February 2007 E-Newsletter

Enjoy a Starbucks Card Compliments of ACP! IMpact Contest Question for February

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If you are among the first 30 respondents to answer the following question correctly you will receive a $5 gift card from Starbucks. E-mail your answer to ImpactContest@acponline.org. The correct answer to February’s contest question will be included in the March issue of IMpact. You must be an ACP Medical Student Member to be eligible to win and contest winners are not eligible to win again for 4 months.

A 53-year-old woman with hypertension and a 12-year history of type 2 diabetes mellitus is evaluated. She is overweight but has lost 4.4 kg (10 lb) on a heart-healthy, low-sodium diet. Her blood pressure is 158/90 mm Hg. Her hemoglobin A1c is 8.6%, serum creatinine is 1.4 mg/dL, and blood urea nitrogen level is 28 mg/dL.

Which of the following agents should be included in this patient’s initial drug therapy?

( A ) Amlodipine
( B ) Extended-release metoprolol
( C ) Low-dose hydrochlorothiazide
( D ) Ramipril
( E ) Transdermal clonidine

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Answer to January’s Contest Question

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Click here to see January’s question.

Answer to January Contest Question: D

Asthma symptoms that recur more than 2 days per week and more than twice per month at night are classified as mild persistent disease. Any patient with asthma of this degree of severity should receive long-term therapy to treat the ongoing inflammation, in this case, albuterol and a low-dose inhaled corticosteroid.

All patients should be given a short acting β-agonist as a rescue medication. Although long acting β-agonists can help with increased control in patients taking inhaled corticosteroids, asthma at this level has significant inflammation, and long-acting β-agonists alone do not decrease the inflammation.

References

National Heart, Lung and Blood Institute, National Asthma Education Project. 1997. Expert Panel Report 2: Guidelines for the Diagnosis and management of asthma. U.S. Department of Health and Human Services, Bethesda, MD. NIH Publication No. 97-4051, April, 1997
National Asthma Education and Prevention Program Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma Update on Selected Topics–2002 The Journal of Allergy and Clinical Immunology Supplement Vol 110 No. 5 S141-S219 Nov 2002. PMID: 12542074
Global Initiative for Asthma

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Medical Student Perspectives: How Should You Plan Your Fourth Year?

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Medical students commonly underestimate the benefits of arranging a desirable schedule for themselves during their fourth year. Below are some questions to ask yourself while scheduling your fourth year rotations.

What Do You Want To Get Out Of Your Fourth Year?
If you are looking for varied experiences to prepare you for residency, you may choose to do electives in a wide range of fields in addition to internal medicine, such as emergency medicine, critical care, neurology, or radiology. If you think you may be interested in a particular subspecialty, complete a rotation in that field to solidify your interest. If you want to get into more competitive residency programs, you should consider doing away rotations at these programs. To get experience teaching students, become a teaching assistant for a basic science class at your medical school. This will help prepare you for the teaching that is required during your residency.

What Rotations Are Required During Your Fourth Year?
If your school requires medicine ward months, medicine subspecialty months, or acting internships in internal medicine, you can use these rotations as opportunities to solidify your interest in medicine. Your school may allow you to schedule these rotations away, allowing you to gain insight into other residency programs while fulfilling your requirements for graduation.

How Many Away Rotations Are You Allowed? How Many Do You Want To Take?
Be sure to confirm how many rotations you are allowed to take at other institutions. Some schools do not have a limit on the number of away rotations students are allowed, while others limit students to only a few away rotations. To increase your chances of matching in more highly ranked programs, try to schedule your rotations at these programs.

When Does Your School Require You To Take The USMLE Step 2 CK (Clinical Knowledge) And CS (Clinical Skills) Exams?
If you want to take boards early or you have to travel a long distance to take Step 2 CS, plan an elective which allows more flexible scheduling and off time during testing time. Step 2 CK exams vary in the way they are administered, but some students feel that emergency medicine and neurology rotations are good preparation for these tests. Many schools do not specify at what time during the third or fourth year students should complete these rotations. Some schools do not require that students complete these rotations at all. If you choose to take these rotations you should enroll in them early in the school year. You should also keep in mind that some residency programs do, while others do not, require that Step 2 CK and CS be successfully completed at the time of interview, match, or post-match confirmation of your residency position.

