We offer a robust set of electives. You can pursue independent research, develop expertise in specialty areas or enrich your coverage of core areas.
In this inpatient and outpatient experience, you will obtain focused medical histories and physical exams, formulate assessments and treatment plans, and discuss these with the allergy or immunology attending. You will see all new consults on the service, which you will then discuss with the fellow and/or allergy and immunology attending. Through this rotation, you will gain a familiarity with how asthma, allergies and immunological disorders present clinically, including the pathogenesis and pathophysiology of important emergency conditions such as anaphylaxis and severe unresponsive bronchial asthma. Your training will also cover triggers that can exacerbate allergic and immunological conditions, interactions between chronic and acute conditions, and the use and limitations of laboratory testing and medications.
You will provide consultative services at Buffalo General Medical Center or the Buffalo VA Medical Center. You will work with a cardiology fellow to initially evaluate patients with a variety of cardiovascular disorders, including acute and chronic manifestations of coronary artery disease, myocardial infarction, congestive heart failure, arrhythmias, valvular disorders and pericardial diseases. You will also participate in the workup of patients with chest pain and syncope. Your responsibilities will include:
Elective training in emergency medicine gives you opportunities to work with a wide variety of undifferentiated patients in a fast-paced acute care setting. You will evaluate acute complaints, generate differential diagnoses, and initiate appropriate management for these patients under the supervision of emergency medicine faculty. You will hone your diagnostic skills, develop triage skills, identify appropriate levels of care for these patients, and coordinate with the larger system of care to ensure each patient receives optimal care and follow-up.
This elective trains you in recognizing, diagnosing and formulating treatment plans for endocrinology disorders. You will work in both inpatient and outpatient settings, obtaining focused medical histories and conducting physical exams. You will learn to interpret common endocrine lab tests, use fine needle thyroid aspiration appropriately, use a full range of imaging studies, and recognize the rationale for therapy modalities such as diabetic diets, exercise programs, glucose monitoring and insulin delivery devices.
Location: Determined by your interests and needs
As a PGY2 or PGY3 you will join a floor team as the designated “EBM resident,” working closely with an “EBM attending,” usually the floor team attending. During morning rounds, team members identify one or more patient management issues and formulate structured clinical questions, with your support and feedback. You’ll search the medical literature to identify relevant publications, and assess their validity and results using the User’s Guide to the Medical Literature’s critical appraisal sheets. During the next rounds meeting (usually that afternoon), you’ll report your findings to the floor team, discuss them together, and assist in evidence-based clinical decision-making, integrating the evidence from your research with patients’ values, clinical states, and circumstances.
In addition, you will be responsible for conducting two to four interactive small-group sessions. These may be critical appraisal sessions, using the format from the User’s Guide to Medical Literature, or didactic sessions to clarify specific concepts.
This inpatient rotation exposes you to the common problems encountered in diagnosing and managing diseases in the field of gastroenterology and hepatology. You will perform histories and physicals on patients on whom the gastroenterology service at your hospital is consulted, present those patients to the attending, and maintain new and follow-up consult notes. You will provide differential diagnoses for a variety of conditions, with particular emphasis on identifying conditions that are immediately life-threatening or which require immediate intervention. You will not be required to perform procedures, but will be encouraged to observe procedures performed on the patients you follow.
Location: Erie County Medical Center
An elective in hematology trains you in taking histories, giving physical examinations, and interpreting laboratory data for patients with a wide range of hematologic disorders, including those common to patients with HIV and patients undergoing chemotherapy. You will conduct microscopic examinations of blood and bone marrow and use morphology to diagnose and treat these patients, seeing new admissions on both inpatient and ambulatory services, and providing follow-up care where appropriate. In addition, you will gain experience with providing subspecialty consultations under faculty supervision, including patient education, communication with referring physicians, and ensuring support for ongoing care of patients’ hematologic conditions.
This elective gives you an opportunity to evaluate and treat inpatients and outpatients as part of a combined hematology/oncology service. You will also care for patients with malignant hematologic diseases, including lymphomas, myelomas, and acute and chronic leukemias. You will review laboratory data, flow cytometry and peripheral smears with fellows and faculty. You may have opportunities to perform bone marrow biopsies under supervision and to review pathology specimens with the hematopathologist.
You will care for a wide variety of patients, with particular attention to evaluating those with possible infections, then diagnosing and treating them. You will also learn to diagnose cases that don’t easily fit into evidence-based guidelines.
