Departmental Course: Internal Medicine

​Medicine Student Programs

Program Coordinator: Lan Nguyen

Phone: 206.616.5137
Email: lnguye17@uw.edu


Block Calendar:

All Medicine rotations are four (4) weeks in length. Your clerkship dates must correspond with our Clinical Elective Schedule. You must start at the beginning of the block(s) and finish at the end of the block(s).

Prerequisites for all Medicine Elective Clerkships listed below:

  • Fourth year medical student standing, and completion of eight weeks internal medicine rotation(s).
  • Students must also complete and upload to VSAS our Medicine Supplemental Application Form.docx.
  • We require all students to have a recent transcript uploaded to VSAS. Canadian students may have them emailed to Lan Nguyen, lnguye17@uw.edu.
  •  Students must have passed Step One or the COMLEX and submit scores on our Medicine Supplemental Application Form.

To Apply:

  1. Complete the VSAS application and upload all supplemental materials to VSAS. No action will be taken on an application until it is complete and fully approved by the UWSOM Visiting Student Office. Applications must be received and approved at least 6 weeks prior to the start of the requested clerkship date. 
  2. We will accept applications starting March 1, 2017 for the 2017-2018 academic year.
  3. Our enrollment period for the 2017-2018 academic year will be May 15, 2017 through December 4, 2017. We will only schedule students during that time, but will fill all spots for the year with eligible students on a first-come, first-served basis.  If you have not uploaded your transcript and our Medicine Supplemental Application Form, you will not be considered for an elective.
  4. If space is available, students will be matched to open elective rotations and notified via VSAS no later than 6 weeks prior to the beginning of the elective.
  5. Students using VSAS to apply should upload their home institution evaluation form.  If it is an electronic evaluation, note this on our medicine supplemental application form.

Cancellations:
You must withdraw at least 6 weeks before your starting date. Fees are non-refundable. All cancelations and changes must be made in writing to the department contact listed above.

Absence Policy:
Please note our absence policy. Absences from subinternships for interviews are particularly discouraged.  Each elective has standard days off (often weekend off for consult electives and 4 total days during the month for a subinternship.) Additional days off are generally not allowed. Please do not schedule an elective during a time when you are expecting to do residency interviews. One day off for a local interview may be granted with at least two weeks of advanced notice at the discretion of the clerkship director.


 

​ MEDECK 604 – Clinical Dermatology

Participation in dermatology clinics and inpatient consultations at the in University of Washington Medical Center, Harborview Medical Center, and the Seattle VA Medical Center. Journal Club and clinical conferences are held each week with entire staff in addition to a continuing series of teaching seminars and weekly dermatopathology conferences.

Objectives
At the end of the clerkship, the student will be able to:

  • Evaluate patients seen in consultation with a member of the Dermatology Inpatient Consulting team.
  • Demonstrate basic approach to the diagnosis and management of the most common skin problems.
  • Discuss basic principles and practice of oral and topical dermatologic therapy with wet dressings, steroids, emollients and antipruritic therapy.
  • Recognize major life-threatening skin diseases and markers of systemic disease.
  • Utilize dermatologic vocabulary in order to generate clinical differential diagnoses and accurately describe a rash or a lesion when requesting consultative services.
  • Recognize common skin tumors, and understand appropriate diagnostics tests used in dermatology.
  • Demonstrate appropriate history-taking and general physical examination with special attention to examination and description of the skin.
  • Construct write-ups and oral presentations to be as precise and efficient as possible in communication about patients.
  • Perform special diagnostic procedures (KOH, Tzanck test, patch test, skin biopsy) to assist in delineating patients’ problems.

MEDECK 605 – Clinical Endocrinology and Metabolism

This clerkship makes use of a number of teaching sites in Seattle, including the University of Washington Medical Center, Harborview Medical Center, and the VA Medical Center. Students will see inpatient consults with an Endocrine Attending and Fellow, and attend a variety of outpatient clinics. The outpatient experience includes subspecies clinics in metabolic bone disease, intensive diabetes management, and atherosclerosis prevention. Students will also spend several half days per week in the office of an endocrinologist in private practice. Finally, each student will select a topic for a reading project in endocrinology. The results of the student’s literature review will be discussed at a post-clinic conference at some point during the month.