Do You Want To Do Research Or Write Publications?
Remember that it sometimes takes several months for acceptance and publication of articles in scientific journals. It is a good idea to choose to do a research month early in the year if your goal is to get published.

How Many Programs Do You Want To Interview With? Where Are These Programs Located?
Many times it is difficult to know what programs you want to apply to and interview with during your fourth year, where they are located, and how many you should choose. Many students use the interview trail as an opportunity to travel. If you choose more flexible rotations during late November to late January, you will find it easier to schedule your interviews or to take a second look at a program if you deem necessary. Scheduling less stressful rotations at your own school during interview season will also ease the stress of the interview process.

Factors To Consider When Scheduling Your Fourth Year

  • Know your school’s requirements and scheduling limitations.
  • Determine what you want to get out of your fourth year.
  • Choose electives in fields you want to experience.
  • Keep in mind the application, interview, and match process.
  • Allow yourself ample time for interviewing.

John Baker
Council of Student Members Representative, Southeastern Region
University of South Carolina, 2007
Email: jbaker@gw.med.sc.edu

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My Kind of Medicine: Real Lives of Practicing Internists: Pamela Zee, MD

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Pamela Zee, MDMany physicians know fairly early on during college or even high school that they want to go into medicine, but that was not the case with Dr. Pamela Zee. As an undergrad at Vassar College in Poughkeepsie, New York, she dabbled in many subjects, trying everything from architectural drawing to plant biology before deciding on a double major in biology and psychology. She was not sure at the time what she was looking for, but she knew that it needed to be stimulating, offer variety, and involve working with people. “I had this project for plant biology where I had to spend like, a thousand hours just hanging out by myself grinding up leaves from a willow tree,” she explains, “and I thought to myself, ‘Gee, this is kind of fun….but working with people would be more fun.’”

This somewhat whimsical statement reveals a lot about the 35-year-old internist from New Jersey. It hints at her strengths—an imaginative mind and a gift for relating to people—and it is an honest declaration of what she needs from a career. It is also an example of her communication style, which is decidedly not dull. She tells you funny stories about college and how going to a Depeche Mode concert makes her feel old. She is likable and quick to laugh and it is easy to see how these qualities make her stand out as an internist.

More Than a Doctor

“On good days, going to work feels like visiting 25 friends,” she says. “I’ve formed many meaningful relationships with my patients. I see my patients as complete people, not just as a stomach or a heart.” Dr. Zee’s patients see her the same way. For some time, she conducted visits to home-bound patients one day a week. One of her patients was a woman who insisted that Dr. Zee come to the house for a “social visit” before any medical matters were addressed. It was a bit unorthodox, but she obliged and spent an afternoon with the woman in her living room drinking coffee, eating cookies and chatting about church and family. By the end of the visit, the woman had even told Dr. Zee about her courtship with her husband of over 50 years. Needless to say, Dr. Zee passed the test and became the woman’s primary physician. The woman passed away some time afterward, but Dr. Zee’s relationship with the family continued. “Her husband started coming to my office as a patient and is still one of our staff’s favorites,” she says. “We even hired one of their children as a member of our office staff.”

Dr. Zee grew up in White Plains, New York and later moved to New Jersey with her family. After her time studying at Vassar College, she attended medical school at the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson School of Medicine. She chose Cooper University Hospital in Camden, New Jersey for her residency and liked it so much she stayed on as an internist, where she has been ever since. She has worked at Cooper for a total of twelve years, during which time she has started treating successive generations in a family. It is an experience she finds to be hugely rewarding, even if she has to contend with a challenge here and there. In fact, it is that reason that makes her job satisfying.

