Electives

In addition to the full array of traditional electives in internal medicine subspecialties, the program offers several special opportunities. Residents are encouraged to choose from important areas within and related to internal medicine. Furthermore, if one of our residents self-identifies an opportunity that she/he would like to try, we work to create a unique month that fulfills their needs. Our emphasis is on flexibility and helping our residents tailor their training to best meet their future career interests and goals.

Sample List of Electives
and Special Opportunities

Alternative/Complimentary Care & Clinical Nutrition Elective at Various Sites and PSL – Dr. Lisa Corbin oversees the complementary / alternative medicine (CAM) portion of this elective. Exposure to a wide array of alternative providers (acupuncture, chiropractors, herbalists, etc.) both in the community and within the Center for Integrative Medicine at University Hospital. Feel comfortable discussing CAM with your patients, be able to dissuade patients from unsafe practices and encourage the use of beneficial CAM therapies.
Clinical Nutrition – This rotation is incorporated into the alternative medicine/complimentary care rotation and combines an outpatient experience based at the UCHSC clinics with a focus on lipid management, DM and obesity as well as an inpatient experience at PSL with a background in nutritional support (enteral feedings, TPN, global nutrition assessment).
Advocacy -- This is a 4 week elective experience open to all residents (Internal Medicine, Pediatrics and Family Medicine) through UCDHSC. The session will be organized around the theme “Health Care Reform.” The elective features small group, seminar style sessions. It provides an opportunity to explore the current US health care system and efforts to reform the system. Participants will meet with faculty, policy experts, legislators, and advocates, and will have the opportunity to interact with the Colorado Blue Ribbon Commission on Health Care Reform as they put forward a plan for comprehensive health care reform in Colorado. The elective will also include advocacy skills building in the following content areas: developing and implementing a legislative strategy, effective communications (message development and media strategy), coalition building and strategic partnerships, and personal leadership.

