Core Rotations

Casey White, MD, resident; Kelly Berchou, MD; Erin Conway, MD.

Faculty members Kelly Berchou, MD, center, and Erin Conway, MD, right, in simulation training facility with resident Casey White, MD.

Your core rotations give you a thorough grounding in the full spectrum of treating conditions germane to practicing internal medicine.

Rotations take place at a variety of sites, giving you opportunities to work in multiple settings with distinct patient bases and documentation systems.

Ambulatory Week

Also known as the +1 in our 4+1 schedule. This week you will be at your continuity ambulatory site for the whole week without call or other interruptions. You will see your continuity patients, urgent ambulatory patients, and patients following up from recent hospitalizations. You will also work on quality improvement and patient safety projects related to your site. This week is an intensive education in ambulatory medicine and a lighter clinical schedule compared to hospital weeks. As a PGY-2 and PGY-3 you also learn how to take ambulatory call for your practice.

  • Acute Leukemia and Lymphoma Service

    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 both inpatients and 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.

  • Cardiac Critical Care/Cardiology Service

    Location: Buffalo General Medical Center

    In this rotation, you will gain experience managing a broad range of cardiac diseases under the supervision of a cardiology attending. To supplement your hands-on clinical experience, you may spend variable amounts of time on electrocardiogram (ECG) interpretation, echocardiography interpretation with emphasis on basic cardiac anatomy, physiology and pathophysiological correlation. Cardiology faculty will supervise your care of patients with primary cardiac problems, including STEMI, NSTEMI, heart failure and CAD. You will work with some patients in the Coronary Care Unit and others on a step-down unit.

  • Community Practice

    Location: Medicore Associates of Chautauqua

    During this rotation, you will participate in a wide range of procedures and gain experience managing complex patients in settings where consults with specialists are not readily available. The clinic where this rotation takes place is Medicore Associates in Fredonia, NY, a rural community.

  • Geriatrics

    Location: Buffalo VA Medical Center and Erie County Medical Center

    This second-year rotation familiarizes you with the distinct challenges and resources relevant to caring for older populations. You will work with patients who have very heterogeneous levels of physiologic function, health statuses, belief systems, values and personal preferences. Diagnoses include those specific to geriatric patients, such as delirium and dementia, as well as conditions common across patient populations, many of which present distinct symptoms and unique concerns with elderly patients. You will learn how to balance observing patients carefully, making judicious diagnostic interventions and accepting limits your patients define, and how to help aging patients maintain functional independence. You will work closely with nutritionists, social workers, hospice staff and other professionals to coordinate interdisciplinary care, a key component of managing these patients’ health.

  • Inpatient Medicine

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

    You will have opportunities to rotate on inpatient services in our affiliated hospital systems over the course of your residency, gaining expertise in managing a variety of patient bases and working with multiple professional environments and electronic health records systems. Your inpatient rotations will give you responsibility for supervising the admission processes for new patients, maintaining progress notes and patient records, communicating patient care issues among members of your work team (including faculty attendings), presenting cases, teaching medical students and, in your later years, junior residents.

  • Medical Intensive Care

    Location: Buffalo General Medical Center and Buffalo VA Medical Center

    Your MICU rotations give you experience treating patients with a full range of cardiac, pulmonary, renal, endocrine and neurological disorders, as well as infectious diseases and cases of overdose. You will take comprehensive medical histories and physical examinations for patients with these conditions, and learn to counsel patients and their families effectively regarding pathophysiology, treatment options and prognosis. Many intensive care patients are at particular risk for iatrogenic complications such as decubitus ulcers and hospital-acquired infections, and you will gain skills to assess these risks and act proactively to reduce them. You will have the opportunity to participate in procedures and practice point-of-care ultrasound at the bedside.

  • Neurology

    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, 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 collaborating with professionals in occupational therapy, physical therapy, speech therapy, acute rehabilitation, long-term care placement facilities, and so on.

  • Palliative Medicine

    Location: Buffalo VA Medical Center and Roswell Park Comprehensive Cancer Center

    In this rotation, 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.