For any of the above rotations, the student should be able to perform and interpret a history and physical examination without instruction. Emphasis on rounds and in the clinic is on basic endocrine clinical pathological correlation and its application to the practical aspects of patient care.

NOTE: Means of transportation between various teaching sites will be necessary.

MEDECK 606 - Clinical Gastroenterology

Goals:
Students acquire in-depth experience in clinical gastroenterology, with close mentoring by members of the Gastroenterology faculty and are exposed to a broad range of state-of-the-art diagnostic and therapeutic endoscopic procedures.

Objectives:
At the end of the clerkship, the student will be able to:

  • Evaluate patients seen in consultation with a member of the Gastroenterology Inpatient Consulting team.
  • Discuss and identify underlying pathophysiologic mechanisms of GI diseases with GI illness and complaints.
  • Discuss the capabilities as well as limitations of endoscopy in clinical practice.
  • Discuss appropriate indications and contraindications for endoscopic procedures.
  • Discuss key elements for providing excellent consultative service in Inpatient medical care.

Description: Students join and become responsible members of the Gastroenterology Inpatient Consulting team at one of the three teaching hospitals of the University of Washington (UWMC, HMC, VA).
Schedule: Weekdays, work hours to be determined by Attending Physician. No night or weekend responsibilities.
Conferences: Teaching rounds with the Attending and Senior Fellow are held 5 days per week. Assigned cases are presented to the full team, and thereafter followed regularly by the student. Students are strongly encouraged to attend regularly scheduled GI educational conference (Fridays, 7:30-10 am).
Presentations: At the discretion of the Attending physician.
Readings/texts: A syllabus containing reading material reprints is available for purchase.

MEDECK 607 – Clinical Hematology/Oncology

This clerkship is taught at the University of Washington Medical Center, Harborview Medical Center, and the Seattle VA Medical Center. At each hospital the hematology-oncology elective consists of one month of training during which students work up patients in the inpatient and outpatient services under supervision of a clinical Fellow and the faculty of the Divisions of Hematology and Oncology. General hematology and oncology problems are evaluated at all hospitals but special opportunities for hemostasis problems and HIV-related disorders are available at Harborview and bone marrow transplantation at the VA Medical Center.

MEDECK 608 – Clinical Infectious Diseases

Inpatient consultation services at the University of Washington Medical Center or Seattle VA are staffed by members of a large faculty and fellowship program. Students see 3 - 5 new patients per week and make daily rounds with an infectious disease fellow and/or medicine resident. Formal attending rounds are held 3 - 5 days per week with additional sessions for urgent patient problems and teaching. Medical microbiology conferences are held regularly at all sites, and there is a weekly interhospital clinical conference. Emphasis of the clerkship is on the varied diagnostic and therapeutic challenges prevalent in general hospitals. The Infectious Disease rotation at HMC involves inpatient consultations under the supervision of faculty, infectious disease fellows and residents, and may involve the opportunity to work with faculty and staff in the STD clinic, Hansen's Disease Clinic, and the TB clinic.

MEDECK 609 – Nephrology and Fluid Balance

A nephrology/fluid balance clerkship at University of Washington Medical Center, Harborview Medical Center, and the Seattle VA Medical Center. It is a one-month elective for fourth-year medical students who will see clinical nephrologic problems under close supervision. They participate in nephrology rounds, see consults with renal fellow and attending, and work up patients in renal clinics. They also attend a series of seminars throughout the clerkship in which clerkships at all three hospitals participate.

MEDECK 610 – Clinical Respiratory Disease

Students are assigned to the consultation service in Respiratory Disease at one of three teaching hospitals (UWMC, HMC, and VAMC). They will gain training and experience in respiratory disease diagnosis and management with emphasis on x-ray diagnosis, pulmonary function testing and interpretation, and use of fiberoptic bronchoscopy. The services are fully integrated with Respiratory Therapy for management of continuous mechanical ventilation and use of inhalational and physical therapy. Patients are seen by the students under supervision of a Fellow, and presented to the Attending. Students from all hospitals will attend a weekly Chest Grand Rounds, a Respiratory/Critical Care teaching conference, and a series of eight student seminars covering basic topics in clinical respiratory medicine. Students will participate in pulmonary function testing and, at some sites, one half-day outpatient clinic.

