize the physiologic basis for clinical manifestations and therapy of cardiovascular diseases. A collection of pertinent review articles will be provided.

Length of Rotation: 2 or 4 weeks (maximum-1 students)

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year

Prerequisite: Internal Medicine Clerkship

Accept Visiting Students: Yes, U.S. only.

Learning Objectives

The student will participate in the daily activities of the cardiology service, including rounds, consultations, conferences, and observe special procedures such as cardiac catheterization, echocardiography and electrophysiologic evaluations and functional cardiac testing. The training experience will emphasize the physiologic basis for clinical manifestations and therapy of cardiovascular diseases.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction:

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: yes

Learning Objectives

This is an opportunity for senior students to participate in critical care medicine activities in the medical intensive care unit (MICU). The emphasis will be on evaluation and acute management of respiratory failure, shock and sepsis and use of invasive monitoring. The physiological basis of disease and rationale for therapeutic interventions will also be emphasized.

Length of Rotation: 2 or 4 weeks (maximum - 1 student)

Scheduling Restriction: Closed May – September

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: no

Learning Objectives

The student will participate as an active member of the endocrine training program, making daily rounds with the endocrine fellows and residents and attending physicians. He or she will work primarily on the inpatient consult service at Yale-New Haven Hospital and, as time allows, will have the opportunity to attend selected endocrine clinics. The student will also participate in the regularly scheduled metabolism-endocrine conferences throughout the week. This is a full-time assignment.

Length of Rotation: 2 or 4 weeks (maximum-1 student)

Scheduling Restriction: Closed: July through September and Winter Recess

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: yes

Learning Objectives

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

Length of Rotation: 2 weeks (maximum-2 students)

Scheduling Restriction: Not offered July or August and Dec 22 - Jan 1

Student's Class Level: 4th year only

Prerequisite: N/A

Accept Visiting Students: no

Learning Objectives

GOALS: The focus of the student elective will be in the areas of geriatric assessment and identifying geriatric syndromes and gaining an appreciation of the full continuum of care for older adults and how transitions of such care occur by working direction with faculty and fellows through direct patient care and mini didactics students will learn about the core geriatric syndromes and how they directly affect function of older adults.

Students will have an opportunity to engage with patients in a variety of clinical settings. They include outpatient sites, both primary care and Adler Geriatric Assessment Center sites, in patient geriatric unit activities, subacute rehabilitation settings, and system-wide consultation services. By directly caring for patients in these various sites students will gain a unique perspective into the scope of care that is available for older patients.

METHODS: The rotation will be either two or four weeks in duration. Students will be exposed to patient care at various hospital subacute long-term care and outpatient sites. Students will learn to identify basic geriatric syndromes such as memory loss, delirium, depression, falls, and polypharmacy. In addition, there will be an opportunity to be involved with palliative care and end-of-life care issues in a variety of settings and goals of care discussion.

• Educational activities will include direct patient care and rounds, introduction to team based care, case conferences and didactic sessions.
• Opportunities will exist to interact with the diverse and expert geriatric faculty.
• Based on student’s individual interests in particular areas of geriatrics, the focus of the elective can be structured in this manner.
• Students will be evaluated by direct observation and will receive dynamic feedback during the course of the elective.
• Will be able to attend the wide range of conferences, didactics and workshops Geriatric Medicine offers if schedule allows.

Length of Rotation: 2 or 4 weeks (maximum-1 student)

Scheduling Restriction: Not offered mid-June to mid-September

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: Internal Medicine Clerkships 1 & 2

Accept Visiting Students: no

Learning Objectives

This elective 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.

Length of Rotation: 2 or 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: yes

Learning Objectives

This is an opportunity for students to see a wide variety of liver problems and patients, with an opportunity for discussion and review. The student will be an integral part of the inpatient liver service, primarily working in an inpatient setting.

