Subspecialty and Interdepartmental Learning
The Internal Medicine Residency Program provides ample exposure to the medical subspecialties through electives as well as a handful of subspecialty teaching teams. Additionally, our residents rotate through the emergency department, and upper-year residents join the neurology team for a consult rotation to gain experience diagnosing and managing strokes and other neurologic illnesses. Additional elective rotations are available in other departments, such as Radiology or OB/GYN.
Each of the medical subspecialties has a fellowship program and enthusiastic faculty who are dedicated to teaching, patient care, and research. Residents rotate with subspecialty attendings in the intensive care units and select subspecialty teaching teams as outlined in the paragraph below, but in general, most subspecialty services do not have their own inpatient team. Instead, most sections provide an active program of ambulatory care and inpatient consultation. Most uncomplicated subspecialty patients admitted solely for procedures are placed on a non-house staff service which is covered by fellows, physician assistants, or sometimes hospitalists. An elective rotation in any of the subspecialty areas affords residents an opportunity to become more familiar with the disease spectrum, the specialized diagnostic and therapeutic resources, and the literature specific to that field while receiving expert clinical teaching.
In addition to our general medicine floor teams, we also have 4 inpatient teaching teams that are led by subspecialists and see patients admitted with complaints related to that particular subspecialty. For example, the heart failure service is run by a teaching attending from the cardiology section who is able to provide the residents with in-depth instruction from the specialist’s point of view. There is also a Medicine Yellow/Green team (nephrology/hepatology), a Medicine Blue team (pulmonary), and a General Cardiology team. This variety of teaching attendings helps to provide residents with exposure to multiple approaches to the practice of medicine. Our residents appreciate the opportunity to care for patients on both general and subspecialty teams, and these experiences are rated very highly.
The Section of Cardiology offers full service in invasive cardiology including cardiac catheterization, endomyocardial biopsy, PTCA, balloon valvuloplasty, atherectomy, stents, left ventricular assist device management, and electrophysiology procedures, including implantation of pacemakers and devices, lead extraction, and radiofrequency catheter ablation. In addition, the section has a full echocardiography service including transesophageal, exercise and contrast echocardiography. They also have a nuclear cardiology program. Other services include a cardiac rehabilitation program, an outpatient clinical practice, an inpatient general cardiology and heart failure teaching team, a busy advanced heart failure and transplantation program, and a cardiac intensive care unit.
The Section of Cardiology includes 6,000 square feet of research space with ongoing research in left ventricular physiology, computer-based image processing of cardiovascular data, and myocardial biochemistry. The Advanced Heart Failure Program is one of the busiest and most respected in the nation.
Endocrinology and Metabolism
The Section of Endocrinology and Metabolism operates outpatient diabetes, thyroid and hypertension clinics, and maintains an active inpatient consultation service. Regular teaching conferences include weekly journal clubs, endocrine/metabolic conferences, seminars and patient walk-rounds. The Section of Endocrinology and Metabolism is responsible for operating an eight-bed Clinical Research Center. Current research interests include pathogenesis of non-insulin dependent diabetes (anti-insulin receptor antibodies, insulin receptor gene abnormalities, effects of metabolic fuels on insulin sensitivity), mechanisms and treatment of autonomic neuropathy, low renin hypertension, and autoimmune thyroid disease.
The Section of Gastroenterology provides a varied clinical and laboratory experience. The clinical service includes state-of-the-art diagnostic and therapeutic endoscopic procedures and innovative motility studies. The Section of Gastroenterology is internationally known for its expertise in gastrointestinal motility disorders and functional gastrointestinal diseases. Research is conducted in the areas of dysfunction caused by drugs and viruses. New areas of investigation include hepatic drug metabolism and small intestinal adaptation. Clinical therapeutic projects include acid/peptic disorders of the esophagus, stomach and duodenum, gastroparesis, irritable colon syndrome, functional dyspepsia, ulcerative proctosigmoiditis and colitis, Crohn's disease, and cancer of the colon. Rounds are made daily on gastroenterology and hepatology services. The teaching program includes weekly GI rounds, case discussions, pathophysiology, endoscopy, radiology and pathology conferences, and a journal club.
