On the general medical floors, each team consists of an attending, a second or third year senior resident, one or two interns, as well as third-and fourth-year medical students. Interns and senior residents provide day coverage while the Night Teaching team provides overnight coverage. Attending rounds are conducted at least five days a week.
The attending physicians will review with the house-staff the presentation and management of patients. In addition, team discussions are led about epidemiology, clinical manifestations, pathophysiology, diagnosis and evaluation, treatment and prognosis of the medical conditions affecting their patients incorporating relevant and recent literature.
Medical Intensive Care Unit
Allegheny General Hospital has a fully staffed ICU. The medical team includes 6 interns, 3 senior residents, a pulmonary-critical care fellow, and two attending physicians who round seven days a week. Interns and senior residents provide day coverage while the Night Float team provides overnight coverage. The pulmonary and critical care fellows provide 24-hour in-house coverage. The housestaff take primary responsibility of managing critically ill patients, including performing most diagnostic procedures. All major management decisions are reviewed by the ICU medical team on daily morning rounds and evening rounds. During the ICU rotation, trainees are taught:
- Techniques of resuscitation
- Respirator management
- Bedside hemodynamics
- Management of acutely ill medical patients
Senior residents also have the opportunity to rotate through the Medical ICU at West Penn.
Cardiac Care Unit
Allegheny General Hospital has a fully staffed CCU. The cardiac conditions seen in the CCU include patients with acute heart failure, myocardial infarction, unstable angina and cardiogenic shock. Cardiac catheterization and intra-aortic balloon pumps are routinely employed. The CCU is staffed by 3 senior residents, 1 intern, 1 cardiology fellow and 1 cardiology attending. The residents rotate between day and night shifts for overnight coverage. The cardiology fellows provide 24-hour in-house coverage.
During the rotation residents are taught:
- Techniques for electrical and chemical cardioversion of arrhythmias
- Swan-Ganz catheter insertion
- Cardiac resuscitation
- EKG interpretation
- Principles of cardiac emergency therapy
- Management of acute cardiac illness
Our institution offers excellent training in the outpatient setting, to prepare those pursuing careers in primary care and outpatient based specialties. In our Medical Ambulatory Clinic (MAC), residents have the opportunity to deliver ongoing care to a group of patients in a setting similar to private office practice.
Utilizing the innovative 4:1 curriculum, residents are provided exposure to many outpatient clinics throughout their residency. Each resident is assigned to a primary care site affiliated with West Penn Allegheny Health System. It is in this primary care clinic that the resident will be exposed to the spectrum of primary care during their ambulatory weeks.
Each ambulatory week consists of five half days at the primary clinic and one half day of didactics. The rest of the week is spent rotating through many subspecialty clinics throughout the community.
The educational portion of the ambulatory rotation is provided through longitudinal lectures and online modules, along with the weekly ambulatory academic half day.
Under the supervision of an attending physician and a hematology/oncology fellow two senior residents rotate through the hematology/oncology service per month. Our residents care for a wide spectrum of cases ranging from new diagnosis and treatment of acute leukemias to end stage metastatic disease.
Clinical sites include the AGH Medical Oncology unit and the WPH Bone Marrow Transplant unit.
Both Allegheny General Hospital and West Penn benefit from a Night Float service. This provides 24-hour resident coverage at both hospitals.
The night teams will admit patients and provide cross coverage for the daytime teaching teams from 7 p.m. to 7 a.m., (Monday through Thursday night) and then attend morning report from 7a.m. to 8 a.m. They will then sign out to the primary day teams.
The night teams are supervised by an overnight attending at both sites.
Third year residents will perform house general medicine consults for a four week block. This elective exposes senior residents to pre and post operative inpatient management.
Third year residents do a four week block of Geriatrics as part of their training. This rotation gives residents valuable insight into community practice including exposure to palliative medicine.
The training program offers an intensive experience in the management of neurological disease. Stroke patients are immediately taken care of by a "Stroke Team" which is staffed by a neurology attending and second year internal medicine residents. In addition, residents rotate through a neurology consultation service to learn to diagnose, evaluate and treat common neurology problems in both the inpatient and outpatient setting.
The emergency room at Allegheny General Hospital is staffed by residents from Emergency Medicine, Surgery and Internal Medicine training programs. Internal Medicine first year residents have the opportunity to see patients with a variety of acute medical and surgical illnesses as the initial physician. On the Emergency Medicine Service, first year residents work under the supervision of emergency medicine attendings. The objective of the rotation is to learn how to approach emergency patients, manage multiple patients, recognize and triage ill patients, and manage these patients acutely and to be exposed to common ED problems. Each resident will have 15 shifts in a month.