Beth Israel Residency Program in Internal Medicine
DIVISIONS

The majority of subspecialty divisions in the Department of Medicine have strong fellowship training programs and offer the residents elective periods of one to several months' duration during the PGY-1, PGY-2 and PGY-3 years. Each subspecialty is fully represented in the Medical Center through the presence of well-respected and widely published faculty and research activity.

Rotations through subspecialties provide opportunities for close personal interaction with fellows and subspecialty attendings and for experience in the relevant diagnostic and therapeutic modalities. Each subspecialty group has daily consultation rounds, journal clubs, subspecialty grand rounds and guest lecture series.

Following are descriptions of the divisions

ALLERGY & IMMUNOLOGY

James M. Rubin, MD, chief of the division, has major interests in drug allergies and the diagnosis and treatment of asthma. He has published numerous papers on these and other subjects in the field. Since 1975, Dr. Rubin has organized a postgraduate course for allergists and immunologists that has come to be recognized as one of the best such educational efforts in the country.

The Residency Experience
Residents are offered an opportunity for one-on-one education, with exposure to patients through a weekly clinic, inpatient consultations and a preceptorship in which private patients are seen in attending physicians' offices. Residents are trained in diagnostic techniques and in immunotherapeutic approaches for allergy and asthma. They also have experience with specialized procedures such as bronchoprovocation, a method for identifying asthma in otherwise undiagnosable patients. The division is active in clinical research, primarily evaluations of various medications and treatment regimens, with particular emphasis on asthma.

This optional rotation is of significant value to residents, since there is little exposure to allergy and immunology during the medical school years. Future clinicians can benefit greatly from the opportunity to explore these fields and become familiar with the most advanced diagnostic procedures and therapeutic modalities.

Faculty:
James M. Rubin, M.D.
Mary Lee-Wong, M.D.
Paul Ehrlich, M.D.
Howard Menikoff, M.D.
Michael Teitel, M.D.
Sharon Yost, M.D.

AMBULATORY MEDICINE/GENERAL MEDICAL ASSOCIATES

Jayson Park, M.D. is the Medical Director of the General Medical Associates(GMA), the Department of Internal Medicine's faculty primary care ambulatory practice of Beth Israel Medical Center. He is also an associate of Global Leadership, Inc, an organization that mentors young emerging leaders around the world. His interests and research involve the field of leadership development and mentorship in academic medicine.

The mission of GMA's training program is to prepare our residents to represent excellence in healthcare in their future ambulatory practice. We are located in the Phillips Ambulatory Care Center in Zeckendorf Towers on Union Square. The Center, which occupies 300,000 square feet, provides a broad range of diagnostic and treatment services in an efficient, patient-friendly environment. Nearly all the subspecialty and surgical departments are conveniently located in this building.

The Residency Experience

GMA approaches each housestaff developmentally in the six core competencies defined by the Accreditation Council on Graduate Medical Education. You will have a dedicated faculty attending assigned to personally coach you through the next three years. With personalized evaluation and feedback, you collaborate and build a relationship with the faculty attending who will intentionally and continually help take you to the next level in your medical knowledge and clinical skills. Residents treat every patient under the direct supervision of actively practicing faculty attendings who are solely dedicated to primary care ambulatory medicine. They will equip you to be professional and have a confident understanding of the systems-based practice in medical care.

Emphasis is placed on training residents to take responsibility for organizing all aspects of patient care and on continuity of care. Residents learn to utilize sub-specialty consultations appropriately, while providing the majority of the patient's care. Beth Israels provides access to healthcare to a rich, ethnic mix of all ages and socioeconomic status. This is where communication skills and cross-cultural awareness is actively developed. Sub-acute and chronic diseases most commonly seen include high blood pressure, diabetes, cancer screening, coronary artery disease, asthma, osteoarthritis, and depression. GMA provides healthcare to over 50,000 patients annually. Residents see their patients a half-day each week during all three years of their residency. In addition, interns and senior residents have one block (4 weeks) time annually devoted to ambulatory medicine. Junior residents have two block time experiences annually. During the ambulatory block, you will encounter an intense primary care academic curriculum with emphasis on evidence-based medicine, the most current practice guidelines, and psychosocial medicine. You may also request a GMA elective where you will benefit from the block month, and in addition, work closely with a mentor on a primary care project. Residents have consistently ranked GMA as one of the top experiences in the residency training program. GMA will lay for you the foundations of practicing excellence in ambulatory medicine.

Clinical Faculty:

Lisa Auerbach, M.D.	Carmela Landes, M.D.
Margaret Baran, M.D.	Tanya Madrid, M.D.
Erika Blank, M.D.	Gary Palatucci, M.D.
Jane Falkenstein, M.D.	Jayson Park, M.D.
Michael Felsen, M.D.	Robin Sadker, M.D.
Donna Finkelstein, M.D.	Orit Saigh, M.D.
John Graney, M.D.	Raveen Saluja, M.D.
Glenn Kashan, M.D.	Stacy Suden, M.D.
Christopher Lau, M.D.

CARDIOLOGY

Cardiology at the Beth Israel Medical Center is a very active clinical service that treats the full spectrum of cardiac diseases. The service admits patients to two fully monitored, geographically localized units and also runs an 8 bed Cardiac Care Unit (CCU) and a post-intervention step down units. The patients we serve represent the full spectrum of New York's socioeconomic diversity, with approximately 50% "private" admissions, the remainder being "service" cases.

