Required Rotations in the Osteopathic Traditional Rotating Internship at St. Luke’s
The curriculum is structured to fulfill all the requirements set by the AOA for the Osteopathic Traditional Rotating Internship and by the ACGME for a Transitional Year Residency. Each rotation is one month long.
The General Medicine Teaching Service
Each resident is required to rotate for four months on general medicine. There are two general medicine teaching services. A board-certified general internist faculty member leads each team and serves as the teaching attending and the attending of record. Other team members include a senior resident who is either in the second or third year of training, two first-year residents and two medical students.
The majority of the patients admitted to this service are from our medical clinic. The admissions represent a broad spectrum of clinical diseases. Patients range in age from eighteen to geriatric. Each first-year resident manages, under the supervision of the attending and senior resident, seven to ten patients. Topics pertinent to patient care and/or otherwise of interest to the teaching team are discussed daily during teaching rounds. A series of pertinent review articles are provided and discussed during the rotation.
Areas of emphasis during this rotation include diagnosis and management of general medical problems, doctor-patient communication, ethical issues related to primary care, indications for subspecialty consultation and appropriate discharge planning.
The faculty and resident staff take an active role in teaching medical students from Temple University School of Medicine and the Philadelphia College of Osteopathic Medicine.
Emergency Medicine
Each resident is required to rotate for one month on Emergency Medicine.
St. Luke's is a Regional Resource (Level One) Trauma Center. Residents, under the direct supervision of a faculty of ten board-certified emergency medicine physicians, participate in the evaluation and treatment of more than 67,000 patients a year presenting to our active, newly renovated facility. There is a broad spectrum of clinical cases including the specialized care of trauma patients, acute and decompensated chronic illnesses and non-urgent complaints that are evaluated in the “fast track” area. Interns attend a three-hour weekly educational session to review a curriculum of topics pertinent to the field. Residents also participate in the monthly Journal Club.
Family Practice
Each resident is required to rotate for one month on the family medicine rotation.
The rotation in family medicine occurs in a private family practitioner's office. The goal is to develop skills in the diagnosis and management of common ambulatory problems. Osteopathic principles are integrated into the practice. Indications for specialty referral and office management issues are reviewed. During this rotation, the resident attends the weekly Family Practice Education Day each Tuesday.
Critical Care Rotation
Each resident is required to rotate for one month on the Critical Care rotation.
Pulmonary critical care specialists serve as the teaching attendings. This popular rotation includes an excellent opportunity to manage critically ill patients using evidence-based medicine, to gain experience in performing invasive procedures and to function as part of a multidisciplinary team. Call is every fourth night.
The Internal Medicine Subspecialty Rotations
Each resident is required to take a minimum of two, one month rotations on the medical subspecialties service which include cardiology, endocrinology, gastroenterology, geriatrics, hematology/oncology, infectious diseases, nephrology, and pulmonary.
A typical day includes completion of consultations; admissions to the service; follow-up visits; performing procedures and discharge planning. Each case is reviewed at the bedside with didactic teaching and case-based discussions integrated into rounds.
Elective Rotations
The traditional rotating osteopathic intern may chose from a wide variety of electives including:
- Additional critical care experience
- Internal medicine subspecialties
- Neurology
- Palliative Care Medicine
- Pediatrics
- Radiology
- Surgery
- Surgical subspecialties
- Women's Health
Each resident has three months of elective time.
Geriatrics
The goal of this rotation is to introduce the resident to the medical, social, functional and financial aspects of the care of older adults. A board-certified geriatrician serves as the faculty for this outpatient-based rotation. The accessing and proper use of community resources is emphasized. Sites for this rotation include nursing homes, retirement villages, home visits, rehabilitative day care centers and hospital consultations.
Palliative Care Rotation
The goal of this one month elective rotation is to develop the resident's competency in end-of-life care (palliative and hospice) in a variety of settings. Working as part of a multidisciplinary team, the resident sees hospice patients in their homes, in the outpatient free standing Hospice House and in consultation in the hospital.
Pediatrics
The goal of this one month elective rotation is to allow the resident, under the supervision of board certified teaching faculty, the opportunity to acquire and develop skills in the diagnosis and management of pediatric disorders. The resident may request to rotate entirely on the inpatient service or split the time between the inpatient and outpatient setting. Clinical experiences are complemented by conferences, lectures and patient directed readings.
Radiology
This one-month elective rotation provides the resident with experience in interpretation of plain films and allows the resident to rotate throughout the specialty areas of neuroradiology, nuclear medicine, ultrasound, interventional radiology, mammography, MRI and CT scanning to develop an appreciation of the indications, contraindications and limitations of various diagnostic and therapeutic imaging techniques.
Surgery
The goal of this one month elective is to allow the resident the opportunity to acquired and develop skills in the diagnosis and management of surgical disorders and to learn the criteria for referral to the appropriate surgical discipline. The resident is an integral part of the team composed of the chief resident, senior resident, junior resident and one to two medical students. The resident participates in the weekly Surgical Core Curriculum Conferences.
Women's Health
This elective rotation emphasizes the evaluation and treatment of common clinical entities in the field of women's health. Under the guidance of the program director in obstetrics and gynecology and the teaching faculty in the obstetrics and gynecology residents' clinic, the resident sees patients daily in the gynecology clinic and other specialty clinics such as abnormal Pap clinic, reproductive endocrine clinic and the prenatal and high-risk obstetrics clinic. Didactic conferences include the weekly half-day educational conference, obstetrics grand rounds and gynecology grand rounds.