Length of Rotation: 2 or 4 weeks (maximum-2 students)

Scheduling Restrictions: Not Offered July or August

Student's Class Level: 4th year only

Prerequisite: N/A

Accept Visiting Students: yes

Learning Objectives

The elective offers a robust learning experience to medical student rotators in general infectious diseases including the diagnostic evaluation and management of common community acquired and nosocomial infections in a diverse patient population, as well as infections in the immunocompromised patient. There are opportunities for learning in subspecialty areas such as medical microbiology, transplant ID, HIV/AIDS, hospital infection control, antimicrobial stewardship and sexually transmitted diseases. Students will function as active members of the consultation and training program in Infectious Diseases at Yale-New Haven Hospital; and will be expected to attend and participate in daily attending rounds, microbiology rounds four times a week, weekly clinical case conferences and monthly journal clubs. Evaluations of students by faculty and fellows would be primarily based on performance in clinical case presentations on the consult service.

Length of Rotation: 2 and 4 weeks (maximum-1 student); only Yale students may elect to participate in a 2-week rotation

Scheduling Restriction: Not Offered first half of July

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: yes

Learning Objectives

This elective offers experience in a busy MICU at Y-NHH. Students are on call every fourth day with an intern and resident pair (there are NO overnight responsibilities), assisting them in the admission of patients. Students follow patients in the MICU, are expected to present during rounds, and assist in patient care with their intern and resident. This elective provides the opportunity for participating in the acute management of common medical emergencies. Although students will be exposed to a variety of ICU based procedures, there will be limited "hands-on" opportunity.

Length of Rotation: 2 or 4 weeks (maximum-2 students)

Scheduling Restriction: Not Offered July 1 -July 12, 2024 and December 23, 2023 – Jan 6, 2024

Student's Class Level: 4th, 5th year, will take 3rd year by special application if medicine rotation completed with Honors

Prerequisite: Internal Medicine Clerkship

Accept Visiting Students: US: Yes / International: No

Learning Objectives

This elective 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 evaluation is also provided. Renal bx get immunofluorescence and electron microscopy routinely as well.

Length of Rotation: 2 or 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: yes

Learning Objectives

This rotation is designed to provide senior medical students (and PA and nursing students) with an introduction to the principals and practice of occupational and environmental medicine, including exposure assessment, and evaluation of disease causality. Students will learn the key elements and art of taking an occupational and environmental history, the clinical tools used to evaluate workplace and environmental exposures, and how to incorporate this data to assess the contribution of such exposures to patients’ diseases. The experience is centered on the YOEMP diagnostic clinic at 135 College St in New Haven, CT, and the VA Connecticut Healthcare System (Employee Health Unit and Military Toxic Exposures Clinic). In addition, students will have the opportunity to participate in ongoing didactic and research conferences, workplace surveillance programs, Veteran Registry and Military Toxic Exposure Exams, and visit workplaces and other environmental sites that are being evaluated for their role in disease causation. Students will be exposed to the varied opportunities in medicine, public health, and regulatory institutions for careers in this discipline.

Length of Rotation: 2 or 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: yes

Learning Objectives

This is an advanced elective offered to students who have completed their 3rd year Internal Medicine clerkship. This elective is designed to expose students to all aspects of clinical medical oncology by direct participation in the daily disease-specific out-patient oncology clinics at Yale Cancer Center. Students will have the opportunity to work-up patients with new cancer diagnoses and to participate in the on-going care of patients with diverse cancer diagnoses working closely with the medical oncology fellows and attending physicians. Students will participate as an active member of the medical oncology training program, attending the regularly scheduled daily clinical conferences as well as weekly disease-specific multi-disciplinary tumor boards and medical oncology fellow education conferences. Although the emphasis of the elective is on out-patient oncology in disease-specific units, students can also opt to work with the in-patient oncology team at Yale-New Haven Hospital. Rotations based at the VA Cancer Center can be arranged as well.