Cardiology services include Catheterization and Interventional Cardiology, Nuclear cardiology, Echocardiography, Electrophysiology, Heart Failure, Consultative Cardiology, Preventive Cardiology and Cardiac Rehabilitation. Approximately 3000 invasive coronary diagnostic and 1500 interventional procedures are performed each year. The Nuclear Cardiology Laboratory performs over 2000 studies annually and includes a large volume of studies performed with Positron Emission Tomography (PET). The Echocardiography laboratory performs over 7000 procedures per year including Transesophageal and Stress Echocardiography. The Electrophysiology section performs all invasive and non-invasive procedures including radiofrequency ablation of tachyarrhythmias, ICD, resynchronization therapy and pacemaker implantation. We have recently acquired a 64 slice CT and perform coronary calcium scoring and "non-invasive" CT coronary angiography.

BIMC sponsors two ACGME accredited fellowship training programs in Cardiovascular Disease, one with all clinical experience at the BI main campus and the other combined BI-LICH program with 50% plus experience at BI main campus and the remaining 50% at LICH which is the Brooklyn campus. LICH also has an active CCU and Consult Service as well as Echo, Nuclear, EP and Catheterization Laboratories. We also offer Advanced, Interventional and Electrophysiology fellowships.

Clinical Research

The Division has an active research component with an emphasis on use of clinical pathways, treatment of acute myocardial infarction, diagnosis and treatment of acquired and inherited arrhythmias, imaging, syncope, prevention of contrast induced nephropathy and therapy for heart failure. Residents are encouraged to participate in these research activities during their elective periods. Publication and presentation of results of research is highly encouraged and supported.

The Residency Experience

Residents are responsible for, and play a major role in the care of all patients. Internal medicine house officers devote approximately five months of their time to Cardiology with the goal of learning the signs, symptoms, diagnostic evaluations, and care of patients with primary cardiac disorders. Two months of the residency is spent in the CCU caring for critically ill patients. Clinical electives in Cardiology are available as well. Residents participate in daily rounds with attending physicians as well as have didactic teaching sessions, and obtain progressive experience in clinical decision-making in an environment of technical and clinical excellence, intellectual rigor, and openness.

Full Time Faculty:

S. Bergmann, MD, PhD Chief of the Division	R. Gowda, MD Interventional Cardiology	N. Papapietro, MD Consultative Cardiology
M. Berger, MD Director, Echocardiography	S. Hanon, MD Electrophysiology	M. Rachko, MD Director, CCU
G. Bhambhani, MD Interventional Cardiology	S. Hecht, MD Echocardiography	H. Rosero, DO Interventional Cardiology
L. Do, MD Consultative Cardiology	S. Jani, MD Consultative Cardiology	O. Samuel, MD Consultative Cardiology
S. Evans, MD Director, EP Fellowship	T. Killip, MD Consultative Cardiology	P. Schweitzer, MD Associate Chief Cardiology Director, BI Fellowship
D. Finkielstein, MD Director, Ambulatory Cardiology	T. Kwan, MD Interventional Cardiology	P. Virzi, MD Consultative Cardiology
J. Fox, MD Director, Interventional Cardiology	P. Lam, MD Electrophysiology	K. Giedd, MD Director, Nuclear Cardiology and CT Imaging
D. Misra, MD Consultative Cardiology Director, BI/LICH Fellowship

CHEMICAL DEPENDENCY

Stanley Yancovitz, MD, a board-certified specialist in infectious diseases and chief of the Nathaniel Meltzer, MD Division of Chemical Dependency, also is director of AIDS clinical activities at Beth Israel. Under his leadership, the chemical dependency division has become a paradigm for educational programs in the field of chemical dependency. The division faculty is involved in clinical research in substance abuse and AIDS.

Research
There is ample opportunity for residents to develop and participate in ongoing clinical research projects. Current studies in which residents are involved include an investigation of the effects of cocaine on the liver and a clinical study of tuberculosis in the addicted population. Other recent research projects have been concerned with the effects of cocaine smoking on the lungs and the utility of routine chest X-ray in identifying disease in the population of patients undergoing detoxification.

The Residency Experience
Patients with alcohol or drug abuse problems who also have an acute medical disorder that requires hospital care are admitted to the General Medicine Services. Many of these patients suffer from infectious diseases, including HIV-related infections; pneumonia and tuberculosis; skin, soft tissue and bone infections related to intravenous drug abuse; and liver disease related to chronic viral infections such as hepatitis. Most do not have a private attending physician, and residents therefore have major responsibility for primary care under the supervision of faculty. In addition to dealing with the many and varied medical complications affecting these patients, residents have the opportunity to learn the principles of the identification of substance abuse, the management of detoxification and the long-term management of substance abusers. Weekly grand rounds in chemical dependency are provided for residents. Speakers from Beth Israel and other institutions discuss various aspects of chemical dependency and its medical and psychiatric complications. The quantity and quality of teaching by faculty with special expertise in dealing with the problems presented by substance abusers set this program apart from the training available in most institutions.