“I’ve had several meaningful relationships in my time at Cooper,” she says. “For one family, I am the primary physician for the mother, the daughter, and two granddaughters. Not too long ago, one of the granddaughters in this family dropped out of school, expressed no desire to hold a job, and became pregnant as an unwed teenager. I started seeing her in my office frequently, for undetectable rashes and ill-defined body aches, along with other vague ailments. Finally, I confronted her and suggested we set some goals together, such as returning to school for a GED or obtaining employment.” Dr. Zee was persistent, reminding the girl of the goals they had set at every office visit; the visits became more life-coaching and less direct medical care. Eventually, Dr. Zee’s message got through and the girl got a job at a major retail store. “This experience reminded me of what I love about internal medicine,” says Dr. Zee, “the opportunity to make an impact. You really get to educate your patients and you can make a difference in someone’s life.”

A Place to Call Home

Dr. Zee’s decision to pursue internal medicine, like her decision to go into medicine in the first place, was a bit of a zig-zag course. Her first plan was to pursue neurology, but after filling out the application, she found herself wanting to continue in internal medicine.

“I had a great advisor for my internal medicine rotation who was such a great physician,” she says. “He was so knowledgeable and he knew his patients so well. He was a great role model and in my eyes, the ideal doctor. He made me not want to give up internal medicine.” She withdrew her application for neurology that day and never looked back.

In the twelve years Dr. Zee has worked at Cooper, she has gone from medical student to faculty member. The transition, both professional and personal, has passed with many milestones: becoming an assistant professor at her own medical school, serving as deputy director of fourth-year clerkships and heading her department’s division on clinical research. She even met her husband at Cooper. “The match-making chief resident put us on call together every fourth night for the first six months of our internship,” she says. “We married at the end of our residency and are now expecting our first child in May.”

In a transient world where people change careers an average of seven times, not many are lucky enough to have Dr. Zee’s extensive professional network at their fingertips. “My teachers and faculty mentors are now colleagues; we sit together on hospital and medical school committees. Some of the hospital staff who watched me develop as a student are now my patients. And it’s very satisfying for me to now witness the transformations of current medical students.”

It may have taken Dr. Zee a while to figure out where she belonged, but once she did she made it stick. These days, the popular doctor satisfies her mental wanderlust by working in travel medicine, a consulting and treatment service for patients traveling abroad. In typical Dr. Zee fashion, she describes it as “really cool.” The would-be architectural illustrator or neurologist says for her, internal medicine was the only way to go. “If I had chosen neurology or something else, I wouldn’t have been able to do everything I do now,” she says. “Choosing internal medicine meant that I didn’t have to give up any of my interests. As an internist, you are only limited by your imagination.”

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Internal Medicine Interest Group of the Month: Texas A&M College of Medicine

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The foundation for the Texas A&M College of Medicine’s Internal Medicine Interest Group (IMIG) is provided by excellent student leadership and supported by knowledgeable faculty sponsorship. The students leading the way are John Reneau (MSI Representative), Dylan Medley (MSII Co-President), David Pham (MSII Co-President), Sarah Jordan (MSIII Representative), and Anisha Arora (MSIV Representative). Our faculty sponsor, Richard Dusold, MD, FACP, shows his dedication to the students and the field of internal medicine through his interactions in the community, the clinic and the classroom.

The 2006-2007 year kicked off with an introductory lunch meeting where first and second year students were exposed to the numerous possibilities for careers in internal medicine. The faculty and students led presentations that described general medicine and the numerous subspecialty career paths within the field. Student recruitment was also a priority during the meeting and 80 new ACP members were recruited during the fall semester. This meeting was followed by an exciting basic life support class performed by certified instructors from the American Heart Association. During this educational class, students learned the valuable life saving tools of cardiopulmonary resuscitation and the automated external defibrillator. Students obtained provider certification cards upon completion of the class.

In October, the Texas Academy of Internal Medicine (TAIM) held their annual conference in Horseshoe Bay, Texas. One of the student events held during the conference was a clinical vignette competition where students were encouraged to submit a presentation of an interesting case they experienced during the course of their clinical education. The Texas A&M College of Medicine’s own Rebecca Pierce, class of 2007, received first place in the competition for her presentation entitled “Bloody Snake,” which discussed the challenges of complex thromboembolic disease.