MEDECK 612 – Clinical HIV Care

The purpose of this elective is to provide students with an intensive one-month experience caring for HIV-1 infected patients. The development of potent antiretroviral therapy has led to marked reductions in morbidity and mortality due to HIV-1 and has shifted the care of infected patients from the inpatient to the outpatient setting. Nevertheless, individuals with limited access to medical care do not benefit from these therapies and often present late in the course of their HIV infection and require hospitalization. Institutions such as HMC that provide care for under-insured and uninsured patients still manage significant numbers of HIV infected inpatients with opportunistic infections and malignancies. The Madison Clinic at HMC provides outpatient care to HIV-infected persons with an emphasis on the management of antiretroviral therapy, prophylaxis of opportunistic infections and treatment of the complications of HIV infection. Students will split time between the Madison Clinic and the inpatient services each day. Exposure to inpatient HIV patients will take place by interfacing with the infectious diseases consult service for 1-2 hours most days. Students will split their time between the Madison Clinic (Harborview HIV Clinic) and the inpatient HIV consult service. Student will usually see patients and interact with providers and the attending physician in the Madison Clinic at the beginning (8:30 - 11:00 am) and end (2:30 - 5:00 pm) of each day. Mid-day (11:00 am - 2:30 pm) students will round on HIV+ inpatients and interact with the ID/HIV consult service. Daily schedules vary considerably depending on the activity of the inpatient consult service, the clinic and the particular interest of the student.

MEDECK 615 – Rheumatology

Elective provides third- or fourth-year students experience in the diagnosis and management of patients with rheumatic diseases. Students will attend outpatient clinics at the University of Washington Medical Center, including the Bone and Joint Center, Harborview Medical Center, or VAMC, and will participate in inpatient consultation. In addition to patient contact, four or five preceptorial sessions are held each week. These seminars cover rheumatic diseases in depth. The topics include: joint examination, laboratory tests in rheumatic diseases, examination of synovial fluid, radiology of rheumatic diseases, rheumatoid arthritis, hyperuricemia, gout, systemic lupus erythematosus, degenerative joint disease, spondylitis, vasculitis, and polymyalgia rheumatica. These sessions emphasize disease mechanisms as well as diagnostic and therapeutic aspects. During the 4-week period, students have ample time for independent reading. Students work closely with faculty and staff of the Division of Rheumatology throughout the 4-week elective.

Paper:
All students will be expected to do a 3-5 page paper on a topic approved by the rheumatology consult attending. In addition, students will be expected to present a weekly topic during inpatient rounds for 5 minutes that is literature based and pertains to a patient issue approved by the consult fellow.

NOTE: Be prepared to travel between UW Medical Center, Harborview Medical Center, and VA Medical Center.

MEDECK 616 – Advanced Clinical Dermatology

This is an advanced dermatology elective; each student will focus on one or two of four areas, which will be determined prior to starting the rotation. These areas are: Dermatologic Surgery, Dermatopathology, Pediatric Dermatology, or Advanced Medical Dermatology. The rotation will be tailored to the student’s interest whenever feasible. Prerequisite: General dermatology at your home institution. If there is no such rotation at your home institution, an equivalent rotation at another rotation will be considered. Verification must be uploaded to VSAS, and can be in the form of transcript, copy of grade, or letter of verification from course director.

Goals & Objectives:

Depending upon the clinical interest of the student, the student will achieve one or two of the following (to be determined prior to starting the rotation). Each area will allow the student practice to refine and condense write-ups and oral presentations to be as precise and efficient as possible in communication about patients. Students will also develop a scholarly project with the intended goal of submission for publication.

Dermatologic Surgery:

  • To learn the natural history of common skin cancers.
  • To learn the principles of surgical and non-surgical management of common skin cancers.
  • To learn basic suturing technique of the dermis and epidermis.
  • Design treatment plans for patients with Basal Cell Carcinoma, Squamous Cell Carcinoma, and Malignant Melanoma that address surgical and non-surgical options, with support from the literature when possible.
  • Perform an excision, including intermediate layered closure, on an animal model such a pig skin, or artificial model substrate.