Faculty:
Om Anand, M.D.
Ellen Birenbaum, M.D.
Jeanne Carey, M.D.
Teresa Gomez, M.D.
Edwin A. Salsitz, M.D.
Randy Seewald, M.D.
Stanley Yancovitz, M.D.
Juan Bailey, M.D.

ENDOCRINOLOGY & DIABETES

Dr. Leonid Poretsky is the Chief of Endocrinology as of June 2000. He graduated cum laude from the First Medical Institute in Leningrad, Russia, in 1977. He completed his endocrine training at Boston's Beth Israel Medical Center Hospital at Harvard Medical School and is board-certified in both internal medicine and endocrinology. Dr. Poretsky's prior position was Director of Diabetes Center, Associate Director of General Clinical Research Center and Professor of Medicine at Cornell University Medical College. He is the author of over 70 publications. His research work has been supported throughout the years with NIH and other funding sources.

He has served on review panels of many general medical and endocrine journals. His research studies are presented annually at the Endocrine Society and American Diabetes Association meetings.

The division's clinical program encompasses all aspects of endocrinology in both in-patient and outpatient settings. The division is administering a two-year endocrine fellowship program. The division operates a fully equipped basic science research laboratory. An innovative diabetes management program, Friedman Diabetes Institute, was open in Spring, 2007.

Research
The division's research programs include studies of interaction between insulin and insulin-like growth factors and their receptors on cellular and molecular levels; studies of endocrinological aspects of AIDS; studies of thyroid disease in patients exposed to radiation from the Chernobyl accident; vitamin D deficiency in patients with diabetes, and clinical outcome trials in diabetes.

The Residency Experience

Rotations provide residents with the opportunity to explore and confirm an interest in endocrinology. Much of the training experience is one-on-one, with exposure to private and clinic patients, as well as inpatients. Faculty members are both knowledgeable and accessible and are prepared to devote substantial time and effort to individualized training. Residents see a wide variety of patients, with the heaviest concentration in the areas of diabetes, thyroid disease and reproductive endocrinology. The division collaborates closely with other departments, particularly obstetrics and gynecology, pediatrics and nuclear medicine. Clinics include general endocrinology, diabetes, gynecological endocrinology and pediatric endocrinology. Residents also participate in the activities of the Diabetes Management Team, which provides intensive coordinated management by physicians, nurses and dietitians. A nuclear scan conference is held weekly, in which residents review thyroid, parathyroid and adrenal scans. Other conferences include Endocrine Grand Rounds, Research Conferences, Journal Club, Clinical Case Discussion, Joint Endocrine/ENT Thyroid/Parathyroid Conferences and Joint Endocrine/Rheumatology Bone Metabolism Conferences.

Clinical Faculty:
Leonid Poretsky, MD
Gerald Bernstein, MD
Augustine Busta, MD
Joel Curtis, MD
Adrienne M. Fleckman, MD
Alina Gouller, MD
Emilia Liao, MD
Lisa Newman, MD
Aida h. Saliby, MD
Donna Seto-Young, Ph.D.
Walter Scott, MD
Dennis Shavelson, D.O.
Barnett Zumoff, MD

DIGESTIVE DISEASES

The Division of Digestive Diseases has expanded rapidly in the past few years with the addition of five new faculty members and provides state of the art expertise in clinical gastroenterology and liver diseases and liver pathology. Henry C. Bodenheimer, Jr., MD is chief of the Division. He is Professor of Medicine, has authored more than 50 peer-reviewed manuscripts, served on NIH study sections, was associate editor of Hepatology and served on the editorial board, and is a medical board member of the New York Organ Donor Network. He has served as president of the New York Gastroenterology Association. His current active research is in the areas of viral hepatitis and primary biliary cirrhosis. The division has recently enhanced and modernized the Endoscopy Unit. This Unit has been treating patients for more than 20 years and is one of the busiest in the region. This unit performs highly specialized procedures such as endoscopic retrograde cholangiopancreatography to outline the ducts of the gall bladder and pancreas, endoscopic ultrasound, laser endoscopy and capsule endoscopy. Dr. David Clain serves as the associate director of the division and has been instrumental in the division's growth. The gastroenterology laboratory performs a number of sophisticated tests such as 24-hour pH monitoring of the esophagus and esophageal and rectal manometry. The division supports specialized expertise in interpretation of liver biopsy pathology. In cooperation with the department of pathology liver biopsy slides from throughout the Continuum system are evaluated by Dr. Neil Theise.

Research
Residents are strongly encouraged to participate with faculty, fellows, associates and co-coordinators in research projects. Albert Min, M.D. is the Director of Hepatitis Research and together with Drs. Henry Bodenheimer and David Clain is specifically involved in many clinical trials of new therapeutic agents in the treatment of HBV and HCV. Douglas Meyer, M.D. is studying the treatment of hepatitis C complicated by hepatic steatosis and is interested in Liver Transplantation. Neil Theise, M.D. is a world renowned hepato-pathologist with a research focus in adult stem cell biology and the canals of Hering. Brett Bernstein, M.D. supervises capsule endoscopy and gastro-esophageal disorders, and is currently investigating the utility of magnification endoscopy in detecting Barrett's mucosa. David H. Robbins, M.D. recently joined the division and will be conducting research in the areas of gastrointestinal oncology and endoscopic ultrasound.

