Scripps Clinic and Scripps Green Hospital Medical Student Rotations

The Scripps Green Hospital and Scripps Clinic Internal Medicine Program offers an intensive inpatient training opportunity for fourth year medical students who want to gain an educational experience in the domain of evaluation and treatment of patients with advanced kidney disease.

Fourth year medical students will function as part of a team, which includes one nephrologist and one senior IM resident. The experience will be largely, but not completely, inpatient based.

Acting interns (AI) will primarily serve in a consultant capacity to evaluate and manage patients at Scripps Green Hospital with both acute and chronic advanced kidney disease. The AI will evaluate and manage patients in the ICU, medical and surgical floors and within the organ transplant unit. Daily bed-side teaching and management rounds will occur with the attending nephrologist. The student will become adept at the evaluation of acute renal failure, analysis of urine sediment, selection and management of renal replacement therapies and evaluation and management of patients in the peri-transplant phase, including management of immunosuppressive therapies. AI's will carry a census of between four to six patients depending upon the volume of the service and the capabilities of the student.

This is a six-day per week assignment.

The Scripps Green Hospital and Scripps Clinic Internal Medicine Program offers an intensive inpatient training opportunity for fourth year medical students who want to gain an educational experience in the domain of evaluation and treatment of patients with advanced liver disease.

Fourth year medical students will function as part of a team, which includes one hepatologist, one senior medicine resident and one intern. The experience is completely inpatient based.

Students will evaluate and manage severely ill patients with a variety of advanced liver diseases — particularly those patients awaiting organ transplant and those recently transplanted. Students will evaluate and manage advanced liver disease patients in both the ICU and medical floors. Students will become adept at performing and interpreting results of paracentesis and become well versed in principles of transplant immunosuppression. 

Opportunity to observe liver transplantation procedure is usually provided.

Students will attend daily IM Morning Report, daily teaching and management rounds with the attending hepatologist, and twice weekly hepatology teaching conference. Acting interns on the hepatology service will typically carry a census between three to five patients depending upon service volume and student capability.

This is a six-day per week assignment.

The Scripps Green Hospital and Scripps Clinic Internal Medicine Program offers an intensive inpatient training opportunity for fourth year medical students who want to gain an educational experience in the domain of evaluation and treatment of patients with critical illness.

Senior medical students will function as part of a team, including two attending intensivists, two or three senior residents and an intern. This is a challenging but exciting rotation wherein the M-4 will have the opportunity to admit, discharge, transfer, teach and perform procedures all under the supervision of the residents and 24/7 in house attendings.

The M-4 will have primary responsibility to care for a diverse population of critically ill medical and surgical patients. The M-4 census is generally two to three patients, based on the severity of the patient’s illness and the students’ abilities. The evaluation and management of patients is directly overseen by the residents and is presented by the student to the attending upon admission and on a daily basis during bedside rounds.

Rounds are multidisciplinary with nursing, respiratory therapy and pharmacy engagement and are a primary source of teaching. There is a heavy focus on communication: during rounds, with the consulting and surgical services and the daily interactions with patients and their families. Daily chest X-ray rounds allow the student to become facile in the interpretation of chest radiographs.

Weekly ICU teaching rounds are conducted in the ICU and include bedside exam skills, bedside ultrasound and interactive sessions focused on critical illness. The M-4 will have the opportunity to conduct or participate in these sessions as well as the twice monthly ACLS simulation sessions. The resident will become increasingly comfortable with evaluation and management of critical illness, interpretation of hemodynamic and respiratory monitors, discussing goals of care and prioritizing tasks.

This is a 6 day per week, 4 week assignment with no night call.

The Scripps Green Hospital and Scripps Clinic Internal Medicine Program offers an intensive outpatient based assignment in our heart failure center at Scripps Green Hospital. An inpatient component at the closely affiliated Scripps Prebys Cardiovascular Institute is included wherein the student will become versed in and assist in the management of patients with recent insertion of left ventricular assist devices (LVAD).

Fourth year students will participate as part of an outpatient and inpatient team, which includes an attending heart failure cardiologist, a general cardiology fellow (at times), an internal medicine resident (at times) and a heart failure allied health professional.

Students will assist in the evaluation and management of patients with new advanced heart failure, as well as those requiring careful maintenance therapy. Students will become well versed in the pathophysiology of heart failure, its acute evaluation and both acute and chronic management. Students will become well versed in both pharmacologic and device assisted management of the disease.

