2023-2024 M3/M4 Course Syllabi
Internal Medicine
COURSE NUMBER:
07 09 05
TITLE:
CLINICAL HEPATOLOGY UH -IM -ICE
In this inpatient elective, the student learns to care for patients with hepatology disorders through performance of inpatient consultations and observation of various endoscopic procedures. Attendance of weekly conferences is also expected. This elective offers and experience on a busy hepatology consult service and also provides an opportunity to observe procedures done on the patients seen in consult as well as other hepatology procedures on patients presenting to the UCMC endoscopy unit.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP)

Successfully pass third year.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
8
CREDIT WEEKS:
4
DOMESTIC VISITING:
NO
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
4 weeks
DIRECTOR:
Donald Schoch, MD
Donald.Schoch@uc.edu
558-5588
MSB, 6467
ADMINISTRATIVE SUPPORT PERSON:
Mike Ruebusch
michael.ruebusch@uc.edu

SITE(S):
UCMC - University of Cincinnati Medical Center
MAX ENROLL:
1 
ROTATIONS:
Rotation Dates Max
1 05/29/2023 - 06/23/2023 1
2 06/26/2023 - 07/21/2023 1
3 07/24/2023 - 08/18/2023 1
4 08/21/2023 - 09/15/2023 1
5 09/18/2023 - 10/13/2023 1
6 10/16/2023 - 11/10/2023 1
7 11/13/2023 - 12/08/2023 1
8 12/11/2023 - 01/05/2024 0
9 01/08/2024 - 02/02/2024 1
10 02/05/2024 - 03/01/2024 1
11 03/04/2024 - 03/29/2024 1
12 04/01/2024 - 04/26/2024 1

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00 am - 6:00 pm Monday - Friday
REPORT 1ST DAY:
UCMC Digestive Disease Diagnostic Center 2nd Floor 8:00 AM (ask for/page liver fellow)

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Research
  • Ward Rounds
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
30% Attending Physician
20% Other Faculty
10% Conferences/lectures
40% Fellow Physician
FEEDBACK:
Attending/Fellow
ASSESSMENT:

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Narrative Assessment
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
  1. Feldman M, Friedman LS, Brandt LJ.  Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th edition, Saunders 2006.
  2. Boyer TD, Wright TL, Manns MP.  Zakim and Boyer's Hepatology -- A Textbook of Liver Disease.  5th edition, Saunders, 2006.
  3. Schiff ER, Sorrell MF, Maddrey WC.  Schiff's Diseases of the Liver.  10th edition, Lippincott, Willians & Wilkins, 2006.
Instructional Methods:
  1. Clinical Experience - Inpatient
  2. Discussion-Small Group (Small Group (=12)
  3. Independent Learning
  4. Patient Presentation--Learner
  5. Self-Directed Learning
  6. Ward Rounds
Knowledge/Skills:
1.       Obtain a working understanding of the major hepatobiliary disorders.
2.       Succinctly evaluate, synthesize, and present the essence of the patient’s illness.
3.       Development of diagnostic and treatment plans for patients with hepatobiliary diseases.
4.       Interpret abdominal X-rays, liver histology, and laboratory tests.
5.       Know the cost-effective use of diagnostic tests and therapies in hepatology.
6.       Develop an understanding of the appropriate indications for consultation of a hepatologist.
7.       Critically review the literature to facilitate effective recommendations for patient care and management.
8.       Properly interpret the results of upper gastrointestinal endoscopy and other interventional procedures (e.g. liver biopsy, transjugular biopsy, TIPS, angiography).
9.       Know the indications for, utility of, and contraindications of standard gastrointestinal and interventional procedures related to the liver and biliary tract.
Main Course Topics :
1.           Alcoholic liver disease (chronic and acute)
2.           Viral hepatitis
3.           Cholestatic syndromes (granulomas, primary biliary cirrhosis, sclerosing cholangitis)
4.           Drug induced liver injury
5.           Hepatobiliary neoplasms
6.           Complications of chronic liver disease (varices, ascites, encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, hyponatremia)
7.           Hepatic infections, including manifestations of HIV
8.           Inherited gastrointestinal disorders (Hemochromatosis, Wilson’s, A1AT deficiency)
9.           Pre- and post-liver transplantation management
10.        Ethical issues in hepatology
Procedures:
1.       Observe colonoscopy, EGD, endoscopic ultrasound, ERCP.
2.       Perform large-volume paracentesis.
Remediation Plan:
 N/A

SAMPLE WEEK

Monday:
8:00AM 6:00PM consults and procedures with the service
Tuesday:
8:00AM 6:00PM consults and procedures with the service
Wednesday:
8:00AM 6:00PM consults and procedures with the service
Thursday:
8:00AM 3:00PM consults and procedures with the service
3:00PM 5:30PM Weekly Conference
Friday:
8:00AM 6:00PM consults and procedures with the service
SCHEDULE NOTE:
**Time of rounds is dependent on attending.

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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