The Residency Experience
In addition to conferences, journal club, bedside teaching and laboratory work, the training experience includes a course in basic physiology as it relates to gastroenterology. An ambulatory GI clinic is held twice weekly and a liver clinic weekly. Patients at all these clinics are seen in consultation for gastrointestinal problems. Residents will work with six clinical fellows and two advanced fellows in endoscopy and pathology. This rotation allows residents to acquire a working knowledge of gastroenterology and p provides a foundation for the practice of general internal medicine.

Faculty:
Full-Time Faculty:
Henry C. Bodenheimer, Jr., M.D. - Chief of Division
Karl Bednarek, M.D. - Attending
Brett Bernstein, M.D. - Director of Ambulatory Service
David J. Clain, M.D. - Associate Chief
Douglas Meyer, M.D. - Medical Director of Liver Transplant
Albert D. Min, M.D. - Director of Hepatitis Research, Fellowship Program Director
David H. Robbins, M.D. - Director Endoscopic Ultrasound
Neil Theise, M.D. - Hepatopathologist

Interventional Endoscopy:
Jerome Siegel, M.D.
Seth Cohen, M.D.
Franklin Kasmin, M.D.

Part-Time Faculty:
Alvin Gelb, M.D. - Former Chief of Division

GERIATRIC MEDICINE

The Betty and Morton Yarmon Division of Geriatric Medicine has expanded the training component of the service and has developed a consolidated approach to caring for the geriatric patient.

The Residency Experience

The Geriatrics consultation rotation includes house officers, a geriatrics fellow, geropsychiatrists and specialized social workers. They collaborate in a true team effort to provide the best possible quality of care for these patients. This serves as the educational base for residents who spend at least one month during the program focusing on geriatric medicine. The goal of the educational program is to educate the resident about the special needs of the elderly, spanning the spectrum from the healthy individual to the dying patient. Residents also learn to apply the principles of long-term care of the elderly, such as the avoidance of restraints and sedating medications. The resident joins in addressing geriatric syndromes through a team effort and enhanced support and educational services for patients and families. In addition, residents are introduced to principles of outpatient management at the Phillips Ambulatory Care Center and home visits.

Clinical Faculty:
Valery Portnoi, M.D.

HEMATOLOGY/ONCOLOGY

The Hematology/Oncology fellowship at Beth Israel Medical Center provides comprehensive training in Medical Oncology and benign and malignant Hematology. The program is directed by Dr. Ronald Blum, an internationally recognized expert in lung cancer, melanoma and sarcoma. The curriculum is designed to offer exposure to patients with the full spectrum of disorders in hematology and oncology. The fellows' experiences with patients are supplemented by a full complement of didactic lectures, disease specific academic conferences, weekly grand rounds, a research conference and a monthly journal club. Fellows are expected to actively contribute to a scholarly research project during their second and third years of training. Because Beth Israel Medical Center and St. Luke's-Roosevelt Hospital are partners with a single division of Hematology-Oncology, fellows also can take advantage of clinical and research opportunities at the St. Luke's-Roosevelt campus.

Faculty:

Michael Grossbard, MD, chair of the Hematology/Oncology Division for both Beth Israel Medical Center and St. Luke's-Roosevelt is a recognized expert in hematologic malignancies and also has contributed to academic programs in thoracic oncology, gastrointestinal cancer and melanoma. He has authored many peer-reviewed publications and is an Associate Professor of Clinical Medicine at Columbia University College of Physicians and Surgeons.

Ronald H. Blum, MD, Director of Continuum Cancer Centers, assumed leadership of the Hematology/Oncology fellowship program in July 2003, and is involved with daily teaching and supervision of the subspecialty program. In addition, he directs the Cancer center research program. Dr. Blum is a Professor of Medicine at Albert Einstein College of Medicine and an internationally recognized expert in lung cancer ,melanoma and sarcoma.

Ralph Zalusky, MD, former division chair, was previously a member of the hematology division at Mount Sinai Medical Center. His research interests include the anemias and bone marrow failure syndromes, and he has published extensively on both topics.

Stephen Malamud, MD, is known for his expertise in the treatment of solid tumors of the lung, breast, colon and prostate. Dr. Malamud has extensive experience in the conduct of clinical trials in patients with GI, thoracic and breast cancers.

Bruce Culliney, MD leads the medical oncology component of the Head and Neck cancer program at Beth Israel Medical Center. This program is internationally recognized for its landmark work in organ preservation, radiation oncology and innovative combined modality approaches to these tumors.

Ilan Shapira, MD serves as the Associate Director of the Hematology/Oncology training program. He mentors the fellows, residents and students in the hematology clinic, helps organize the journal club. His interests are benign and malignant hematology, coagulation disorders and GU and GYN oncology.

Peter Kozuch, MD joined the faculty at Beth Israel Medical Center in 2006. Prior to coming to Beth Israel, he was an Assistant Professor of Clinical Medicine, Columbia University College of Physicians and Surgeons and Attending Physician, Division of Hematology/Oncology, St. Luke's-Roosevelt Hospital Center. His primary area of expertise is in gastrointestinal malignancies and is one of the program directors of the newly formed multidisciplinary GI cancer program of the Continuum Cancer Centers of New York.