Office based bedside teaching rounds will occur daily. Inpatient teaching rounds will occur when the student is assigned inpatients for evaluation and management. Students will evaluate between four to eight outpatients in the heart failure clinic per day (depending upon volume and type of visit), collaborate with the heart failure management team in chronic disease management, evaluate patients for LVAD, bi-ventricular pacing, AICD needs and performance on a daily basis and participate on inpatient heart failure rounds depending upon patient volume.

This is generally a five-day per week assignment.

The Scripps Green Hospital and Scripps Clinic Internal Medicine Program offers an intensive combined inpatient and outpatient based assignment in infectious diseases (ID) at Scripps Green Hospital for fourth year medical students who wish to gain an in-depth educational experience in the evaluation and management of severe infectious disorders.

Fourth year students will participate as part of an inpatient and outpatient team that includes an infectious disease attending, an ID fellow (at times) and an IM resident (at times).

The student will provide consultation and ongoing care for patients who have documented infections. Student and staff will evaluate patients with undiagnosed fevers (FUO), unusual illnesses, travel-related illnesses and advise patients and physicians on the appropriate use of antimicrobial agents in the care of human infectious diseases.

Patients who have undergone, or will undergo, solid organ or stem cell transplantation are also cared for in conjunction with the transplant physicians and surgeons. A large volume of patients on the ID service are severely immunocompromised. Opportunities exist to work in the microbiology and virology laboratories in the diagnosis and supervision of viral infections and the use of culture and non-culture techniques.

The student will attend daily internal medicine morning report, attend several teaching conferences weekly and participate in daily bedside teaching and management rounds. Students will typically consult upon and carry a patient census of four to seven patients per day depending upon student capability.

This is generally a five-day per week assignment.

The Scripps Green Hospital and Scripps Clinic Internal Medicine Program offers an intensive outpatient-based assignment at the Scripps Center for Integrative Medicine for fourth year medical students who wish to gain an in-depth educational experience in the principles of integrative and alternative medicine.

Students will experience different integrative approaches for specific conditions including, heart disease, non-narcotic pain management and women’s health. Students will learn about conventional and evidenced based holistic medicine techniques and modalities. These may include lifestyle change consults and heart disease recovery, acupuncture, biostimulation and biofeedback, natural supplements, nutrition, Healing Touch, stress reduction, massage and much more.

Research opportunities also abound at the center. Interaction with the various providers, and consultation with primary care physicians, will be an important component of this educational experience. Attendance at the weekly Tuesday conference in the center, involving all faculty and practitioners is required.

This is generally a five-day per week assignment.

The Scripps Green Hospital and Scripps Clinic Internal Medicine Program offers a mainly outpatient- based assignment in the Division of Hematology/Oncology for 4th year medical students who wish to gain an in-depth educational experience in the principles of hematology and medical oncology.

Students will participate in a variety of outpatient clinics gaining experience in solid tumor oncology, malignant hematology, stem cell transplantation, and benign hematology. They will learn about diagnosis and prognosis of malignant and benign diseases as well as complications and therapeutic options. Interaction with the various providers, fellows, pharmacists, social workers and nursing will be an important component of this educational experience. Students may have the opportunity to participate in inpatient hematology and oncology rounds with an attending and fellow. Attendance is expected at weekly core didactics as well as Friday morning Division Rounds.

This is a five-day per week assignment.

The Scripps Clinic/Scripps Green Hospital Division of Diabetes and Endocrinology offers an intensive outpatient-based assignment at the Anderson Medical Pavilion and satellite clinic locations for 4th year medical students who wish to gain an in-depth educational experience in the management and treatment of endocrine disease.  

Students will have their own scheduled patients and will be closely mentored and attended in the care of each by our 10 faculty members including our Program Director, Associate Program Director, and Division Head.  Outpatient management will include participation in procedural endocrinology such as interpretation of diabetes technology modalities (insulin pump data, continuous glucose monitor data, bone densitometry/DEXA reports) as well as observation and potential assistance with thyroid and neck ultrasonography and ultrasound-guided fine needle aspiration. Detailed attention will be paid to instruction in diabetes care including insulin management and use of different classes of non-insulin therapies. Students will also be able to see patients in our weight management division and learn about the practice of obesity medicine which includes management of patients pre- and post-bariatric surgery.

Interaction with and learning from our Endocrinology Fellows will be a critical component of the rotation experience as will potential collaboration with referring providers. Attendance at weekly Thursday didactic conferences as well as at Journal Clubs, Interdisciplinary Conferences, and, if applicable, Morbidity and Mortality conferences is required.

This is generally a 5-day per week assignment.