The spring semester began with a recruitment meeting for the TAIM General Internal Medicine Statewide Preceptorship Program (GIMSPP). The focus of the program is to offer first year students the chance to “shadow” internal medicine doctors throughout the state on a daily basis during their summer break. This is an outstanding, hands-on approach for students to experience the daily clinical life of an internal medicine physician. The IMIG also organized the First Annual Armadillo Dash benefiting Scotty’s House, a local center for abused and neglected children. The IMIG enticed students to participate in the race by designing a T-shirt to show their support for the organization. In addition, the IMIG organized a school donation to the charity, which was graciously matched by our faculty sponsor, Dr. Dusold.

With the USMLE Step 1 Exam around the corner, Dr. Dusold has started holding lunch review sessions for the second year class. During these reviews, students revisit material they have already learned in the USMLE exam format. These reviews have proved helpful in reinforcing the material and aiding students in adjusting to the testing style of the exam. The Texas A&M College of Medicine IMIG purpose is to introduce the world of internal medicine and its countless possibilities to students. During the year, meetings are designed to spark students’ interests and provide an education in the field of internal medicine. Exposure is gained in university and community settings as students interact with many practicing physicians in the area. Through these activities we hope to attract students to a rewarding and exciting career in internal medicine.

Dylan Medley and David Pham, IMIG Co-Presidents
Texas A&M College of Medicine, Class 2009
E-mail: dbmedley@medicine.tamhsc.edu

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Winning Abstracts from the 2006 National Medical Student Poster Competition: The Role of EB1 and Adenomatous Polyposis Coli in Microtubule Dynamics and Organization

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Author:
Ryan K. Louie, Stanford University School of Medicine, 2007

Introduction:
End-Binding Protein 1 (EB1) is a member of a class of proteins which bind to the plus-ends of growing microtubules. A binding partner of EB1 is the tumor suppressor protein adenomatous polyposis coli (APC), which is mutated in familial and sporadic colorectal cancers. In addition to being a key component in the Wnt signal transduction pathway controlling cell differentiation and proliferation, APC also plays a role in microtubule organization and cell migration. We focus on EB1 and APC to track their dynamic properties in context of the cytoskeletal architecture.

Methods:
In this study, we use live cell video microscopy to investigate the structural cytoskeletal roles of EB1 and APC by examining protein motion behavior in Madin-Darby canine kidney epithelial cells. Dual-color fluorescence imaging is used to simultaneously visualize both proteins, with APC tagged with green fluorescent protein and EB1 tagged with a tandem-dimeric red fluorescent protein.

Results:
We demonstrate that EB1 comets at the plus-ends of growing microtubules show preferential movement towards regions of the cell with cortical APC clusters at the tips of membrane extensions. EB1 displays tracking behavior, with EB1 comets following one after another along the same path. In contrast, for regions of the cell with no APC clusters, EB1 motion is less directed and less organized. There are two distinct pools of APC - “cluster” APC and “interior” APC. While cluster APC is less motile and shows no accumulation of EB1 in that region, interior APC in the forward direction can be matched together with EB1 comets and travel at the velocity of microtubule plus-end directed growth.

Conclusion:
APC protein may serve a cytoskeletal role by organizing and directing the travel patterns of growing microtubules tipped with EB1 protein. Together, these data help to understand the dynamic properties of EB1 and APC during physiological processes such as cell membrane extension and cell migration.

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Subspecialty Careers: Highlights about Careers in Internal Medicine: Infectious Disease

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The Discipline

From the Latin word inficere, "to dye or stain" but also "to corrupt or spoil." The ancients conceived that disease could result from the entrance of invisible agents into the body, a sort of "tainting."

Infectious disease medicine requires an understanding of the microbiology, prevention, and management of disorders caused by viral, bacterial, fungal, and parasitic infections. This understanding includes the appropriate use of antimicrobial agents, vaccines, and other immunobiological agents. Important content includes the environmental, occupational, and host factors that predispose to infection, as well as the basic principles of epidemiology and transmission of infection.

Procedures

Important procedural skills include the proper collection of culture specimens, Gram and other staining techniques. The specialist in infectious disease is an expert in ordering and interpreting antibiotic sensitivity tests and serum levels, CD4 counts, ELISA, polymerase chain reaction, immunoblotting studies, and serology for infections.