Facilities:

Research
The division's current research interests include many protocols for the clinical investigation of newer agents in the treatment of malignant diseases. As a satellite member of the Eastern Cooperative Oncology Group (ECOG), as part of our affiliation with the Albert Einstein College of Medicine, several cooperative group trials are available for patients. A monthly research conference serves a forum for the discussion of both new and currently active protocols. All fellows are required to actively participate in the research program.

The Residency Experience
Residents and interns rotate through the hematology/oncology inpatient unit, receiving in-depth instruction by fellows and sub-specialty attendings. During elective rotation on the consult service, each resident is assigned to a hematology/oncology fellow who sees all service consultations in both hematological and neoplastic diseases. Residents become familiar with blood morphology and bone marrow biopsy procedures and may assist in performing them. They also attend the division's two weekly outpatient clinics, one in hematology and one in oncology, and meet regularly with the assigned attending physician for review and discussion of case management of both inpatients and outpatients.

Divisional conferences and tumor board conferences are held each week. This rotation offers the opportunity to become familiar with the fundamentals of neoplastic disorders and a variety of hematological disorders and is valuable in helping house officers determine whether they wish to specialize in these areas.

Clinical Faculty:
Michael Grossbard, M.D.
Ronald Blum, M.D.
Bruce Culliney, M.D.
Peter Kozuch, MD
Stephen Malamud, M.D.
Ilan Shapiro, M.D.
Ralph Zalusky, M.D.

HOSPITALISTS

Since its inception in 1998, the Beth Israel Hospitalist Program has become an integral part of the Department of Medicine's training program. The group's initial focus was to provide inpatient medical care and continuity for the medical center's primary teaching practice. However due to the growing needs of many primary physicians and specialists throughout the community, the Hospitalist Program has grown to become a critical part of the institution as a whole. Paralleling the nationwide trend towards increasing numbers of hospital based physicians, Beth Israel's Hospitalist Program has expanded from one to eleven full time physicians in just this short period with plans for future growth based on current successes. The group's mission is to provide excellent quality of care with a focus on patient satisfaction and safety, utilizing evidence based medicine and best practices.

The Hospitalist Department over recent years has grown to care for over 50% of all hospitalized medicine patients (over 7,000 admissions last year alone) with responsibilities that include direct patient care and supervision of medical students and medical housestaff. This supervision is done with the intention of allowing the housestaff to remain autonomous without ever feeling alone in the management of their cases. Our coverage includes 7 day, 24-hour availability and allows the primary care physicians and specialists in the community to keep up with the increasing demands of busy outpatient practices and procedures. This trend has allowed the inpatient group to truly become expert in the care of sicker, hospitalized patients in various areas of medicine.

Beth Israel's hospitalists have been integrated into key areas of hospital culture-making important contributions to initiatives in decreased length of stay, reduction in medication errors, patient safety, patient satisfaction and improved test utilization. Perioperative and consultative medicine have also been a focus. With our diverse backgrounds, clinical skills and interests, we will continue to make our mark with administration and contribute to the many facets of inpatient medicine providing a dynamic and positive experience for all.

Faculty includes 11 full time board certified physicians all with academic appointment to The Albert Einstein College of Medicine:

Dahlia Rizk, D.O. - Hospitalist Program Director
Veevek Agrawal, D.O.
Rebecca Calabrese, M.D.
Yaju Chang, M.D. - board certified Rheumatologist
Sung-Hae Cho, M.D.
Sharon Goldberg, M.D.
Hayden Goltz, D.O.
Erica Grabscheid, M.D. - Hospitalist Program Associate Director
Jeffrey Low, M.D.
Svetlana Matayev, M.D.
Armine Michael, M.D.
Latha Sivaprasad, M.D.
Daniel Steinberg, M.D. - Associate Program Director Residency Program

INFECTIOUS DISEASES

Donna Mildvan, MD, is Chief of the Division of Infectious Diseases, Director of AIDS Research at Beth Israel Medical Center in New York, NY and Professor of Medicine at the Albert Einstein College of Medicine, Bronx, NY. Dr. Mildvan is an elected fellow of the Infectious Diseases Society of America and of the American College of Physicians. She has served on numerous national committees and panels, including the AIDS Charter Research Review Committee for the National Institute of Allergy and Infectious Diseases (NIAID), and has been a consultant to the Centers for Disease Control and Food and Drug Administration. Dr. Mildvan has authored more than 200 articles on HIV/AIDS clinical trials and is principal investigator of the NIAID-sponsored AIDS Clinical Trials Unit at Beth Israel Medical Center.

Inpatient Rotation
Residents in Internal Medicine rotate through the HIV/Infectious Diseases clustered unit as ward rotation learning about the care of HIV-infected patients and the management of the diverse complications of HIV infection. The core curriculum for this rotation address, among other things, the pathophysiology of HIV infection, the epidemiology of HIV, the clinical manifestation of infectious, hematological-oncologic, neurological, ophthalmologic, gastroenterological, renal, mental health as well as antiretroviral therapeutic approaches and strategies to promote adherence. Attending physicians on the AIDS rotation include members of the Infectious Diseases Division, and other attendings from the Department of Medicine with significant clinical experience and interest in the care of patients with complications of HIV infection. Residents participate in multidisciplinary conferences and a multidisciplinary team approach to care of the HIV-infected patient.