Length of Rotation: 2 or 4 weeks (maximum-3 students)

Scheduling Restriction:

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: yes - departmental approval

Learning Objectives

During this 2 week Palliative Medicine Elective rotation at the YNHH (York Street Campus) the Medical Student will focus on promoting quality of life and preventing suffering in patients with serious illness and their families and clinician providers across a broad scope of diseases by providing an extra layer of support. The experience will encompass intensive, hands on inpatient clinical care of patients on the YNHH Adult Palliative Medicine Consultation Service. Our team creates an opportunity for focused skill building in symptom management, interdisciplinary team function, basic and advanced aspects of serious illness communication, whole person and family focused care, and reflection on practice and self-care.

The student will work one on one with a palliative care attending, join the interdisciplinary team meeting daily, and have the option to attend additional relevant conferences and to provide a 10 minute presentation to the team on a relevant topic. All activities are based at YSC with varying elements of Zoom/virtual activity.

Length of Rotation: 2 weeks (maximum-2 students)

Scheduling Restriction: N/A

Student's Class Level: 4th & 5th year

Prerequisite: Completion of the first two years of medical school

Accept Visiting Students: no

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.

The four-week rotation allows for optional time spent with allied services and/or home care. The goal of this rotation for students is 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.

Length of Rotation: 2 or 4 weeks (maximum-2 students)

Scheduling Restriction: N/A

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: All students are required to provide a letter of good academic standing from the Registrar; a copy of their recent PPD; and acceptance or declination of Hepatitis B; documentation of no communicable diseases; evidence of private health insurance and evidence of professional liability from the Registrar; and a personal letter stating why the student wants to do a rotation in Palliative/Hospice Medicine. All documentation must be sent to Mary Fitzgerald two weeks prior to the start of your rotation.

Accept Visiting Students: yes - departmental approval

STUDENT INTERN REQUIREMENTS

1. Authorization from school that you are available for rotation here (with dates).
2. Short letter/paragraph explaining your interest in spending a week at The Connecticut Hospice (America’s first Hospice).
3. Immunization records PPD results within 3 months of start date
4. Copy of health insurance card
5. Liability insurance coverage
6. Emergency contact information
7. Confidentiality agreement

Learning Objectives

The Yale New Haven Medical Center (YNHH) consult elective in Pulmonary Medicine is designed to provide medical students an in-depth knowledge of respiratory diseases through consults on the patient care floors and through didactic sessions and directed reading. Students become an integral part of the Pulmonary and Critical Care (PCCM) Section consult service, working with the attending and PCCM fellow(s). From two to six new consults on average are seen daily. Formal didactic lectures are given on Wednesday afternoons at 3:00 p.m. at the Yale Pulmonary, Critical, Care, and Sleep Medicine Grand Rounds and and 4:00 p. m. at the Fellows Case Conference, both in the Fitkin Amphitheater. Students are expected (1) to learn the differential diagnosis and treatment of respiratory disorders, (2) to learn to interpret pulmonary function tests and (3) to learn to read a chest radiograph and understand the essentials of a chest CT scan. Students work closely with faculty and staff in the pulmonary group and participate in daily consulting and rounds. Students 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 chest images and pulmonary function tests and their interpretation, clinical and laboratory methods in diagnosis and management, including intensive respiratory care and respiratory therapy, and an opportunity to observe fiberoptic bronchoscopy. Students receive didactic lectures in a number of areas relating to airway pharmacology, lung cell biology and lung immunology (respiratory cells, immunologic reactions, etc). A separate experience is available in intensive care medicine.

Length of Rotation: 2 or 4 weeks (maximum-1 students)

Scheduling Restriction:

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: yes

Learning Objectives

The goal of this elective is to reinforce the MD-PhD students' clinical skills prior to return to formal clerkships. The emphasis will be made on history, physical examination skills, interpretation of data, morning presentation, medical terminology, patient communication and coordination of care. Students may be assigned to a house-staff team that consists of one intern, one resident, and one attending, or they may be assigned to a hospitalist team that consists of one attending and possibly a physician assistant. Students will be expected to perform at the clerkship level (not sub-intern level) performing admission history and physical exams, presentations, and following/presenting patients on daily rounds with supervision. History, physical diagnosis and laboratory interpretation skills will be emphasized daily on rounds.