Hematology and Oncology
The Hematology and Oncology Sections are divided into three services:
Inpatient Hematology/Oncology Consultation service with special emphasis on anemia, hemostatic and thrombotic disorders
The autologous and allogeneic Bone Marrow Transplant Unit at Jeanes Hospital
Members of the Section of Hematology direct the Clinical Coagulation Laboratory, the Special Hematology Laboratory, and the Blood Bank. The Sol Sherry Thrombosis Research Center is staffed by Section of Hematology investigators. Research activities include cellular and molecular biology of platelets, megakaryocytes and endothelial cells, biochemistry of coagulation proteins, regulation of hematopoiesis, and studies of the therapeutic potential of monoclonal antibodies and biologic response modifiers.
Oncology research involves clinical trials oriented toward drug development and bone marrow transplantation and studies on the cell biology of hematopoietic stem cells and the immunohematology of bone marrow transplantation.
The Section of Infectious Diseases conducts one of the busiest consultation and teaching services at Temple University Hospital. Residents have the opportunity to see and discuss a wide range of adult infectious disease problems. Conferences are held within the Section five days a week. The Section of Infectious Diseases also operates a travel and immunization clinic. Research interests include alterations of drug protein binding in disease states, novel mechanisms of antimicrobial resistance, clinical epidemiology, clinical applications of new antimicrobial agents, and infections complicating cancer. Two of the Section members are also in the Section of HIV Medicine and participate in the HIV ambulatory clinic. All Section members care for hospitalized patients with HIV and a wide spectrum of infections related to organ transplantation, cancer, substance abuse, and altered immunity.
Nephrology and Kidney Transplantation
The Section of Nephrology and Kidney Transplantation provides an active inpatient consultation service as well as experiences in hemodialysis centers and chronic kidney disease clinics. Nephrology attendings also care for inpatients with issues related to hemodialysis or renal transplant on the Medicine Yellow team. Participation in the weekly nephrology grand rounds, journal clubs and pathology conferences is an integral part of the inpatient and outpatient electives. The end-stage renal disease program provides exposure to patients undergoing hemodialysis, peritoneal dialysis and renal transplantation. Faculty research interests include mechanisms and hormonal modulation of ion transport, mechanisms of hypertension and clinical studies on progression of renal disease and fluid, electrolyte and acid-base metabolism.
Pulmonary and Critical Care Medicine
Clinical and research programs in the Department of Thoracic Medicine and Surgery reflect an interest in obstructive airways disease (asthma and COPD), sarcoidosis, respiratory muscle function and disturbances in the control of breathing. The Pulmonary Section directs and operates a twenty-six bed respiratory intensive care unit, a large ventilator rehabilitation unit, and a multidisciplinary pulmonary rehabilitation program. The Section of Pulmonary and Critical Care Medicine has an innovative procedure service which performs many diagnostic studies including bronchoscopy and pleural and transthoracic needle biopsies. A multidisciplinary sleep lab is jointly managed by the Section of Pulmonary and Critical Care Medicine and Department of Neurology. Finally, our pulmonologists are an integral part of an ever-growing pulmonary transplant program which has ranked in the top five programs for total surgical volume since 2015.
The Section of Rheumatology maintains active ambulatory care and inpatient consultation services in the broad range of rheumatic and connective tissue disorders. Residents participate in daily office hours with faculty and attend the weekly rheumatology clinic. They are encouraged to learn various procedures essential to the practice of rheumatology such as arthrocentesis and joint fluid analysis. Formal educational programs include weekly journal club, rheumatology grand rounds, and a patient management conference.
Temple University Emergency Medical Services provides a walk-in care center as well as one of the busiest emergency departments in Philadelphia. Temple University Medical Services is a Level I Regional Trauma Center. This affords the house staff an opportunity to see a wide spectrum of clinical problems with around-the-clock back-up by attending physicians. Teaching activities include individualized bedside rounding, an exposure to urgent care (fast-track), and bedside ultrasound, to name a few. In addition, Temple University Hospital has a formal residency training program in Emergency Medicine.
Although not an exhaustive list, we offer additional electives in the following areas:
Health Center rotation (free clinics of Philadelphia)