Elective Rotations

Location: Buffalo General Medical Center and Conventus

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.

Location: Buffalo General Medical Center and Buffalo VA Medical Center

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:

• assessing preoperative cardiac risk in patients undergoing non-cardiac surgery
• managing cardiac issues in medical, surgical and neurologic patients
• evaluation observation unit patients, including following up on abnormal cardiac testing

Location: Erie County Medical Center, Buffalo General Medical Center and Buffalo VA Medical Center

In this rotation, you will work with a wide variety of undifferentiated patients at one of several fast-paced hospital emergency rooms. You will evaluate acute complaints, generate appropriate differential diagnoses, and initiate appropriate management for these patients under the supervision of emergency medicine faculty. You will participate in resuscitating patients from the field and become adept at performing quick, focused patient histories and physical examinations in order to ensure that each patient receives optimal immediate and follow-up care.

Location: Diabetes and Endocrinology Center of WNY or Buffalo VA Medical Center (outpatient clinic)

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, when to order  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: Erie County Medical Center

As a PGY-2 or PGY-3 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.

Location: Erie County Medical Center, Buffalo General Medical Center, and  Buffalo VA Medical Center

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 acute pathologies that are 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.

Location: Buffalo VA Medical Center, Erie County Medical Center and Roswell Park Comprehensive Cancer Center

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.

Location:  WNY House Physician PLLC

This is an innovative and unique elective, designed to empower medical residents to participate in seeing, evaluating, and managing patients in their houses. Home based medical care typically involves patients who are very complex, high-risk individuals, who have difficulty traveling to see their primary care providers and may end up being admitted to the emergency room or having gaps in their care as a result. During this elective, you will be familiarized with home-based patient care approaches, the strengths and challenges associated with this type of care.

Location: Buffalo General Medical Center, Erie County Medical Center, and Buffalo VA Medical Center

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. 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. 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.

Location: Roswell Park Comprehensive Cancer Center

Your rotation at Roswell Park gives you key experience with medical oncology, supervised by specialist faculty. You will learn to care for outpatients with a wide variety of diagnoses, including malignant hematologic diseases and solid tumors. You will conduct targeted physical examinations and take patient medical histories, order appropriate laboratory tests and interpret data, manage patients with chemotherapy, and address the complications of these treatments. In addition, you will get experience with ancillary methods of care, including radiation oncology and surgical oncology.

Locations:  Erie County Medical Center and Buffalo VA Medical Center 

You will learn about the pathogenesis, clinical presentation, treatment modalities and prognosis of the full range of diseases in both didactic and clinical settings, including end-stage renal disease, acute and chronic renal failure, tubulointerstitial diseases and glomerulonephritis. You will also gain proficiency with diagnostic testing and monitoring methods key to the discipline of nephrology.

Location: Buffalo General Medical Center  

Your required neurology rotation 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. You will participate in 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 collaborating 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: Buffalo VA Medical Center and Erie County Medical Center

During this elective, you will acquire, expand and improve your knowledge base and clinical skills to enhance care for patients with chronic pain. You will be responsible for gathering accurate and essential information from a multitude of sources, creating and enacting diagnostic and therapeutic plans, and counseling patients and their families about the pain management plan in an ambulatory setting. You may also participate in outpatient procedures and become familiarized with the indications for medical marijuana and substance abuse.  

Location: Multiple clinical sites, including hospital and hospice settings

In this rotation, 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. You will learn how to facilitate goals of care and participate in complicated family discussions.

Location: Buffalo General Medical Center and Buffalo VA Medical Center

In this elective, you will work with patients who have a broad range of pulmonary pathologies. You will learn to perform physical examinations and take histories focused on the signs and symptoms of lung diseases, including extrapulmonary signs and symptoms. You will learn to order appropriate studies and create management plans for a wide variety of lung diseases.

Location: Determined by your interests and needs

In your second or third years, you may take a research elective, tailored to your individual goals. Prior to taking this protected time, you are partnered with a mentor and identify a research topic or project. You will gain broad understanding of the fundamental principles and methods of research: developing research questions, analyzing current literature, designing studies, presenting research projects and writing manuscripts for publication. 

Location: Erie County Medical Center

The Residents as Educators elective provides residents with a unique opportunity to enhance your residency training with additional experiences and skills training in various educational domains. This mixed synchronous, asynchronous model covers topics such as feedback & evaluation, clinical precepting models, core concepts for the culturally responsive educator, adult learning theory and active learning models, and more! You also have the opportunity to practice your skills under direct attending supervision, participate in a medical education journal club and engage in educational leadership rounds!

Location: Erie County Medical Center

This elective familiarizes you with diagnosing and treating the core rheumatic diseases through direct patient contact in the ambulatory setting. 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 imaging appropriately, learn to distinguish inflammatory from degenerative musculoskeletal diseases, develop reasonable differential diagnoses for common rheumatic symptoms, and gain experience in joint and bursa/tendon injections.

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: Multiple clinic sites.

These blocks expand your education in the ambulatory experience of Ophthalmology, , Sports Medicine, Dermatology, Gynecology and Pre-operative evaluation.

Location: Buffalo General Medical Center

For PGY-2s or PGY-3s, 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.