Infectious Diseases Elective Rotation
Medicine residents have the opportunity to be part of one of two active infectious diseases consult teams, composed of one of the infectious disease fellows, the teaching infectious disease attending, and possibly medical students on elective. The medical resident sees consults under the supervision of the fellow and attending. A wide variety of viral, bacterial, fungal, and parasitic diseases are seen. There is a particularly extensive exposure to HIV-related complications. Residents may attend sessions in the infection diseases outpatient clinics. They will also attend weekly case presentation conferences, interdisciplinary conferences, infectious diseases grand rounds, evidence-based journal clubs, and basic science and clinical review sessions.

Peter Krueger Clinic
The Peter Krueger Clinic is an HIV primary care clinic with co-located mental health, dental, social, and specialty services, including dermatology, pain management, neurology, and ophthalmology services. The medical staff includes 6 HIV specialists and four Infectious Diseases fellows who together provide longitudinal care to over 1100 HIV-infected patients. The Peter Krueger Clinic represents a unique opportunity for outpatient elective and for clinical research.

Infectious Diseases Fellowship Program
The fellowship is a two-year program of clinical training, with 7 months devoted to the performance of a clinical research project. In addition to general infectious diseases inpatient consultations, there are rotations in transplant infectious diseases, infection control, sexually transmitted infections, pediatric infectious diseases, and the microbiology laboratory. Fellows follow a panel of patients in their weekly sessions in the Peter Krueger HIV Clinic, and see other patients in monthly general infectious disease clinic sessions.

Research
The AIDS Clinical Trials Unit (ACTU) at Beth Israel Medical Center has been conducting studies under the auspices of the National Institute of Allergy and Infectious Diseases (NIAID), a division of the National Institutes of Health, and the pharmaceutical industry since 1987. During the past 16 years Beth Israel has participated, and continues to participate, in numerous trials that led to the approval of many of the treatments that are now licensed for use in HIV infection and the associated opportunistic infections. The BI ACTU has enrolled over 1000 patients in ACTG studies and industry-sponsored trials. The Division also engages in research on epidemiologic, health service and clinical aspects of tuberculosis in general, in drug users and other subgroups, on epidemiologic, clinical and health service aspects of viral hepatitis, on sexually transmitted infections in drug users, on vaccine development for HIV, on many aspects of infection control, and on a wide range of infectious diseases issues.

Clinical Faculty:

Name	Title
Donna Mildvan, M.D.	Chief, Division of Infectious Diseases
Stanley Yancovitz, M.D.	Fellowship Program Director, Division of Infectious Diseases
Jeanne Carey, M.D.	Sr. Associate Director, Medicine Residency Training Program
Tessa Gomez, M.D.	Associate Attending
Brian Koll, M.D.	Director, Infection Control
Sanjana Koshy, M.D.	Assistant Attending
David Perlman, M.D.	Associate Chief, Division of Infectious Diseases
Manuel Revuelta, M.D.	Physician-in-Charge, Infectious Diseases Clinical Practice
Jorg Ruhe, M.D.	Assistant Attending
Nadim Salomon, M.D.	Director, Peter Krueger Clinic
Mary Waldron, M.D.	Assistant Medical Director, Peter Krueger Clinic

NEPHROLOGY

James F. Winchester, M.D., FRCP (Glasgow), FACP, received his internal medicine and nephrology training in Glasgow, Scotland, developing clinical and research interests in poisoning and removal of toxins with dialysis and hemoperfusion. Dr. Winchester joined the staff at Georgetown University Medical Center, Washington, DC, in 1976, achieving tenure as Professor of Medicine (1987), as well as Chief of the Division of Nephrology from 1988-1994. From 2000-2004, he was Chief Medical Officer, Renal Tech International, directing research into the use of sorbents in end-stage renal disease, inflammation and sepsis. His New York appointments include faculty positions at Albert Einstein College of Medicine, Downstate Medical Center and Columbia University. He was appointed Chief, Division of Nephrology and Hypertension at Beth Israel Medical Center in July, 2004 and Vice- Chair Department of Medicine in 2007. He has over 300 scientific papers, reviews and chapters. He was editor of "Clinical Management of Poisoning and Drug Overdose", and is currently Editor-in-chief of "Replacement of Renal Function by Dialysis." He is past President of the American Society for Artificial Internal Organs, and was in leadership positions in the International Society for Peritoneal Dialysis, and the National Kidney Foundation.

Research

The Division of Nephrology and Hypertension is recognized nationally as a leader in the refinement of state-of-the-art technology for both hemodialysis and peritoneal dialysis. Current active areas of research include dialysis kinetics, body composition, cytokine responses to dialysis as well as inflammation, and hemodynamics. A new interest of the Division is the initiation of the Cardiorenal Protection Initiative (CAPRI) - a joint ambulatory clinical service provided by the Cardiology and Nephrology divisions to identify cardiac risk factors in patients with impaired kidney function and subsequently manage investigation and treatment. A major interest of the division is the treatment of renal osteodystrophy with new calcium receptor sensitizing agents. In addition the division has a clinical research laboratory on site at BIMC. This laboratory supports the cytokine and chemokine studies being performed by the division in collaboration with both RRI and other divisions in the Department of Medicine. The residents are encouraged and mentored during their research experience, and are given the opportunity to attend and present their findings at national meetings.