Training

Infectious disease fellowship training requires two years of accredited training beyond general internal medicine residency. During the two years, a minimum of 12 months must include clinical training in the diagnosis and management of a broad spectrum of medical diseases.

Certification

The American Board of Internal Medicine offers certification in infectious disease.

Training Positions

As of August 2005, there were 141 ACGME-accredited training programs in infectious disease with 679 active training positions. 41% percent of the trainees were female, and 48% were US medical graduates.

Practice

Approximately 40% of the graduates in the United States enter clinical practice in infectious disease, and 43% enter academic medicine.

Major Professional Societies

Infectious Diseases Society of America
66 Canal Center Plaza, Suite 600
Alexandria, VA 22314
(703) 299-0200
http://www.idsociety.org

Major Publications

Clinical Infectious Diseases
Emerging Infectious Diseases
Journal of Infectious Diseases

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Advocacy Briefs: Health Professions Education Programs Receive Funding Increase

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On February 15, 2007 President Bush signed a $463.5 billion spending package to fund much of the federal government for the remainder of fiscal year 2007. The measure includes $185 million for the Title VII health professions programs, an increase of $40 million (27.6%) over fiscal year 2006. The additional Title VII funds include $32 million to restore the geriatrics training programs to the fiscal year 2005 level and an $8 million increase for primary care programs. ACP is a member of the Health Professions and Nursing Education Coalition, which has been actively advocating for increased funding for Title VII programs.

Title VII includes general internal medicine, general pediatrics and family medicine education programs. Serious health professional shortages continue to exist in rural and underserved areas. This is partially due to market forces driving health professionals to practice where higher wages are available. The health professions programs were designed to combat this pattern by educating and training providers with the goal that they return to serve in rural and underserved areas. As a result, the graduates of these programs are three to ten times more likely to practice in medically underserved areas than graduates of non-funded programs.

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Did You Know ACP Medical Student Members Can Attend Internal Medicine 2007 with No Registration Fee?

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Medical students are warmly welcomed each year at ACP’s national conference and 2007 will be no exception. The conference provides an opportunity to meet like-minded students and physicians, to learn more about internal medicine, and to experience the camaraderie and cutting-edge developments in the field. Read on to discover why you should attend Internal Medicine 2007 (formerly Annual Session) held April 19-21 in San Diego, California!

Scientific Program Sessions

Physicians from all over the country are drawn to the meeting for its 250 educational sessions. Workshops range from general internal medicine to its many subspecialties and include topics as varied as Arthrocentesis and Soft Tissue Injections; Best Drug or Best Advertised Drug?; Business of Medicine 101; Disaster Preparedness; Healthcare for the Homeless; HIV Update; Mastering Cardiac Murmurs; and Grand Rounds: The Professor in Action. Students are welcome to attend all sessions.

Workshops Designed for Medical Students by Medical Students

The Council of Student Members develops content for the following sessions held especially for Medical Student Members: Brush Up for the Boards; Ethics and Professionalism for Medical Students; Getting Through the Match; and Stump the Professor.

Clinical Skills Review Course

Students can prepare for the USMLE Step 2 Clinical Skills Examination by participating in the Waxman Learning Center’s Clinical Skills Practice Session. This session has four stations that simulate the experience of the USMLE Step 2 Clinical Skills Exam. Standardized patients will present you with common problems and provide expert feedback on your history and physical examination skills, communication skills, and written note. A checklist score will be generated and shared with you in addition to other verbal feedback on your overall performance. You will be provided with a written evaluation summarizing the feedback as well as highlighting areas of strengths and weaknesses. Two students will be paired together for the four station workshop, allowing each student two "hands-on" experiences and two observation experiences.

Medical Student Abstract Competition Winners and Poster Finalist Competition

The top ten winners of the 2007 Medical Student Abstract Competition will present oral abstracts of their research, community initiatives, and clinical cases. A group of poster finalists will display their work in the Medical Students-Associates Poster Area and compete for additional prizes.