Length of Rotation: 2 weeks (maximum - 2 students)

Scheduling Restriction: All students must receive approval from the elective director, Lauren Cohn, prior to registering for this elective.

Student's Class Level: Any MD-PhD student who has already completed 3 months of required clerkships who is re-entering after one year or more of clinical inactivity.

Prerequisite: N/A

Learning Objectives

The Yale New Haven Medical Center (YNHH) consult elective in Rheumatology is designed to provide medical students an exposure to a wide variety of inflammatory rheumatic diseases though consults on the patient care floors at YNHH and Saint Raphael Campus (SRC) hospitals. Students will work closely with the faculty member and fellow assigned to the inpatient consultative service at all 2 sites. They are expected to attend rounds and evaluate patients with rheumatic conditions and other diseases with rheumatic manifestations. In addition, they may participate in outpatient clinics at our sites at the North Haven Medical Center and Orchard Street Students are expected to attend all didactic sessions. Weekly conferences at the Yale-New Haven campus emphasize the pathophysiology and management of complex autoimmune conditions. The section also has combined lecture series with several other specialties. Students are expected to (1) gather all necessary information for rheumatology history, (2) complete a pertinent physical exam, (3) know about common rheumatologic conditions, (4) interpret results on the most common rheumatology work up.

Length of Rotation: 2 or 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: N/A

Accept Visiting Students: Yes

Learning Objectives

The Internal Medicine subinternship offers medical students the opportunity to function in the role of an intern on an Internal Medicine inpatient team. Subinternship opportunities are available throughout the academic year at Yale-New Haven Hospital (York Street Campus and Saint Raphael Campus) and the VA Medical Center (West Haven, CT). Subinterns will join a team consisting of an upper year medical resident and attending and will be responsible for admitting patients, writing admission and daily progress notes, presenting cases on rounds, communicating with consultants, ordering medications and tests, and serving as the front line physician for patients admitted to the hospital. Students will be responsible for managing approximately half the number of patients typically managed by an Internal Medicine intern. The Internal Medicine Subinternship offers medical students an outstanding opportunity to prepare for internship, whether the student intends to pursue a career in Internal Medicine or another specialty. To qualify for an Internal Medicine Subinternship, students must have successfully completed their third year Internal Medicine Clerkships.

Length of Rotation: 4 weeks

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year

Prerequisite: Completion of inpatient Internal Medicine Clerkships required.

Accept Visiting Students: no

Learning Objectives

This one-year weekly outpatient elective in the Yale Adult Primary Care Clinic on 150 Sargent Drive, New Haven, CT provides experience in the longitudinal care of adult patients. Students are directly responsible for care of medical problems and preventive care as well as coordination of specialty care for their own patient panel. There are weekly pre-clinic conferences, which include Journal Club and primary care case-centered topics presented by students or specialty attending physicians. The clinic is held every Wednesday evening, 5.15 pm–8.30 p.m., except the day before Thanksgiving and between Christmas and New Year’s. It is open to a limited number of senior medical students who have completed at least half of their clerkships (M.D./Ph.D.) or most of their primary care clerkships (M.D.) Students are responsible for 3 patient visits/session. There are weekly pre-clinic conferences 4.45-5.15 pm, which include Journal Club and primary care case-centered topics presented by students.

For additional information visit our Wednesday Evening Clinic page.

Length of Rotation: Longitudinal experience over 1 year, (mandatory 36 clinical sessions).

