Allegheny General Hospital offers extensive inpatient and ambulatory services through 15 subspecialty divisions and sections within the Department of Medicine including:

• Allergy
• Cardiology
• Clinical Trials Unit
• Dental Medicine
• Dermatology
• Endocrinology
• Gastroenterology
• General Internal Medicine
• Hematology
• Infectious Diseases
• Medical Oncology
• Nephrology and Hypertension
• Occupational Health
• Respiratory Diseases
• Rheumatology

The Department of Medicine is committed to offering the highest quality educational programs to residents, including the Categorical Medicine Residency, Primary-Care Tract, Preliminary Medicine Year, Combined Internal Medicine/Emergency Medicine Residency and five subspecialty fellowships. The core of full-time teaching faculty, as well as the voluntary attending staff, provides a strong academic environment for training residents. The program’s philosophy is to prepare residents to enter competitive fellowship programs or deliver quality primary medical care, as they choose.

The Divisions

The Division of Allergy offers therapeutic and diagnostic services to both adults and children. Special interests include asthma, allergic rhinitis, cystic fibrosis, hay fever and insect sting sensitivity.

The Division of Cardiology is one of the most active services within the Department of Medicine. Cardiologists provide comprehensive evaluation, consultation and medical management of diseases

of the circulatory system and heart. Fourteen full-time staff members participate in the teaching program. Each year, 12,600 catheterizations — including more than 3,000 angioplasties — are performed in the division’s seven catheterization laboratories.

The Noninvasive Cardiology Laboratory is a referral center for two-dimensional, Doppler, transesophageal and stress echocardiography. More than 8,000 studies are performed per year in the laboratory. The laboratory also provides cardiac MRI services in collaboration with the Department of Diagnostic Radiology.

The Nuclear Cardiology and Exercise Physiology Laboratory possesses extensive facilities for noninvasive imaging of thallium, technetium and a variety of investigational isotopes. This laboratory also provides clinical and research programs in advanced heart failure.

Five full-time cardiac electrophysiologists staff two electrophysiology laboratories and treat life-threatening cardiac arrhythmias using a variety of conventional and investigational anti-arrhythmic agents, as well as antitachycardiac pacemakers, automatic implantable defibrillators and radiofre-quency ablation. The Division of Cardiology actively assists in evaluating and caring for heart transplant patients through the hospital’s cardiac transplant program.

Through the Cardiology Service rotation, medicine interns care for patients with cardiac disease on a team led by a staff cardiologist. During year 2, house staff officers have an eight-week assignment on the Coronary Care Unit. In addition, clinical cardiology, noninvasive laboratory, electrophysiology, nuclear cardiology, clinical and research electives are available.

The Clinical Trials Unit coordinates a program of clinical investigators for the Department of Medicine. This multispecialty group is comprised of physician-investigators, statisticians, epidemiologists and study coordinators. Among other projects, they serve as the data coordinating center for the Thrombolysis and Acute MI (TIMI) and other major national and international cardiac trials. They serve as a resource to local investigators and provide an excellent opportunity for residents and fellows interested in clinical research.

Dental services at Allegheny General Hospital include orthodontics, pediatric dentistry, geriatric dentistry, periodontology and oral medicine, and restorative and prosthetic dentistry. Hospital-based practitioners also are supported by a full staff of dental assistants and hygienists.

Dermatologists in this division diagnose and treat all forms of cutaneous disease. Services also include phototherapy and dermatologic surgery. Residents rotate through dermatology during their ambulatory blocks and can do inpatient dermatology consultation as an upper-level elective.

Patients in the Division of Endocrinology reflect the full range of routine and complex endocrine/metabolic diagnostic and treatment problems. House staff officers participate in daily teaching rounds, care for patients admitted to the Endocrinology Service and serve on a consultative basis. Through weekly endocrinology clinics and in the offices of the staff endocrinologists, residents gain experience in the outpatient care of those with less acute endocrine/metabolic problems.

All significant hormone assays, including immunoassay of peptide hormones, are performed in the Endocrinology Laboratory. The Division of Endocrinology conducts a weekly clinicopathologic conference as well as a monthly interdepartmental endocrine conference and a bimonthly thyroid/nuclear medicine conference.

Through the Allegheny Diabetes and Lipid Program, residents participate in the outpatient care of diabetic and hyperlipidemic patients and have an opportunity to participate in research activities.

Allegheny General Hospital’s Gastroenterology Service is one of the largest clinical training programs in the country. More than 7,000 gastrointestinal procedures were performed at the hospital last year.

Through its major inpatient consultative and diagnostic sections, the Division of Gastroenterology offers broad exposure to procedures and techniques essential to diagnosing and treating gastrointestinal disorders. Specialty clinics in inflammatory bowel disease and functional bowel disorders are available in the Center for Digestive Health.

In addition to the usual diagnostic procedures, esophageal motility, endoscopic ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), endoscopic papillotomy, stone removal and stent insertion are performed in this division. Laser therapy, including photodynamic therapy (PDT), is used in treating gastrointestinal bleeding and cancer.