Medical Student Mentoring Breakfast

The Medical Student Mentoring Breakfast is a 90 minute session where students can meet with internists in a casual setting. Invited mentors include physicians – both general internists and subspecialists – practicing or teaching in a variety of settings and of a broad range of ages, backgrounds, and interests. Bring your questions!

Third Annual Internal Medicine Residency Fair

Representatives from internal medicine residency programs across the country will be on hand to discuss the unique aspects of their programs with students.

Medical Students, Associates, and Young Physicians Recognition Reception

All medical students are invited to a wine and cheese reception on Saturday evening, where winners of the ACP Associate and Medical Student Poster Competitions in addition to the winner of the 2007 Doctor’s Dilemma™ Championship are honored.

Medical Students, Associates, and Young Physicians Hospitality Room

The hospitality room is open each day for students to come together for coffee, snacks, socializing, and relaxing. Books containing the top research abstracts will also be available in the hospitality room.

San Diego

Take some time in the evenings or in your free time to enjoy the spring weather in one of the country’s most beautiful cities!

ACP Medical Student Members attend Internal Medicine 2007 free! Nonmember medical students pay a $99 registration fee. To register for the conference, visit here. See you there!

Lucy Goddard
CSM Representative, New England Region
Yale School of Medicine, 2007
e-mail: lucy.goddard@yale.edu

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MKSAP for Students 3 Question 1

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A 71-year-old man is evaluated because of intermittent cough and increasing dyspnea on exertion. He has smoked one pack of cigarettes per day for 49 years. He has no other symptoms.

On physical examination, distant breath sounds are audible in both lungs and there are scattered rhonchi. Chest radiograph shows a perihilar mass. Abnormal laboratory results include hemoglobin of 10.5 g/dL and a serum sodium of 127 meq/L. Endobronchial biopsy reveals small-cell lung cancer.

Which of the following is most appropriate treatment for this patient's hyponatremia?

( A ) Chemotherapy
( B ) Hypertontic saline
( C ) Fluid restriction
( D ) Fluid restriction and demeclocycline

MKSAP for Students 3 Question 2

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A 62-year-old man with a nonhealing diabetic ulcer is evaluated for preoperative clearance. He has a 10-year history of diabetes, hypertension, and severe peripheral vascular disease. He receives insulin, amlodipine, and aspirin.

On physical examination, blood pressure is 140/90 mm Hg. No cardiopulmonary abnormality or volume overload is detected.

Which of the following is the most appropriate method to evaluate this patient's renal function?

( A ) A 24-hour urine collection for creatinine and volume
( B ) Estimate creatinine clearance with a creatinine-based formula
( C ) Measure the fractional excretion of sodium
( D ) Measure the serum creatinine

MKSAP Answer 1

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Answer: A

Educational Objective: Treat asymptomatic hyponatremia due to malignancy.

This patient with mild hyponatremia is newly diagnosed with small-cell lung cancer. He has no symptoms that are clearly attributed to the hyponatremia and therefore initiating nonspecific therapy such as fluid restriction with or without demeclocycline therapy, or aggressively treating the hyponatremia with hypertonic saline is not warranted. The most important therapeutic intervention is to treat the underlying cancer with chemotherapy.

References

Kapoor M, Chan GZ. Fluid and electrolyte abnormalities. Crit Care Clin. 2001;17:503-29. PMID: 11525047

MKSAP Answer 2

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Answer: B

Educational Objective: Recognize the appropriate method for evaluation of renal function.

The National Kidney Foundation, in the guideline Kidney Disease Quality Outcomes Initiative, defines and suggests therapies for patients with chronic kidney disease. The staging of chronic kidney disease is based on the glomerular filtration rate. The estimated glomerular filtration rate is therefore paramount for Correct diagnosis and treatment. To minimize error and ensure widespread availability, the National Kidney Foundation suggests using creatinine-based formulae to estimate the glomerular filtration rate, such as the Cockcroft–Gault formula or the formula derived from the Modification of Diet in Renal Disease (MDRD) study.