Allergy, Asthma and Clinical Immunology – Dr. Stephen Dreskin oversees this elective. Know the clinical manifestations, presentations, pathophysiology and management of allergic and immunologic diseases including asthma, rhinitis, urticaria, angioedema, immunodeficiency diseases, food allergy, and eczema, learn how to perform and interpret spirometry, learn how to perform and interpret percutaneous skin tests. This is an outpatient experience. The residents see assigned patients with a broad mix of allergic and immunologic diseases and disease severity. Since the residents attend allergy, asthma and immunology clinics at both the University of Colorado Hospital and the National Jewish Medical and Research Center, they see a broad range of patients. Depending on the specific cases seen, residents may have the opportunity to perform spirometry, skin tests, rhinolaryngology, and skin biopsies. Resident duty hours are 50 hours per week. Residents have the opportunity to see inpatient consults with the allergy fellow on call if this is desired.
Cardiology (Community Based) – Available as part of the Outpatient Cardiology and Treadmills. This large general cardiology group allows you to tailor your time with them to your needs. You will spend time with the senior partners (many of whom are former UH faculty) seeing patients with them, but their first question to you is, "What do you want to get out of this time?” They are happy to let you spend time interpreting ECHOs, nuclear stress tests, seeing inpatient consults, or doing more treadmill tests. The partners are excellent general cardiologists who place an emphasis on CAD prevention (primary/secondary) and have a thriving cardiac rehab program.
Outpatient Cardiology and Treadmills – Dr. Judy Regensteiner. Residents will divide their time between cardiology clinic and treadmills. The clinical experience is at a busy private practice in Denver with emphasis on outpatient care of cardiac disease. What happens when you send a patient for a treadmill? In this course, we discuss picking the right test for each patient and what kind of testing protocol to use. In addition, we discuss reasons for testing, interpretation of data (EKG, functional status, etc). At the end of the course, you should be able to conduct exercise testing independently and we will certify you as ready to do this. Many physicians who have completed this rotation are now performing treadmills in their practice settings.
Genetics – Objectives of Rotation: Develop family history pedigree construction and interpretation skills, evaluate the indications and merits of various molecular genetic tests, develop genetic counseling skills, recognize the partnership between the general internist or internal medicine subspecialist and the medical genetics team and better understand the importance of ethical, legal, and confidentiality issues as they relate to genetics. Attendance will be required at relevant conferences including Human Medical Genetics Conference, Genetics Ethics conference and the Adult Medical Genetics Monthly Meeting. Core clinical experiences will include: Adult Medical Genetics clinic, Hereditary Cancer clinic and Children’s Hospital Travel Clinic. Elective Clinical experiences will be built around availability and interest of resident and may include: Cystic Fibrosis clinic, Alpha-1 Antitrypsin clinic, Hemophilia clinic and/or Neuromuscular clinic.
HIV Mini Sabbatical – The Mountain-Plains Education and Training Center, part of the ID Division, conducts monthly HIV mini-sabbaticals which are 2-3 day exposures to HIV care including didactic sections and rotations at clinical sites.
Informatics – Coordinated by Lisa Traditi. The goals and methods of this elective are: To understand the information resources and tools available to support life-long learning: Receive an introduction to a variety of electronic resources and software that will assist in searching, evaluating and organizing medical information. Learn to retrieve information, review basic searching and learn advanced database searching techniques. Learn to filter, evaluate, and reconcile information: Learn how to evaluate and organize information. There are also sessions on keeping up with Professional Resources, PDAs in Clinical Practice, and how to turbo charge Your Web Browser: Plugins .
International Rotations – Learning and practicing medicine in another country is a unique opportunity. The Department of Medicine supports a number of opportunities for residents to train and practice medicine in remote communities. Recent highly rated experiences include The Himalayan Health rotation in India http://www.himalayanhealth.com/ , Spanish language immersion programs with clinical rotations in Peru http://www.machupicchuschool.org/, or Spain http://www.donquijote.org/ Experiences are available in a variety of locations. Residents may choose sites that have been well rated by their fellow housestaff or new opportunities that have an established educational program and a medical school affiliation. Important steps to ensure an excellent experience include identification of a primary supervising physician and health care facility with a daily/weekly schedule describing direct patient care as well as other educational activities. We also ask each participant to outline their personal goals for the rotation. For example, increased awareness of cultural values other than your own, improved communication with patients in another language, exposure to medical cultural beliefs, and unique diseases or health care systems practices.
International Health – Tropical Medicine Courses – In addition to clinical rotations at international sites as outlined in the preceptorship descriptions, The Gorgas Course in Clinical Tropical Medicine http://info.dom.uab.edu/gorgas/ and the London School of Hygiene and Tropical Medicine http://www.lshtm.ac.uk/ are also excellent opportunities for interested residents who are encouraged to apply.
Intro to International Health and Tropical Medicine – Two week course – Monday through Friday 8:00 AM to 5:00 PM .This elective is designed for residents who have a particular interest in tropical infectious diseases and global public health.The course is a combination of lectures, small group sessions and labs that help prepare residents for the unique challenges they are likely to encounter working in a resource-poor setting. The emphasis is on practical medical skills and knowledge while exploring the major public health issues affecting the developing world.The elective is one monthwith 2 weeks devoted to class time and 2 weeks devoted to the resident's individual clinical interests. Options include working in the UH or Rose Travel Clinic, other ID clinics, research, and/or clinical work abroad.
Leukemia/Lymphoma/Bone Marrow Transplant – Learn one-on-one with a faculty member for a month of outpatient and inpatient malignancy experience for interested residents and students. This elective will include intake of newly-diagnosed patients as well as patients with recent relapse, use of diagnostic studies include bone marrow biopsy and molecular testing, and formulation of treatment recommendations. The elective will also include immersion in research meetings as well as multi-disciplinary weekly clinics and case conferences. Opportunities for procedures include bone marrow biopsy and lumbar puncture, the planning and administration of chemotherapy, and stem cell collection and processing.
Primary Care Research – The objective of participating in primary care research is to allow residents exposure to the process of conducting research while allowing them to explore issues that are relevant to them. As a secondary objective it is our aim to encourage presentation of research results at a national meeting as well as publication in a peer-reviewed journal. We encourage residents to take the first research month in conjunction with Medical Informatics. Objectives for this initial month are: 1) Conduct complete literature review, 2) Develop research protocol study plan, 3) Confirm data sources, availability and reliability, 4) Develop study timeline. Objectives for subsequent research months are: 1) Conduct proposed study, 2) Data analysis (working with statistical analyst) and interpretation, 3) Abstract/manuscript, 4) Preparation for abstract presentation meeting. Prior to beginning their research month we encourage residents to begin to identify a research mentor who will be able to work closely with them to achieve the above goals. Dr. Tom Denberg provides oversight to the research program and can assist in identifying research mentors and defining projects. He will also be available to you to provide study design and analytic advice, and should be contracted for approval of research block electives.
Practical Orthopedics for Internal Medicine at PSL – Dr. Ted Parks. This popular rotation has been rated as one of the most valuable outpatient experiences. Practical experience with a personable, superb clinician-educator. Learn good joint exam skills and injection techniques.
Palliative Care/Geriatrics Elective – This month is designed to provide the resident with exposure to the hospice model of care through a variety of inpatient hospice and home hospice experiences. The resident will primarily work at Hospice of St Johns, taking the primary responsibility for patients receiving intensive hospice care for acute symptoms management. In addition, the resident will have a chance to participate in home hospice care both at HSJ and with other hospice providers. One on one educational sessions occur throughout the month with Dr. Dan Johnson. In addition to the end-of-life care experiences, residents will also spend time with the Alzheimer’s Association, a community-based organization that provides education and support to persons with Alzheimer’s dementia and their families. Activities include a tour and information session on some of the resources available through the AA, as well as an opportunity to attend a support group, and a morning at Memories in the Making, a unique program that allows persons with dementia to express themselves through painting.
(Preceptorship) Community Based Private Practice – Drs. Aboaf, Gilmer and Warkinton. An excellent opportunity to participate actively in a busy 4 internist community-based practice with a variety of managed care plans (HMOs, PPOs, POS, and indemnity insurance). Multiple opportunities to learn flex sigs with and without biopsy, treadmills, joint injections, skin biopsy, etc. Learn to code, refer, pre-authorize, use superbills and understand the myriad variations of insurance reimbursement and office expenses. Options for attending peer review and utilization review meetings also available. A terrific opportunity to get accustomed to practicing in the real world.
Research Elective (Clinical or Basic Science) – Residents work closely with a faculty research to complete an independent project or to make a meaningful contribution to an ongoing endeavor. Many residents present abstracts and publish their work.