The Residency Experience

The nephrology and hypertension division offers comprehensive training in all aspects of nephrology, including hypertension, transplantation, renal biopsy performance and interpretation, acid-base and electrolyte disorders, statistics and clinical trial design, clinical and bench research, acute renal failure as well as hemodialysis and peritoneal dialysis for end stage renal disease (now called chronic kidney disease (CKD) - stage V). Training specifically addresses the 6 competencies of medical training, as required by the Accreditation Council for Graduate Medical Education (ACGME). Inpatient experience for the resident is at Beth Israel Medical Center (BIMC) Petrie Division, where there are significant numbers of admissions of new-onset end stage renal failure as well as acute renal failure related to patients in the medical, cardiac and surgical intensive care units. The rich clinical environment at BIMC is conducive to the rapid acquisition of knowledge in clinical nephrology.

Clinical experience with dialysis is gained from the management of patients receiving hemodialysis at two large outpatient facilities, one located on the lower east side of Manhattan (Irving Place Dialysis Center) in proximity to the Petrie Division, the second on the upper east side of Manhattan (Yorkville Dialysis Center). Peritoneal dialysis experience is gained by rotation to Long Island College Hospital, Brooklyn, where Dr. Paul Fein has the largest ambulatory peritoneal dialysis unit in the New York Metropolitan area. Transplantation experience is gained at Montefiore Medical Center, Bronx, where Dr. Daniel Glicklich has a large group of kidney transplant patients. Continuity clinical experience is gained at the Phillips Ambulatory Care Center in proximity to BIMC, and the Irving Place Dialysis Center, where the residents see their own group of patients through the training years, supervised by the nephrology faculty.

The hemodialysis program is a unique experience for the residents as a result of the expertise of our faculty and our relationship with the Renal Research Institute. The Renal Research Institute is an organization designed to promote the highest caliber of care based on advanced clinical technology and is committed to research and innovation that will lead to improved patient outcomes and quality of life. Dr. Nathan Levin, the medical and research director, is an international figure in the field of dialysis. Major publications by the Renal Research Institute since its inception in 1996 along with divisional faculty members have resulted in changes in the practice of dialysis. Nephrology fellows and Beth Israel medical residents may participate in RRI projects.

The fellows and faculty are involved in research in various aspects of nephrology including, treatment of poisoning, all stages of CKD, acute renal failure, hypertension, bone disease, anemia and dialysis.

Teaching is bedside-oriented and based on the application of physiological principles to the analysis of clinical phenomena. Teamwork is stressed, with physicians working closely with nutritionists, nursing staff, technicians and social workers to deal with all the medical, social and psychological problems of the patient with end-stage renal disease. Scheduled conferences include a "Renal Grand Rounds" with rotating journal club, renal grand rounds, renal biopsy conference, research conference and a separate clinical case conference presided over by Dr. Winchester and Dr. Feinfeld and members of the attending staff. Visiting professors from other institutes frequently give lectures and describe their research experiences. Members of the division collaborate closely with other sub-specialists, allowing for a coordinated and multidisciplinary approach to the wide variety of diseases and disorders to which end-stage patients are susceptible.

Key Clinical and Research Faculty:

James F. Winchester, MD, FRCP(Glas), F.A.C.P. Chief
Donald A. Feinfeld, MD, F.A.C.P, F.A.S.N, Director, Fellowship Training
Richard Amerling, MD, Director, Outpatient Dialysis
Alan Dubrow, MD, Director, Inpatient Dialysis
Steven Gruber, MD, Director, Nephrology Development
Nikolas Harbord, MD, Director, Nephrology Outreach
Viktoriya Kuntsevich, PhD, Clinical Scientist
Nathan W. Levin, MD, Medical Director RRI (Renal Research Institute)
Zinovy Z. Brener, MD, Director, Clincal Case Studies

OCCUPATIONAL MEDICINE & EMPLOYEE HEALTH

David D. Souza, M.D., M.P.H., medical director of the Division of Occupational Medicine and Employee Health, is a board certified physician with over 15 years of experience in Occupational Medicine. Under his direction, the Division provides occupational health care to Beth Israel employees, as well as to the employees of various metropolitan area employers, and also provides consultations regarding occupational health and safety programs to employers. The division brings a very important perspective regarding the prevention, medical surveillance, diagnosis and management of work-related illness to the Beth Israel Medical Center system.

Research
Clinical research studies include the evaluation of various tools for surveillance for tuberculosis infection. The utility of various incentives to achieve high participation rates in medical surveillance is also being tracked.

The Residency Experience
All residents will receive a broad exposure to occupational medicine and toxicology. The occupational health of both health care workers and workers in many other occupations will be reviewed. Residents will become familiar with the structure and support necessary for delivering high-quality occupational health care, as well as the role of various entities such as the federal, state and local governments, unions and employers. The patient mix includes patients with occupational pulmonary disorders, heavy metal poisoning and repetitive motion musculoskeletal injuries.

Residents will work several sessions per week in the occupational medicine/employee health clinic. Residents also will participate in occupational medicine and toxicology consultations within the Medical Center.

Faculty:
David D'Souza, M.D.
Ira Cohen, M.D.
Mekdes Hailu, M.D.
Jason Pachman, M.D.