The serum creatinine concentration alone is not recommended for estimation of the glomerular filtration rate, but is a useful tool to monitor progression of chronic renal failure. This concentration represents the balance between production of creatinine, which is relatively constant, and elimination through glomerular filtration, tubular secretion, and nonrenal pathways (usually negligible in healthy persons). Muscle mass; comorbid conditions, such as malnutrition; and amputations can cause the serum creatinine concentration and the glomerular filtration rate to lower than expected for the degree of actual renal insufficiency. A 24-hour urine collection by itself is not useful but when used to calculate a creatinine clearance can provide an acceptable estimate of glomerular function; however, daily and diurnal variation in creatinine excretion and problems with collection can cause error in the estimate of glomerular filtration rate. The fractional excretion of sodium is not useful in estimating the glomerular filtration rate but is useful in the diagnosis of pre-renal azotemia in an oliguric patient.

References

Coresh J, Astor BC, McQuillan G, Kusek J, Greene T, Van Lente F, Levey AS. Calibration and random variation of the serum creatinine assay as critical elements of using equations to estimate glomerular filtration rate. Am J Kidney Dis. 2002;39:920-9. PMID: 11979335

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Internal Medicine Residency Program Fast Facts

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Program Name: Virginia Mason Medical Center
Location: Seattle, Washington
Hospital Type: Community-based Hospital
Program Size: 15 First Year Positions, 30 Positions Total
First Year Salary: $41,000
Web Site Address: https://www.virginiamason.org/body.cfm?id=838

Program Name: University of Southern California
Location: Los Angeles, California
Hospital Type: University-based Hospital
Program Size: 55 First Year Positions, 163 Positions Total
First Year Salary: $38,000
Web Site Address: http://www.usc.edu/schools/medicine/departments
/medicine/education/residency/index.html

Program Name: Thomas Jefferson University
Location: Philadelphia, Pennsylvania
Hospital Type: University-based Hospital
Program Size: 48 First Year Positions, 125 Positions Total
First Year Salary: $43,000
Web Site Address: http://www.jefferson.edu/internal/residency/

Program Name: Presbyterian Hospital of Dallas
Location: Dallas, Texas
Hospital Type: Community-based Hospital
Program Size: 12 First Year Positions, 24 Positions Total
First Year Salary: $44,000
Web Site Address: http://www.texashealth.org/phd/residency

Program Name: University of Vermont
Location: Burlington, Vermont
Hospital Type: University-based Hospital
Program Size: 19 First Year Positions, 43 Positions Total
First Year Salary: $43,000
Web Site Address: http://www.fahc.org/gme/Medicine/
Int_Medicine_Pgm/index.html

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Students Needed to Work at Internal Medicine 2007

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The College needs medical students with basic to intermediate computing skills to help in our medical informatics workshops. We also need 2 medical students to assist in the central venous line placement workshop in the Herbert S. Waxman Learning Center. The students assisting in the central venous line placement workshop will be required to wear a surgical scrub shirt over their regular clothes and lie down. They also need to be comfortable with participants touching and using a handheld ultrasound on their neck and collarbone area. Students will be paid a small honorarium ($100 per half-day, $200 for a full day). If you are attending Internal Medicine 2007 and would like to help, please contact Lisa Rockey at (800) 523-1546 ext. 2588 or lrockey@mail.acponline.org.

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Student Members Receive a 30% Discount When Ordering MKSAP for Students 3

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MKSAP for Students 3 includes over 400 patient-centered self-assessment questions and their answers in print and on CD-ROM. Designed for medical students participating in their clerkship rotation, the questions help define and assess a student’s mastery of the core knowledge base requisite to internal medicine education in medical school. The questions reflect the daily management dilemmas faced by internal medicine physicians and when coupled with the answer critiques, provide a focused, concise review of important content.

New in MKSAP for Students 3:

  • All new questions and critiques
  • More topics and chapters
  • 12 electrocardiogram questions
  • 24 color figure dermatology questions

List Price: $44.50; Student Member Price: $30.00

To order MKSAP for Students 3 please visit here.

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Students: Join ACP for Free

Benefits of Membership for Students: ACP's free Medical Student Membership includes benefits designed especially to meet students' needs.

Join Now: Sign-up today and begin enjoying the benefits of ACP Medical Student Membership.