The Ochsner Medical Institutions offer a diverse array of hospital-based and/or ambulatory care Internal Medicine rotations for medical students.

The hospital-based experiences use the advanced facilities and resources of the Ochsner Clinic Foundation. The Joint Commission on Accreditation of Health Care Organization (JCAHO) has awarded the Ochsner Clinic Foundation a Four Year Accreditation with Commendation. This is recognition of excellence that is given to less than 5% of hospitals in the United States.

Internal Medicine practice increasingly emphasizes diagnostic and therapeutic decision making in the ambulatory setting. Ochsner ambulatory care activities take advantage of the Ochsner experience in pioneering outpatient multispecialty medicine. The ambulatory care electives can occur in several different settings, including one of the world's largest multispecialty clinic group practices, a primary care internal medicine clinic, a primary care neighborhood clinic, and tertiary care clinics.

Both the inpatient and the ambulatory care activities take advantage of the uniquely large and diverse Ochsner patient population. Ochsner has extensive experience providing both primary care and tertiary medical services. Therefore, residents and students care for patients with common as well as unusual medical problems. The diversity of sites and patients assures students a comprehensive exposure to the full range of medical problems.

Each of the Internal Medicine sections has provided a description of its senior student elective. In addition to these experiences, students at Ochsner can attend daily morning report conferences, daily noontime general and subspecialty internal medicine conferences, internal medicine grand rounds, and many other didactic programs.

General Internal Medicine Inpatient Elective

Duration

4 weeks

Objectives

The General Internal Medicine Inpatient Elective is designed to provide students with exposure to the highest quality inpatient internal medicine patient care services in a state-of-the-art medical facility with the most modern diagnostic and therapeutic modalities of care. This elective will allow students to see a wide variety of medical conditions in a diverse patient population in post-Katrina New Orleans.

Course Outline

The elective will be based at the main Ochsner Campus on Jefferson Highway. Students will be part of an internal medicine team that includes two first-year residents, a second- or third-year resident, a PharmD, and an attending physician. Most of the attendings are Internal Medicine hospitalists who specialize in inpatient care and who practice and teach the most effective, efficient, and cost-effective treatment of hospitalized patients.

The Ochsner Medical Center is both a community medical center for the New Orleans area as well as a tertiary care referral center for patients from the Southeastern United States and Central and South America. Students will therefore admit and follow patients with a wide variety of medical problems ranging from primary through tertiary levels of medical care.

Students will also attend daily morning report and noon conference. They will participate in extensive formal patient teaching rounds, during which the entire team will review in depth the pathophysiology, differential diagnosis, physical examination findings, medical/legal issues, treatment, and cost-effective practice of medicine.

Method of Evaluation

Standardized online student evaluations through myevaluations.com will be utilized for most students. Some exceptions to this may include, but are not limited to, LSU students and visiting students. Given that the student rotation in general is a month in duration, the attending who spent the most time with the student will be the evaluating staff in most circumstances.

Cardiology

Duration

4 weeks

Course Outline

This is 4-week rotation for a third- or fourth-year medical student (preferably fourth) on one of our inpatient cardiology teams. The medical student will be attached to an internal medicine resident (usually PGY 1 paired up with either a PGY 2 or PGY 3), along with a cardiology attending and a cardiology fellow. The medical student will participate in daily morning rounds in the coronary care unit and inpatient cardiology floor. He or she will be expected to work up selected patients and to act as that patient's intern ("extern"). During this rotation, case presentations will be given to various members of the cardiology staff by the internal medicine resident teams rotating on cardiology. The medical student will have the opportunity to attend daily morning report, to observe and perhaps participate on selected occasions, with the more senior medicine residents in presenting interesting admissions. Opportunities to participate in formalized interpretation of electrocardiograms are available and can be arranged through the assigned attending staff cardiologist(s) for that rotation. In addition, the Cardiology Section has five to six conferences per week as part of the Cardiology Fellowship Training Program. Some of these lectures will be particularly valuable for the medical student (e.g., Friday morning catheterization conference). For interested students, time can be arranged for the medical student to observe the operation of an exercise stress laboratory and echocardiography laboratory. Basic approaches to the interpretation of exercise stress testing and a general understanding of the capabilities of a cardiology echocardiography laboratory can be achieved by such an exposure. In summary, this elective will give a medical student a well-rounded exposure to a modern cardiology service.

Clinical Endocrinology and Metabolic Diseases

Duration

4 weeks

Objectives

This elective focuses on the pathophysiology, diagnosis, and therapy of endocrine and metabolic diseases, including:

  • Diabetes Mellitus
  • Diabetes Education
  • Disorders of Lipid Metabolism
  • Hyper and Hypothyroidism
  • Thyroid Nodules and Thyroid Cancer
  • Pituitary Deficiencies
  • Secretory Abnormalities of the Pituitary, including:
    • Hyperprolactinemia
    • Acromegaly
    • Adrenal Disorders
  • Abnormalities of Calcium Metabolism
  • Metabolic Bone Diseases and Bone Density Interpretation
  • Reproductive Endocrinology Disorders

The elective also provides an opportunity to improve general internal medicine knowledge and patient care skills. Students will be active members of the Endocrinology Section patient care team and will evaluate and manage selected hospital and clinic patients. They will attend daily Ochsner Clinic Foundation teaching rounds and clinical literature review and research conferences. In addition, students may attend any of the many other Ochsner conferences.

