Ophthalmology with Dr. Kenneth Heist
The transitional year resident will be precepted by a faculty member specializing
in ophthalmology and optometry through the office location(s) of Dr Kenneth Heist
and colleagues. The resident will work alongside the ophthalmologist/optometrist and
will be on a one to one basis so didactic material is delivered to the resident on
an informal basis throughout the rotation. The resident will be exposed to ophthalmic
procedures and diseases commonly encountered by primary care physicians, and gain
insight into the field of ophthalmology itself. The resident with contact Dr. Heist
at least one week prior to the beginning of the rotation to confirm, and obtain a
schedule for the month.
Nephrology with Dr. Michael Levin
Renal disorders are commonly evaluated by general internists. Disorders may be primarily
renal in origin or systemic diseases that have profound secondary effects on the kidney,
such as diabetes, vasculitides and atherosclerosis. General internists must be able
to recognize, evaluate and initiate treatment for common renal disorders as well as
understand the relationship between systemic processes and the kidney. Prevention
of renal disease assumes paramount importance in decreasing the burden of chronic
kidney disease. Occupational exposures in the dialysis unit to blood borne pathogens
such as Hepatitis B and C and HIV are discussed. Caring for chronic renal patients
involves occupational risks to the practitioner. The socioeconomic aspect of chronic
kidney disease on overall health care spending is important for the residents to understand.
Environmental, nosocomial iatrogenic causes of renal disease are considered including
the use of contrast dye, drug induced renal disease and medication induced changes
in initiating renal hemodynamics and drug disposition. The difficult ethical issues
of withholding renal replacement therapy and discontinuing renal replacement therapy
are encountered.
Hematology/Oncology with Dr. Jean Marie Koka
Hematologic problems are extremely common in hospitalized patients and patients with
chronic illnesses in the outpatient setting. These diseases may be primarily hematologic
or may be secondary to other illnesses or conditions. It is important for the internist/family
practitioner to appreciate these abnormalities and know the appropriate work-up and
therapies available. Internists/family practitioners may use these hematologic abnormalities
to uncover primary disease elsewhere in the body. Thus, it is incumbent upon the internist/family
practitioner to have a working knowledge of typical hematologic conditions.
End of life issues, aggressiveness of care issues in patients with incurable malignancies,
use of hospice programs and discussion of pain control are regularly encountered and
discussed during this rotation. Universal precautions include the handling of blood
products; the complications of blood transfusions, including antibody reactions and
infectious complications such as HIV and hepatitis care, are reviewed. Occupational
and environmental exposures to hydrocarbons and benzene containing compounds are reviewed
when patients present with leukemias.
Geriatrics with Dr. Katherine Galluzzi, Dr. Nicole Joseph and Dr. Michael Srulevich
The resident will be exposed to a range of health issues within the elderly population.
The role of the physician as part of a multidisciplinary health care team will be
demonstrated in a variety of clinical experiences, Residents will have clinical exposure
in a number of sites depending on the focus and objectives of the resident. These
may include community assessment visits, inpatient and outpatient rehabilitation services,
acute care consultations, and ambulatory clinics. The resident will acquire competence
in the assessment and management of specific diseases common in the elderly and gain
experience providing clinical care to frail elderly.
Pulmonary Medicine with Dr. Michael Venditto and Dr. Daniel Parenti
Pulmonary diseases are very common. Acute respiratory disease are among the most common
illnesses affecting humans and are responsible for more absences from work and school
than most other types of illnesses. Chronic respiratory diseases, especially bronchitis,
COPD, and emphysema, are exceeded only by cardiovascular diseases as causes of disability
payments. Malignancies of the lung rank first among deadly neoplasms. Because of these
high rates of pulmonary diseases, it is important for the internist to be able to
identify clinical manifestation of pulmonary disease and to be aware of the diagnostic
methods, therapeutic options and preventative strategies of these diseases. The impact
of cigarette smoking as well as other environmental toxins will receive early emphasis.
Learning how to increase cessation rates among cigarette smokers provides powerful
prevention tool for pulmonary as well as many other disorders. End of life care discussion
commonly occurs in patients with end stage lung diseases.
The pulmonary rotation is a month-long elective rotation, with a focus on outpatient
Pulmonary and inpatient pulmonary consults.. During this rotation, the residents will
admit patients to the pulmonary service, perform inpatient consults and assist in
the longitudinal management of patients with common pulmonary problems. During the
rotation, the Transitional year resident will gain a broad knowledge base in the care
of patients with pulmonary diseases. The resident will be expected to recognize, diagnose,
evaluate and treat pulmonary disease commonly encountered by a practicing internist.
The resident will be introduced to some of the major pulmonary ailments, discuss the
major pathophysiologic mechanisms of disease and use these mechanisms to better understand
therapeutic modalities.
Anesthesia with Dr. Heather Livezey
The goal of this rotation is to expose the trainee to the concepts of the pharmacology
and principles of regional and general anesthesia, the pathophysiology of pain, as
well as procedural skills crucial to airway management and invasive cardiac monitoring.
Basic airway management skills will be emphasized, but the trainee will gain experience
with more advanced techniques like the Glidescope
Internal Medicine with Dr. Erik Polan
Transitional year residents will be exposed to and learn to care for internal medicine
patients in the ambulatory setting, as well as, additional inpatient exposure on Dr.
Polan’s inpatient service at Roxborough Memorial Hospital. In addition to learning
and practicing medical management of ambulatory patients, residents will be exposed
to additional aspects of running a clinic/outpatient office—such as preventive visits,
medical coding and billing. The experience will occur over one, four-week block. A
schedule will be provided at the time of elective choice.