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Hiv-Positivity, Aids, And The Military Psychiatry Residency Experience, Ronald J. Koshes, M.D.

Jefferson Journal of Psychiatry

Psychiatry residents in the military work with a diverse population of HIV-positive and AIDS patients who are in various stages in their illnesses, military careers, and acceptance of the disease process. In this circumstance, the military psychiatry resident must be a clinician, administrator, and patient advocate. Additionally, the military resident must uphold Department of Defense regulations which mandate that soldiers be both physically and emotionally fit to perform their duties. This paper describes the unique role of the military psychiatrist in working with HIV-positive and AIDS patients in the military setting.

Editor's Column, Edward Kim, M.D.

Jefferson Journal of Psychiatry

He sat on the other side of the large government-issue desk, a bland, a pathetic expression on his face. His vague, contradictory story of visual and auditory hallucinations was punctuated by frequent pauses and "you know,"as if he were expecting me to help him fabricate his symptoms. He himself didn't seem to be trying very hard to convince me of his alleged distress. It would have been simple to admit him; the paperwork was minimal, and there were plenty of beds. I mentioned my skepticism of his history as I told him why I wouldn't admit him. The ensuing flood …

A Sexually And Physically Abused Child: His Inner World, Carmen Mayugba-Sugai, M.D.

Jefferson Journal of Psychiatry

This paper describes how a sexually abused 8 year old boy's internal dynamics correlated with and influenced his behavior while he was on an inpatient unit. Through play therapy and unit staff's observation, the psychopathological sequelae to the abuse unfolded in a very interesting way. This process of correlating play material with observations of behavior on the unit, helped the treatment team in understanding the child's inner world.

Treating Dual Diagnosis Patients: Challenges And Opportunities, Robert H. Howland, M.D.

Jefferson Journal of Psychiatry

The use and abuse of drugs and alcohol have recently gained greater attention both from the public and the medical profession. Despite increasing cognizance of its unfortunate consequences, substance use has become a more pervasive element of contemporary society. As substance abuse has come to affect more segments of the population, it is not surprising that this problem also has affected the mentally ill. Awareness of the mentally ill substance abuser has grown, although this population has not been well studied or well served by the mental health system. These dually diagnosed patients often are depicted as the square pegs …

Download The Full Pdf Of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2

Jefferson Surgical Solutions

Download the full PDF of Jefferson Surgical Solutions Fall 2011, Volume 6, Number 2.

Koniaris Heads Expanding Multi-Disciplinary Surgical Program At Methodist Hospital

Jefferson Surgical Solutions

Leonidas Koniaris, MD, FACS, is the newly appointed Chief of Surgery at Methodist Hospital in South Philadelphia, an affiliate of Jefferson that now has the strongest presence of full-time Jefferson faculty surgeons to date. One of the oldest hospitals in the Philadelphia region, Methodist has been treating patients continuously since 1892. Professor of Surgery and Vice Chair of the Department of Surgery at Jefferson Medical College, Dr. Koniaris is leading the effort to help what he describes as “an already great local hospital become an even more essential and integral partof this vibrant community.” Dr. Koniaris replaces Melvin Moses, MD, …

The Surgeon Speaks: Leonidas Koniaris, Md, Facs

Jefferson Surgical Solutions

Leonidas Koniaris, MD, FACS Chief of Surgery, Methodist Hospital Vice Chair of Surgery, Jefferson Medical College

The professionalism and work ethic of the Methodist hospital staff are second-to none, and the dedication to superb patient care is a top priority. Over the next three to five years, our focus is to take this existing gem in the Jefferson brand and continue to develop it into a strong top-tier facility.