The elective is flexible and can easily accommodate specific interests of individual students, including diabetes and osteoporosis, evaluation and management of hypercholesterolemia and other lipid disorders, clinical research, and medical informatics.

Gastroenterology

Duration

4 weeks

Objectives

The objective of the elective is to introduce the student to clinical gastroenterology. We attempt to integrate the student into a clinical rotation similar to that of the interns whereby he or she is responsible for the admission history and physical examination of a hospitalized patient for whom the primary service has requested a GI consultation. The student will be expected to discuss the case with the GI fellow, review the scientific literature pertinent to the case, and finally present the case to the attending during rounds. The student will make daily rounds with the house staff and attending on all patients on the GI service, will attend all of the GI-oriented conferences, and may be asked to participate in one during his or her period of time here. He or she will be introduced to the procedural aspects of gastroenterology, including endoscopy and colonoscopy, and will have the opportunity to observe these in both his or her patients and others. There will be a strong interaction between the student and the other services that share in the management of gastroenterology patients, such as general and colorectal surgery, pathology, and radiology.

Method of Evaluation

The student will be evaluated by the attending staff on the hospital service in Ochsner Clinic Foundation during the time of his or her stay.

Clinical Infectious Diseases

Duration

4 weeks

Objectives

To familiarize the student with methods of diagnosing and treating infectious diseases due to common and exotic microorganisms.

Course Outline

Make daily rounds with attending staff, Infectious Diseases fellow, and Internal Medicine postgraduates. Be responsible for certain patients in association with Internal Medicine postgraduates. See outpatients under supervision of attending staff. Attend all Infectious Diseases conferences and participate in case presentations on occasion.

Method of Evaluation

Review of work performed including expression of knowledge during rounds.

Clinical Nephrology

Duration

4 weeks

Objectives

To familiarize the student with diagnostic evaluation and therapy of patients with acute and chronic renal diseases, fluid and electrolyte problems, acid base disturbances, kidney and kidney/pancreas transplantation, and hypertension of renal parenchymal or renovascular origin.

Course Outline

The student will be assigned patients with renal, hypertension, or fluid and electrolyte problems for initial evaluation and follow-up. During the clinical clerkship, exposure to patients with chronic renal failure and secondary complications is emphasized. During rounds with the attending nephrologist, discussions will focus on differential diagnosis, evaluation, and therapy of patients' problems. Physiologic and pathophysiologic concepts will be emphasized. Experience with management of patients on dialysis is provided. Nephrology conferences are conducted twice weekly to cover basic topics in nephrology and hypertension. The student, if admitted to the service, may manage post-kidney and post-kidney/pancreas transplant patients.

Method of Evaluation

Subjective evaluation by the attending nephrologist on hospital service during time of the elective using standard evaluation sheets provided by Ochsner Clinic Foundation, Office of Graduate Medical Education.

Clinical Neurology

Duration

4-6 weeks

Course Outline

Introduction to clinical neurology in a clinical setting.

Method of Evaluation

Staff observation of clinical ability.

Pulmonology/Critical Care Medicine

Duration

Four-week rotations can include Pulmonary, Critical Care Medicine, or combined experiences.

Objectives

Intensive teaching of clinical pulmonary medicine with applied pulmonary physiology. Emphasis on evaluation; diagnosis using radiographic, bronchoscopic, and other techniques; and treatment of both common and unusual pulmonary diseases.

Course Outline

Students make morning rounds with staff, attend conferences (clinical topic, pathology/physiology) within the pulmonary section, work up select inpatients, and participate in their cases. Students will have the opportunity to participate in bronchoscopy and other procedures and presentation cases and chest x-ray interpretation that are given particular stress.

Method of Evaluation

The student is evaluated through a compilation of information from the various staff and residents to whom he or she has been assigned from the standpoint of knowledge, participation, and enthusiasm. No formal examination is given.

Rheumatology

Duration

4 weeks

Objectives

To demonstrate and teach rheumatologic principles and practice skills in a multispecialty clinic setting designed for outpatient rheumatologic management. In addition, daily rheumatology consult rounds provide experience in the rheumatologic evaluation of hospitalized patients.

Course Outline

Morning outpatient clinics will take place daily under the direct supervision of one of four full-time staff rheumatologists, with opportunities both to work up individual cases as well as to tag along with the attending staff and see patients with the attending as well as to participate in a broad exposure to a multitude of rheumatic diseases, with opportunities for demonstration of historical points, physical findings, and therapeutic management strategies. The student will also participate in oral presentations and scheduled rheumatology conferences and will attend lectures as scheduled in conjunction with house staff and other attending physicians. Students will also be exposed to the latest evaluation techniques (DEXA, heel ultrasound) as well as new management strategies for osteoporosis. The student is strongly encouraged to write case reports or clinical reviews under the direction of one of the staff, often leading to publication.

Method of Evaluation

By attending medical staff.