Our residency elective will help you develop a core understanding of the clinical manifestations, pathophysiology and management of infectious diseases and systemic diseases. Through your training you will develop expertise in relevant basic and clinical science topics.
This elective emphasizes rigorous data accumulation when taking histories and conducting physical examinations, and interpreting a wide variety of laboratory data, including cultures, imaging and other tests.
You will learn about the pathogenesis, clinical presentation, treatment modalities and prognosis of the full range of nephrologic diseases in both didactic and clinical settings, including end-stage renal disease, acute and chronic renal failure, tubulointerstitial diseases and glomerulonephritides. You will also gain proficiency with diagnostic testing and monitoring methods key to the discipline of nephrology.
Location: Buffalo General Medical Center
An elective in neurology helps you develop core neurological evaluation skills, including taking histories, conducting physical examinations, and performing accurate and thorough neurologic exams. You will see patients with a variety of conditions, including acute ischemic stroke, acute hemorrhagic stroke, status epilepticus and brain tumors, for new admissions and follow-up care, including post-discharge follow-up planning where appropriate. When necessary, you will anticipate patients’ needs in a complex health system and guide them appropriately by collabroating with professionals in occupational therapy, physical therapy, speech therapy, acute rehabilitation, long-term care placement facilities, and so on.
Location: Buffalo VA Medical Center
The program exposes you to clinical and research aspects of nuclear medicine. You will cover the diagnostic, therapeutic, and investigational uses of radionuclides, and gain an understanding of important aspects of radiochemistry, computer science, and modeling. Through this elective rotation, you will learn the key techniques and methodology of the major nuclear medicine diagnostic and therapeutic applications. It includes an active clinical and research experience in positron emission tomography (PET).
Location: Multiple clinical sites, including hospital and hospice settings
In this elective, you learn to propose and defend comfort care for patients when cure is no longer a rational goal in settings including hospital consultation services and hospice home care. You will evaluate and treat symptoms common in terminally ill patients, focusing on how physical, psychological, social and spiritual factors affect suffering. In addition, you will gain an understanding of the neuroanatomy and physiology of different pain mechanisms and how to honor medical decisions that are guided by patients’ philosophies and values.
In this elective, you will work with patients who have lung disease problems common to the inpatient setting, and you will learn about additional pulmonary diseases and problems pulmonary specialists see. You will learn to perform physical examinations and take orderly histories focused on the signs and symptoms of lung diseases, including extrapulmonary signs and symptoms, and you will plan and provide treatment for inpatients with a wide variety of lung diseases.
Location: Determined by your interests and needs
In your second year, you may take a research elective. At the beginning of this rotation, you’ll be asked to identify a research topic or project and be linked with a research mentor. You will gain broad understanding of the fundamental principles and methods of research: developing research questions, analyzing current literature, designing studies (including statistical analysis), presenting research projects and writing them up.
This elective familiarizes you with diagnosing and treating the core rheumatic diseases through direct patient contact in the rheumatology attendings’ offices. You will conduct all new patient evaluations, obtaining complete histories, conducting examinations, reviewing relevant medical records, and developing appropriate differential diagnoses and treatment plans. Where appropriate, you will also see patients for follow-up appointments. The attending rheumatologist will review the clinic’s long-term patients daily, selecting individual additional cases to give you the broadest experience possible.
You will become proficient at the musculoskeletal exam, learn to obtain a relevant rheumatic history and review of systems, understand appropriate medication and non-drug therapies for rheumatic disease, use diagnostic laboratory and X-ray testing appropriately, learn to distinguish inflammatory from degenerative or metabolic musculoskeletal diseases, develop reasonable differential diagnoses for common rheumatic symptoms, and gain experience in joint and bursa/tendon injection.
Location: Buffalo General Medical Center
This rotation exposes you to a variety of sleep disorders, focusing on how other medical conditions and medications can cause them, and their effects on overall health. You will learn to take a sleep history, perform a sleep physical, and classify the major problems encountered in sleep medicine, such as narcolepsy and obstructive sleep apnea. You will also gain an understanding of the basics of insomnia, circadian rhythms and how to treat patients with sleep-altering medications.
Location: Millard Fillmore Suburban Hospital
For PGY2s or PGY3s this rotation trains you in performing stress tests, monitoring these tests and interpreting the data they provide. You will gain confidence in ordering, administering, and interpreting exercise, pharmacological and nuclear stress tests.