MetroHealth Medical Center Advanced Core Curriculum

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MetroHealth Medical CenterAdvanced Core
Curriculum

• Louis Binder, M.D.

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Clinical CurriculumYears 3 - 5
Acting Internships 8 weeks
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Advanced Core CurriculumFour Required Disciplines

• The Aging Adult
• Pending
• Emergent and Undifferentiated Care
• Michael Smith, MD
• Chronic Disease Management
• Pending
• Perioperative Medicine and Pain
• - Pending

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Aging Adult Content

• 4-week rotation with focus on acute and chronic
  medical conditions of the older adult patient
• Focus on the bio-psychosocial perspective and
  gender specific health conditions
• Discuss challenging topics such as end-of-life
  care, diagnoses of chronic and/or incurable
  medical conditions and transitions of care
• Acute and chronic pain management

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Aging Adult Sites

• Ob/Gyn faculty, wards, and clinics (2 wks)
• Work with faculty/services addressing
  urogynecology, osteoporosis, hormone replacement,
  gyn cancer, etc.
• Geriatrics faculty service, MetroHealth (2
  wks)
• Hospital wards
• Clinics
• Hospice
• Nursing home and skilled care network
• VNA and Home Health Care resources

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Aging Adult Seminars

• Functional Assessment
• Falls/ Gait Assessment
• Normal Aging
• Osteoporosis
• Hormone Replacement
• Urinary Incontinence

• Advanced Directives
• Elder abuse Neglect
• On Death and Dying
• Depression, Dementia, Delirium
• Care Transitions
• Insomnia and sleep disorders

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Emergent Undifferentiated Care

• 4-week week rotation with focus on
  undifferentiated, acute, first contact
  medical, surgical, and pediatric presentations
• Goal is to develop differential diagnoses,
  management plans, and demonstrate the ability to
  carry them out.
• Focus on procedural skills

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Emergent Undifferentiated Care Sites

• Adult undifferentiated experiences (2 wks)
• MetroHealth ED, Urgent Care area
• IM Urgent Care clinic
• Broadway satellite Care Access Center
• Pediatric undifferentiated experiences (2 wks)
• Pediatrics Rapid Access Center
• MetroHeatlh ED, Urgent Care area

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Emergent and Undifferentiated Care Seminars

• Airway problems
• Chest pain
• Shortness of Breath
• Abdominal Pain
• Musculoskeletal pain
• Back pain
• Fever in adults
• Fever in children
• Rashes

• Gyn complaints
• Headache
• Neurological complaints
• Overdose
• Suicide/psychosis
• ENT problems
• Visual Problems
• Laceration/wound care

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Chronic Disease Management

• 4 week experience compartmentalized into two
  consecutive 2-week blocks.
• The overall goal is to provide the student with
  more focused appreciation of longitudinal care
  for both medical and surgical routine and complex
  patients
• Students will be exposed to concepts that are
  common to management of chronic diseases
• The students will be able to choose from among a
  number of rotation options.

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Chronic Disease Management Sites

• Congestive Heart Failure
• Nephrology
• Oncology
• Pediatrics Comprehensive Care
• Infectious disease and HIV
• Obesity
• Spinal cord patients
• Others being identified

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Chronic Disease Management Seminars

• Introduction to Chronic Disease model
• Evidence based-guidelines
• Quality of life studies
• Cost-effectiveness
• Critical presentation by students of either an
  evidence based-guideline, a quality of life
  study, or a cost analysis study

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Perioperative Medicineand Pain Content

• 4-week focused on evaluating patients risk for
  planned surgery and managing them medically
  preoperatively, intraoperatively and
  post-operatively.
• Acute and chronic pain management will also be
  addressed during this rotation.

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Perioperative Medicine and Pain Sites

• Two weeks assignment to pre-operative assessment
  faculty and SICU/critical care experiences
  (either sequentially, morning/aft format, or
  creatively in progress)
• Two weeks assignment to anesthesiology,
  perioperative management, and pain management
  (either sequentially, morning/aft format, or
  creatively in progress)

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Perioperative Medicine and Pain Seminars

• The Preoperative Evaluation, medication
  management, lab Testing and principles of medical
  consultation
• Cardiac Risk Assessment and Risk Reduction for
  non-cardiac Surgery
• Fluid and Transfusion Management
• Principles of Airway management, hemodynamic
  monitoring and pressor management
• Postoperative Complications (VTE, shortness of
  breath, delirium and Fever)
• Acute and chronic pain management