Dermatopathology:

  • To learn the approach to examining histologic specimens of the skin.
  • To learn how to build a differential diagnosis for both tumors and inflammatory conditions in skin biopsies.
  • To learn the importance of the clinicopathologic correlation.
  • Recognize normal skin histology and dermatopathology terminology.
  • Recognize the histopathologic appearance of common skin tumors.
  • Recognize the general categories of histopathologic inflammatory patterns.

Pediatric Dermatology:

  • To learn the approach to the diagnosis and management of the most common skin problems encountered in the pediatric population.
  • To learn the basic and intermediate principles and practice of oral and topical dermatologic therapy in children, with steroids, calcineurin inhibitors, antibiotics, and isotretinoin.
  • To learn how to interact with both child and parent to obtain a complete history and effectively communicate a treatment plan.
  • Recognize common pediatric skin diseases.
  • Describe the features of two less common genetic skin diseases or syndromes.
  • Develop a treatment plan for a child with chronic atopic dermatitis.
  • Understand options for managing common pediatric skin infections including impetigo, warts, molluscum, and tinea.

Advanced Medical Dermatology:

  • To refine the approach to the diagnosis and management of the most common skin problems encountered in a complex medically ill population.
  • To learn basic and intermediate principles and practice of oral and topical dermatologic therapy with wet dressings, steroids, emollients and antipruritic therapy.
  • To learn to recognize major life-threatening skin diseases and markers of systemic disease.
  • Develop a differential diagnosis for one inpatient or outpatient with complex medical dermatologic diseases with a member of the Dermatology inpatient team or outpatient attending.
  • Develop a treatment plan, with support from the literature when possible, for one inpatient or outpatient with complex medical diseases.

MEDECK 618– Medicine Consult Service

Goals:

  • Reinforce excellence in history taking, physical exam, and clinical reasoning skills.
  • Achieve better understanding of the assessment and management of multisystem disease.
  • Understand basic peri-operative risk assessment and management.
  • Gain competency in best practices of effective consultation

Objectives:

  • Student will be exposed to peri-operative consultative internal medicine.
  • At UWMC, the student will work with the team of Medicine Consult physicians to evaluate and manage inpatients and outpatients on a consultative basis.
  • At HMC, the student will operate as a member of the consult team, working closely with residents and attendings to evaluate surgical and psychiatric patients on a consultative basis in the emergency room, as outpatients and as inpatients.
  • The student will assume responsibility for all aspects of patient care in keeping with his/her interest and ability. ​

MEDECK 624 - Hospitalist Subinternship

Availability is extremely limited July-Sept

Students will serve as interns working primarily one-on-one with hospitalist attending.  They will attend all regular medical rounds and conferences as their schedule permits. Students are given responsibilities commensurate with those of interns under supervision by the Attending.  Descriptions of our two sites:

  1. HMC Hospital Medicine Subinternship: This is an intensive experience in hospital medicine at a county hospital in which the student works for two weeks on a hospital medicine service during the day and for two weeks at night, doing "cross-cover" and admitting patients. The student works primarily one-on-one with an attending hospitalist or nocturnist but does interact with the ward medicine team at night.
  2. The University of Washington Medical Center subinternship is on the hospitalist service at a tertiary care center with a significant proportion of patients with end-stage liver disease, inflammatory bowel disease, cystic fibrosis and complications of solid organ transplants. Students spend two weeks working directly with the attending physician on the hospitalist service during the day and two weeks with the nocturnist and resident team admitting patients and assisting with "cross-cover" issues on existing patients.

​MEDECK 671 Subinternship in Boise, Idaho

This course is by permission only. Please contact Linda Clark, Linda.Clark4@va.gov for more information and requirements to apply.

  • Students will serve as interns at the Boise Veteran Affairs Medical Center in Boise Idaho. on the medical wards under supervision of house staff and attending physicians. They will attend all regular medical rounds and conferences as their schedule permits. Students are given responsibilities commensurate with those of interns under supervision by the Resident and Attending Staff. More information about the Boise VA Medicine Residency program can be found at www.boiseinternalmedicine.com