Residents as Teachers – Graduating from medical student to intern, intern to resident, and resident to attending physician often requires a fine tuning of teaching skills. While all new R2’s attend a seminar intended to ease the transition to that of an upper level resident, some residents wish to further develop their teaching skills. This new elective has been developed to help residents become better teachers in a variety of settings; on rounds, in traditional lecture settings and small group sessions. It is an ideal course for those who want to improve their teaching skills and for residents who hope to pursue an academic career as a clinician/educator.

Systems Based Practices – Independent study month “structured” with defined goals/interviews/projects each week. Residents learn about the health care system, participate in quality improvement projects and develop teaching tools/curriculum for their peers. It will change the way you read the newspaper, watch the news, and interact with patients and multidisciplinary health care teams. I would encourage people to do the elective if you think you are going to like the topics (understanding healthcare systems, what’s Medicare/Medicaid, who pays, how do you define “quality”, what is a quality improvement plan?)

The Walk-In-Clinic At Denver Health Medical Center – The Walk-in-Clinic, or WIC, is the urgent care clinic serving the Denver Health population. We are located in the main hospital at Denver Health Medical Center. The clinic consists of fifteen examination rooms, and serves up to 160 patients per day, 365 days a year. The WIC is an active place, with a wide variety of cases in medicine, surgery, gynecology, orthopedics and others. We also care for pregnant women up to twenty weeks gestation. Our attending staff consists of faculty general internists (most of whom are CU medicine grads), and while there is always close supervision and assistance, resident autonomy and independent decision-making is stressed. The Walk-in-Clinic at Denver Health offers a unique experience that most internal medicine residents don’t get anywhere else during their training. Here, you will see a broad spectrum of acute and subacute conditions that will present to your office as a practicing internist, often requiring entirely different management skills than you have acquired on the wards or in your continuity clinic. You won’t spend an hour suturing a laceration at the WIC, but you may work closely with a surgeon diagnosing acute appendicitis, or tap a hot joint, manage a complication of early pregnancy, or even treat a straightforward case of strep pharyngitis. Schedules can be flexible (for the occasional weekday ski-day or 3-day weekend in exchange for working a weekend day).

Women's Health/Neurology – The Women's Health elective provides residents exposure to several diverse outpatient clinical experiences including gestational diabetes, metabolic bone disease, breast and thyroid clinics, and high risk OB. The High Street Women's Services component involves diagnosis and treatment of sexually transmitted infections, performance of well-woman examinations, treatment and management of abnormal pap smears, workup of abnormal and dysfunctional uterine bleeding, diagnosis and work-up of incontinence, including urodynamics, and counseling regarding risks and benefits of hormone therapy. Residents will spend several half days a week in neurology clinics at DHMC.

rev 8/7/07