PULMONARY DISEASE & CRITICAL CARE MEDICINE

Steve H. Salzman, MD, is Chief of the Division of Pulmonary, Critical Care and Sleep Medicine. Dr. Salzman's research interests include clinical pulmonary physiology (the clinical role of pulmonary function tests and cardiopulmonary exercise tests) and the role of different bronchoscopic techniques in the diagnosis of pulmonary infections and other pulmonary disorders.

Dr. Salzman is known nationally as a teacher of pulmonary physiology. He has been on the faculty of the American College of Chest Physicians (ACCP) annual Pulmonary Board Review for the past eight years, and lectures annually at CHEST, the international conference of the ACCP on pulmonary, critical care and sleep medicine.

Research
Research within the division covers clinical pulmonary physiology, pulmonary and critical care complications of HIV infection, emergency endotracheal intubation, thoracic and critical care ultrasonography, arterial and central venous catheter insertion, quality improvement in critical care units, respiratory monitoring, computer simulation in training, sleep medicine and related disorders, and pulmonary arterial hypertension.

The Residency Experience
Residents rotate through the medical ICU during all three years and are responsible for management of critically ill patients under the supervision of full-time certified intensivists along with a pulmonary and critical care fellow, both of whom are present in the MICU for the entire day. Multidisciplinary rounds by members of the division are held daily in the 16-bed unit MICU.

Residents also rotate through a 6 - 12 bed respiratory special care unit that focuses on care and weaning of patients on prolonged mechanical ventilation, typically after care in one of the ICUs. In addition, residents have an opportunity to participate in the Pulmonary Consultation elective rotations on this popular service. A Sleep Disorders Laboratory is available on site and run by the division staff.

An outstanding and enthusiastic faculty offers a program of training in the diagnosis and treatment of a wide variety of pulmonary diseases, critical illnesses and sleep disorders. A series of conferences cover topics that include pulmonary radiology, pathology and physiology. Residents on elective participate in consultations and are trained in indications for procedures such as bronchoscopy, pulmonary function testing and cardiopulmonary exercise testing.

Clinical Faculty:

Frank L. Acerra, DO	Jonathan Raskin, MD
Samuel O. Acquah, MD	Steve H. Salzman, MD
Paul H. Mayo, MD	Roxana Sulica, MD
Mangala Narasimhan, DO	Patricia Villamena, MD

QUALITY IMPROVEMENT

The Mission Statement of Beth Israel Medical Center is to provide the highest quality patient care, with compassion and concern for patients' well being. To this end, we are committed to furnish training of the highest caliber for our residents so that they may deliver the finest quality health care services to our patients.

Quality is emphasized in each and every formal and informal activity that the trainee participates in throughout their tenure at Beth Israel. The program emphasizes state of the art treatment and services, outcomes of care, patient satisfaction and safety. All resident activities are geared toward quality care. These include grand rounds, morning report, noon conferences, morbidity and mortality conference, journal clubs as well as attending rounds. If a concern is raised regarding the standard of care rendered to a patient, the Quality Improvement Executive Committee will suggest actions that are non-punitive and educational.

The Division of Quality Improvement, through its monitoring process and multidisciplinary committee, objectively assesses patient care and services by monitoring and evaluating programs established by each Division of the Department and the Residency Program.

The Residency Experience
One of the Chief Residents is a standing member of the QI Committee and other residents have joined as well. Many house staff participate in real-time quality projects. For example, residents have conducted a survey to determine the current usage of deep vein thrombosis prophylaxis in their patients and have taken part in a customer satisfaction improvement program in response to observations provided by their patients.

Research
Several residents have participated in research projects that were first identified during a quality improvement activity including studies of:

• The medical management of spinal epidural abscess that resulted in a hospital wide guideline and presentation at a national meeting.
• House staff knowledge and attitudes regarding the use of Linezolid, a very expensive antibiotic, which resulted in a presentation at a national meeting and the submission of a manuscript.
• The diagnosis and care of Hepatitis C virus-infected patients in a primary care clinic. This study also resulted in a presentation at a national meeting as well as a manuscript.

Quality Improvement Committee:
Jeanne Carey, M.D.-Chairperson

RHEUMATOLOGY

Harry D. Fischer, MD, heads the Division of Rheumatology. Dr. Fischer was one of the first rheumatologists to describe the rheumatic manifestations of HIV infections. Additional clinical interests include systemic lupus erythematosis, rheumatoid arthritis, vasculitis and Lyme Disease.

Paula Rackoff, MD, has a particular interest in women's health. She is a principal investigator for the Women's Health Initiative. Beth Israel Medical Center is the Manhattan site for this NIH-funded study. Her other area of interest is osteoporosis, and she serves on the board of a major osteoporosis journal. Residents on rotation have the opportunity to evaluate, diagnose and help manage patients with rheumatic diseases. The underlying disease mechanisms as well as the multi-system nature of rheumatic conditions are emphasized. Physicians see patients in both an inpatient and ambulatory setting.

Ya Ju Chang, MD, is primarily a hospital based Rheumatologist who has expertise in treating conditions seen in an inpatient setting from the simple case of gout to complex vasculitis. He has been recognized by the housestaff as an outstanding teacher.

Clinical Faculty:
Harry Fischer, MD
Ya Ju Chang, MD
Paula Rackoff, MD

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