House staff officers electing rotations in Gastroenterology participate indivision activities, attending weekly interdisciplinary conferences and seminars in pathophysiology, clinical gastroenterology, hepatic biopsy review and radiographic interpretations. The division also provides residents with training experience in flexible sigmoidoscopy.

Members of the Division of General Internal Medicine admit patients to all areas of the hospital and are active as attendings on the various teaching services. They serve as on-site supervisors in the Department of Medicine’s ambulatory-care programs. The hospital has established primary-care satellite offices through which residents rotate at PGY–2 and 3 levels. The division’s major interest is to maintain an environment in which residents can develop skills in consultative, as well as primary-care, medicine.

The division participates in health services and clinical studies aimed at cancer prevention, geriatrics and delivery of cost-effective care. Residents are encouraged to participate in research activities. 

The hospital’s Section of Medical Ethics serves as a valuable resource for physicians in dealing with the complex ethical issues that can arise in managing patients. An active consultation service is avail-able, and house staff and medical students are provided with the opportunity to attend a variety of lectures and seminars designed to increase their awareness of issues in clinical ethics, such as the role of advance directives and the withdrawal of life-sustaining treatment.

The Division of Hematology maintains an active inpatient and consultative service, providing house staff officers with exposure to diagnosing and treating benign and malignant hematologic disorders. Residents are trained in reviewing peripheral blood smears and performing bone marrow aspirations and biopsies. House officers also are offered the opportunity to see hematology patients in a freestanding outpatient setting.

Joint hematology–oncology conferences are conducted, as are conferences and seminars on clotting and bleeding disorders, hematologic morphology, anemias, leukopenias, thrombocytopenias, myeloproliferative disorders, leukemias, lymphomas and myelomas.

The Division of Infectious Diseases (ID) has a consultative service with an average of 30 patients distributed among all medical and surgical subspecialties, including transplantation, oncology and ntensive care. Ambulatory experience is available to residents in the ID Clinic, where many of the HIV-infected patients are followed. The division maintains active programs in infection control and hospital epidemiology. Residents are encouraged to participate in all aspects of ongoing ID research.

The Division of Medical Oncology provides inpatient and outpatient evaluation and management of patients with neoplastic and hematologic problems. Treatment programs include adjuvant and multimodality therapy as well as chemotherapy and immunotherapy for advanced disease.

Clinical research is emphasized through participation in national treatment protocols and in approved local protocols. The division also stresses multidisciplinary care, including support services, for pa-tients with cancer. Residents are primarily responsible for evaluating and treating patients admitted

to the Oncology Nursing Unit. Both divisional and interdisciplinary oncology conferences are conducted weekly. Residents in the Medical Oncology Service learn the techniques of combined medical, surgical and radiation therapy of malignancy.

The Hematology/Medical Oncology Specialty Unit allows residents to participate in the administration and supportive care related to chemotherapy agents, various biological response modifiers including hematopoietic growth factors, interleukins and interferons, and management of infectious diseases in the immunocomprised cancer patient. Additionally, residents have a concentrated experience in autologous and allogeneic bone marrow transplantation.

Activities in the Division of Nephrology and Hypertension provide house staff officers with broad exposure to the diagnosis and management of renal diseases and fluid/electrolyte disorders. Residents participate in daily teaching rounds with full-time faculty. The division conducts a weekly clinicopathologic conference as well as a monthly renal biopsy conference and a weekly ABIM board review conference.

Clinical experiences include caring for patients with acid-base and fluid/electrolyte disorders as well as acute and chronic renal failure and other renal diseases. Residents also gain experience in renal biopsy, hemodialysis, peritoneal dialysis, continuous ambulatory peritoneal dialysis (CAPD) and chronic venovenous hemodialysis (CVVHD). Residents are encouraged to participate in independent research projects in clinical nephrology with a faculty member.

The Division of Pulmonary and Critical Care Medicine provides residents with exposure to patients with a wide variety of pulmonary and critical illnesses. Through rotations on a consultative service and a medical intensive care service, residents are directly involved with evaluating and managing such patients.

House staff officers perform an array of diagnostic procedures such as thoracentesis, pulmonary artery catheter insertion and arterial line insertion. Emphasis is given to residents’ use and interpretation of pulmonary function testing data in the preoperative management and daily care of patients with both acute and chronic illnesses. A wide variety of pulmonary illnesses — including asthma, obstructive lung disease, lung cancer, tuberculosis and collagen vascular disease — are seen during these rotations. Interested residents may spend additional time in the Pulmonary Function Laboratory to learn the techniques of performing specialized studies including spirometry, lung volume measures and exercise testing.

Members of the Division of Rheumatology participate in an active consultative service in the hospital and treat patients admitted to the primary care of the division.

Division members present lectures on a regularly scheduled basis, and residents are afforded elective rotations with staff rheumatologists. Outpatient experience is provided by resident participation in the Rheumatology Clinic and in the private practice offices of staff rheumatologists.