YNHH (York Street) Clerkship Inpatient Firms
Cardiology Critical Care (CCU) (SP 5-1 – recommended Med II students). This is a 14-bed ICU providing care to patients with life-threatening cardiovascular illness such as acute myocardial infarction, heart failure, cardio-myopathies, and arrhythmias. Patients undergo advanced diagnostic procedures such as cardiac catheterization and electrophysiology studies, as well as invasive procedures such as pacemakers, intra-aortic balloon pumps and left ventricular assist devices, coronary stents and brachytherapy.
Hospital Medicine-(EP 5): One attending and one resident team without an intern. Focus is on inpatient general medicine with attention to patient safety and quality processes. This Firm is new and not yet open to students but we anticipate it will be soon.
Donaldson (EP 9th floor, 9/5). All hospitalized HIV/ID patients are admitted to this floor which is staffed by ID faculty members; depending on census, between 25-50% of the patients have an HIV diagnosis. Specific HIV curriculum delivered on Fridays.
Generalists (EP 5th floor). Like it sounds, this service focuses on general medicine and has a connection with the resident Primary Care Clinic such that the concentration is on transitions of care from inpatient to outpatient, substance use disorders, and systems of care coordination.
Goodyer (SP 5-2 Floor). A general Cardiology team with one cardiology attending and two teams (resident/intern dyad).
Hematology (NP 11th Floor). Patients with benign and malignant hematologic disorders including bone marrow transplant patients.
Klatskin (WP 9th floor). All patients have liver disease, but the problem for which they are admitted may or may not be primarily due to their liver disease. Intense, but students love it. The attendings are GI faculty.
Oncology (NP 12th Floor). All Patients have a solid tumor/malignancy and this firm is not available for every rotation because the staffing varies. It is a very busy service with a lot of sick patients.
Peters (EP 7th floor). All patients have kidney disease, but as in the Klatskin service, they may be known to the renal service as they are on dialysis or near dialysis and may be admitted to the service for other reasons. There are lots of hands-on analysis of urine sediment and increased exposure to dialysis types and indications. The attendings are one renal faculty member and one general medicine faculty member.
Medical Step Down Unit (NP 10th Floor). The medical SDU is a 15-bed unit where patients with intermediate severity of illness are admitted. The range of illness is anywhere from severe sepsis to heart failure and acute renal failure. Many patients with metabolic issues such as DKA and thyroid storm are also cared for in the YSC SDU. The SDU is also used as a transition unit for patients ready to leave the Medical ICU.
Cardiology Blue (EP 5th Floor). This is a unique team structure that combines assessing and consulting on patients in the Emergency Room with acute cardiac issues and staffing a small inpatient team of patients with cardiovascular problems.
Non-York Street Clerkship Inpatient Firms
Yale – Saint Raphael Campus (SRC)
Cooney (Verdi 4 West). In November 2014, the Cooney firm moved from YNHH into the SRC Geriatric Center of Excellence. This is a 22 bed-firm that focuses on the unique needs of the elderly with acute illnesses, as well as the importance of multidisciplinary care and how to collaborate and coordinate outpatient services and resources in the community.
General Medicine (SLA 3). SLA is the inpatient unit ‘owned’ by the Yale Internal Medicine Primary Care program. All patients on this unit are general medicine teaching cases and staffed by ‘old fashioned’ general medicine / internist attendings, who practice both inpatient and outpatient medicine. Many faculty and residents are trained in POCUS. Night rotations are available for interested students.
VA CT Health Care System – West Haven
The VA rotation offers the unique experience of working with our veterans very closely. In general, these patients are wonderful, grateful and very appreciative of the care they receive. The VA also provides many hands-on opportunities to do both commonly, as well as less commonly, medical procedures for the students. These procedures include, but are not limited to, the assessment of orthostatic vital signs, walking oximetry, EKG, NG tubes, phlebotomy, arterial blood gases, paracentesis, removal of PICC and central lines amongst many others. Given the somewhat lower turnaround time and census compared to other teaching facilities, there is more of an opportunity for the interns and residents to be autonomous and have some time to teach patent care procedures to the students. In addition, students learn to appreciate the complex interplay of social factors which affect the inpatient and outpatient care of our veteran population. There are 4 inpatient teams (patient population the same): The teams do not have one floor assigned to the team. The patients are generally located on 5 East, 5 West, 4 West and 6 East in Building 1.
Team Cohen – This floor is staffed by two residents, two interns (or Sub1-generally 2 SubI’s in place of one intern) and two primary care attendings. Students have an opportunity to learn inpatient care from the primary care attendings perspective as well as appreciate how outpatient factors impact inpatient care and vice versa.
Team Coleman and Team Hayslett – Staffed by two residents, two interns (or Sub1 generally 2 SubI’s in place of one intern) and subspecialty attendings. Here the students have an opportunity to learn inpatient care from the specialty attendings. The sub specialist faculty member contributes towards the team education by sharing their experience and knowledge from their own specialty and how that may pertain to inpatient care.
Team Hospitalist – A smaller team with one resident and one intern and is staffed by Hospital Medicine attendings, many of whom are subspecialty trained. Here the students have the opportunity to learn specialized aspect of inpatient care, as well as other aspects of health care delivery (patient safety, quality of care patient flow, resource utilization and patient experience).
VA MICU – Patients with critical illness (respiratory failure, septic /other shock). The MICU team is a small team with one third year resident, one intern, one attending and one pulmonary fellow. MICU bed capacity is limited to 6 beds. The student will get the opportunity to learn about critical care patients by admitting and caring for them and will also participate in evaluating and treating patients on the pulmonary consult service. Open to Med II students only.
Bridgeport Hospital
There are two inpatient general medicine teams on which the students rotate. Team Care A is acutely ill patients and is the largest of the two firms and Team Care B/Hospitalist. Each team is staffed by one resident and two interns, has one medicine attending, and rounds two mornings weekly with a rotating Yale visiting professor who concentrates on the basics of history and physical exam findings. These teams are very busy and allows exposure to a wide variety of general medical problems. The goal of both teams is to have the core clerkship student