Scheduling Restriction: Approval required by the Director

Student's Class Level: 3rd, 4th, 5th year

Prerequisite: See above

Accept Visiting Students: No

Learning Objectives

This one-year weekly outpatient sub-internship in the Yale adult Primary Care Clinic on 150 Sargent Drive, New Haven, CT provides experience in the longitudinal care of adult patients. Students are directly responsible for care of medical problems and preventive care as well as coordination of specialty care for their own patient panel. The clinic is held every Wednesday evening, 5.15–8.30 p.m., except the day before Thanksgiving and between Christmas and New Year’s. It is open to a limited number of senior medical students who have completed ALL of their primary care clerkships (M.D.) Students are responsible for 3 patient visits/session. There are weekly pre-clinic conferences 4.45-5.15 pm, which include Journal Club and primary care case-centered topics presented by students. Students are expected to complete a clinical project relevant to WEC to be eligible for Sub-I credit. The project is chosen based on students’ interest in discussion with the program director.

For additional information visit our Wednesday Evening Clinic page.

Length of Rotation: Longitudinal experience over 1 year (mandatory 36 clinical sessions)

Scheduling Restriction: Approval required by the Director

Student's Class Level: 3rd year MD/PhD students upon review, 4th and 5th year

Prerequisite: Completion of all clerkships

Accept Visiting Students: No

Learning Objectives

The purpose of this elective is to provide medical students interested in psychiatry and/or primary care an experience of working with patients with serious mental illness (SMI) in an integrated primary care setting. The Wellness Center provides primary healthcare services for individuals receiving behavioral health services at the Connecticut Mental Health Center. Patients who receive services at community mental health centers are often of low income, living in a depressed urban environment, include a significant percentage of people of color, and have limited educational opportunities and English proficiency. The goal of the Wellness Center is to improve the physical health of adults with SMI (e.g., decreased rates of obesity, hypertension, diabetes, hyperlipidemia, and tobacco and drug use) who are at increased risk for medical comorbidity and poor health outcomes.

In this longitudinal elective, students will work directly with an attending as a clinical team member one afternoon a week for six months. Students will be responsible for following patients longitudinally, building clinical alliances, leading patient encounters, and devising treatment plans and managing chronic disease (e.g. HTN, diabetes). During the elective, students will learn about the unique care considerations of patients with SMI, the social determinants of health, and the use of patient-centered approaches to promote healthy lifestyles, smoking cessation, and medication adherence.

Length of Rotation: 6 months, 1 afternoon/wk (maximum -1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th & 5 th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: no

Learning Objectives

The Hospital Medicine Firm (HMF) was started during the 2022-2023 academic year on the YNHH East Pavilion (EP) 5-5 Unit before transitioning to (and remaining on) the East Pavilion 9-7 Unit since. The EP 9-7 Unit is a busy general internal medicine service with high acuity and patient turnover. The unit includes 34 patient beds which are staffed equally by both the HMF and the Whitman (formerly Generalist) Firm. A capstone and unique service for senior residents, the HMF is staffed by two hospitalist attendings and (usually) two third-year residents in Internal Medicine. Given the high volume of clinical work, there are no formal rounds and no students otherwise scheduled on this service. However, through the Yale School of Medicine Performance Improvement Program (directed by Dr. Wijesekera), students can be provided the opportunity to rotate on the HMF to build their clinical skills prior to residency.

Prior to the rotation, the students will work closely with the Director of Performance Improvement (also elective director) to create an individualized educational plan, which will include targeted resources to build their medical knowledge and clinical skills. During the rotation, elective students will follow and provide clinical care for 2-4 patients at a time including, but not limited to, pre-rounding, writing notes, oral presentations, calling consultants, responding to acute events, updating families, and writing handoffs. The elective director, supervising attendings, and senior residents will meet regularly with the student to assess and provide feedback on their communication (with patients and health care team members), clinical skills (history, physical examination, clinical reasoning), and presentations (oral and written). The students will participate in all education for the residents (e.g., noon conferences, skills labs, ad hoc teaching activities).

Length of Rotation: 2 weeks
Scheduling Restriction: Offered only with written permission from Director of Performance Improvement (Dr. Wijesekera)
Student’s class level: 3rd, 4th, 5th year
Prerequisite: Completion of the first two years of medical school
Accept Visiting Students: No

Learning Objectives