Subspecialty and Interdepartmental Learning

The Internal Medicine Residency Program provides ample exposure to the medical subspecialties through various electives and subspecialty teaching teams.  Residents also rotate through the Emergency Room and have the opportunity to rotate in non-medicine electives such as Neurology, Radiology, OB/GYN, Anesthesiology, Dermatology, and more.

Each of the Internal Medicine subspecialties has a fellowship program with enthusiastic academic faculty who are dedicated to teaching, patient care, and research. Residents have the opportunity to work with these faculty and gain exposure to these subspecialities in a few ways:

• Longitudinal Ambulatory Subspecialty Experience:  Each resident has the option to select 1-2 continuity Ambulatory Subspecialty Electives that occur during their ambulatory weeks in a subspecialty of their choosing, with the option to modify based on career interests. This gives residents the opportunity to have a longitudinal experience in a subspecialty clinic and to develop a relationship with a clinical mentor.
• Electives: These are 1-2 week electives (outpatient or inpatient) in any of the subspecialty areas that 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 from our Faculty & Fellows.
• In-patient subspecialty teaching teams: These are inpatient teaching teams led by specialists. They include
  
  • Heart failure: This service consists of patients with heart transplants, VADs, pulmonary hypertension and right heart failure. It is staffed by a Heart Failure trained attending.
  • Pulmonary: This service consists of patients with complex underlying lung disease, many who are undergoing transplant evaluation.
  • Nephrology: This is dually staffed by a Nephrology and Transplant Nephrology attending where residents learn about the nuanced care of dialysis patient and transplant patients.
  • Bone Marrow Transplant: This is located at Temple University-Jeanes Hospital and Fox Chase Cancer Center and is led by oncologists who work at the nationally recognized Fox Chase Cancer Center. Residents care for patients with liquid and solid malignancies, including stem cell transplant recipients.

Details about the specific subspecialties are listed below.

Cardiology

The Section of Cardiology offers full service in invasive cardiology including cardiac catheterization, endomyocardial biopsy, balloon valvuloplasty, peripheral arterial and venous interventions,  pulmonary hypertension/right heart failure, CTEPH, percutaneous mechanical circulatory support, ventricular assist devices, heart transplant, balloon pulmonary angioplasty, advanced electrophysiology procedures including device implantation, lead extraction, and radiofrequency catheter ablation for VT and atrial arrhythmias. Other specialized cardiology areas include preventive Cardiology, advanced echocardiography including transesophageal, advanced structural, exercise and contrast echocardiography, and both nuclear cardiology and cardiac MRI programs. Other services include Cardio-Obstetrics, cardiac rehabilitation, and a dedicated cardiac intensive care unit (CCU).

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 Pulmonary Hypertension, Right Heart Failure, and CTEPH Program is one of the busiest and most respected in the nation, drawing patient referrals from all over the United States.

The Bashir Endovascular Catheter developed by Temple Cardiologist, Dr. Riyaz Bashir, received premarket clearance by the FDA in 2019 and is used for catheter directed thrombolytic therapy for acute PE.

Resident rotations:

• Inpatient Heart Failure service
• Cardiac ICU
• In-patient Elective Consults or Outpatient Clinic: General Cardiology, Electrophysiology and Pulmonary Hypertension and Right Heart Failure
• Longitudinal Ambulatory Subspecialty Clinic:  Residents can select any of the above or outpatient Interventional Cardiology as a longitudinal experience

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.

Resident rotations:

• Inpatient Endocrinology consults
• Outpatient Endocrinology elective
• Longitudinal Ambulatory Subspecialty Clinic

Gastroenterology

The Section of Gastroenterology provides 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. The elective experience includes inpatient consultation GI rounds, outpatient GI experience, hepatology consults, case discussions, pathophysiology, endoscopy, radiology and pathology conferences, and a journal club.

Resident rotations:

• General inpatient Gastroenterology consults
• General outpatient Gastroenterology elective
• General inpatient Hepatology consults
• General outpatient Hepatology elective
• Interventional Gastroenterology elective 
• Longitudinal Ambulatory Subspecialty Clinic

Hematology and Oncology

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.

Resident rotations:

• Inpatient Hematology consultations at Temple
• Inpatient Bone Marrow Transplant service at Temple University – Jeanes Hospital
• Outpatient Oncology electives at Fox Chase Cancer Center
• Longitudinal Ambulatory Subspecialty Clinic at Fox Chase Cancer Center

Infectious Diseases

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. Many 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.

Resident rotations:

• Inpatient general ID consults
• Inpatient transplant ID consults
• Outpatient ID elective, including HIV Primary Care
• Longitudinal Ambulatory Subspecialty Clinic

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 Nephrology service. Participation in the weekly nephrology grand rounds, journal clubs and pathology conferences are 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.

Resident rotations:

• Inpatient Nephrology service
• Inpatient Nephrology consults
• Outpatient Nephrology clinics – Dialysis clinic, Peritoneal Dialysis clinic, General hypertension clinic, CKD clinic, Lupus clinic
• Longitudinal Ambulatory Subspecialty Experience

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.

Resident rotations:

• Inpatient Pulmonary service
• ICU
• Inpatient Pulmonary consults
• Outpatient pulmonary elective – Clinic, PFTs, Pulmonary Stress Test, bronchoscopy suite
• Longitudinal Ambulatory Subspecialty Experience

Rheumatology

The Section of Rheumatology maintains active ambulatory care and inpatient consultation services in the broad range of rheumatic and connective tissue disorders. They have the opportunity to rotate in clinic where they can gain experience in arthrocentesis and joint fluid analysis.

Resident rotations:

• Inpatient rheumatology consults
• Outpatient rheumatology clinic
• Longitudinal Ambulatory Subspecialty experience

Emergency Medicine

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 residents 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, urgent care (fast-track), and emergency medicine bedside ultrasound, to name a few.  In addition, Temple University Hospital has a formal residency training program in Emergency Medicine with renowned academic and clinical teaching faculty.

Other Electives

In addition to the many electives noted above, we currently offer additional electives in the following areas:

Addiction Medicine

Anesthesia

Cardiothoracic ICU

Outpatient Dermatology

Geriatrics

Global Health

Hospital Leadership and Quality Improvement

Neurology

Palliative Care

Point of Care Ultrasound

Radiology

Transgender Medicine

Teaching Resident