We have been fortunate to have the support of hospital leadership in meeting our goals and embracing change. Several initiatives – a new endovascular suite and multidisciplinary breast care clinic, coupled …

Overview

Jefferson Surgical Solutions

The academic year 2011/2012 is now four months old, and we are off to a splendid start! We (a) have welcomed several new faculty members and a bolus of categorical interns (see below), (b) had a leadership transition at our Methodist Hospital, (c) are in growth mode at Methodist with initiatives in General Surgery, Vascular Surgery, Wound Care and Surgical Oncology (see the cover story), and (d) with the leadership of Dr. Nicholas Cavarocchi have seen remarkable growth in our adult ECMO program with outstanding clinical results and several research projects brought to fruition. Exciting times again this year at …

Surgeon-Led Ecmo Treatment Improves Survival Rates In Surgical Cardiac Care Unit

Jefferson Surgical Solutions

The Jefferson Surgical Cardiac Care Unit (SCCU), reorganized in July 2010, delivers the best survival rates in Pennsylvania for patients plagued by serious lung and/or heart dysfunction. Nicholas Cavarocchi, MD, FACS, FCCP, the SCCU Director and Associate Professor of Surgery, leads a highly trained team that uses extracorporeal membrane oxygenation (an ECMO machine) to provide respiratory and cardiac support to patients whose lungs and/or hearts cannot function on their own. Because of the excellent outcomes – 70 to 80 percent survival rates for patients with life-threatening situations, up from a previous zero-based survival rate – Dr. Cavarocchi believes the Jefferson …

Meet Our Surgical Interns

Jefferson Surgical Solutions

We have welcomed an amazing new group of categorical interns, selected from over one thousand applicants to our program. These doctors, who recently matched with Jefferson Medical College (JMC), started on June 20, 2011. Just a few months into their Jefferson surgical residency, we have all noticed their dedication to patient care, their energy and their excitement in joining the Jefferson community.

Meet Our Surgical Interns

Please welcome (from left to right):

• Christine Feldmeier, MD, JMC
• James Crawford, MD, New York University
• Kate Holoyda, MD, University of Wisconsin
• Vishen Sooppan, MD, SUNY Upstate - Syracuse
• Caitlyn Johnson, MD, JMC
• Jonathan …

Alumni Support Jefferson Through Service And Giving

Jefferson Surgical Solutions

On Wednesday, June 29th, the Department of Surgery hosted a reception to recognize Melvin Moses, MD, FACS, for his contributions and many years of service. Dr. Moses graduated from Jefferson Medical College (JMC) in 1962 and remained at Jefferson for his residency training and three separate clinical and research fellowships. He joined the hospital surgical staff in 1970 and became a JMC faculty member in 1982.

In 1990, Dr. Moses was named the Vice Chairman of the Department of Surgery, Methodist Hospital Division of Thomas Jefferson University Hospital (TJUH), where he remained for the duration of his career- a career …

News In Brief

Jefferson Surgical Solutions

Gurjyot Bajwa, MD, has joined the Division of Cardiothoracic Surgery. She is fellowship-trained in Adult Cardiac Surgery, Congenital Cardiac Surgery and General Thoracic Surgery. She also trained in complex adult cardiac surgery and minimally invasive and robotic surgery at the Cleveland Clinic.

Patrick Greaney, MD, has joined the Division of Plastic Surgery. He completed his General Surgery residency at Jefferson in 2007, followed by a fellowship in burn reconstruction at the William Randolph Hearst Burn Center of the Weill Cornell / New York-Presbyterian Hospital, a plastic surgery residency and a fellowship in microsurgery. He will provide services at …

The Role Of The Resident On The Psychiatric Inpatient Unit: A Systems Perspective, E. Michael Kahn, Md

Jefferson Journal of Psychiatry

A resident in psychiatry is customarily assigned to inpatient duty for the first year of training. The resident's tasks in this setting are complex, and he' is rarely prepared to perform all of them well (1,2,3). The stress on the resident in this situation is great. Most often, these challenges and their mastery are discussed in terms of intrapsychic conflicts; the traditional remedy is the assignment of a supervisor. Little consideration has be en given to the interpersonal and systems matrices in which these events occur, and the coping techniques and conceptual tools which the resident may use to meet …

The Potential Role Of Psychiatry Residents' Councils, J. Thomas Pichot, Md

Jefferson Journal of Psychiatry

There are numerous books and articles within the scientific literature that deal with issues of training psychiatry residents and the characteristics of that milieu. Those authors that deal primarily with stress usually discuss the sources of the stress and the resultant behavioral changes that are manifested by the trainees. Typically, are relatively small portion of the discussion is devoted to how these problems are, or might be, addressed. This paper, while not itself intended to be an overview of stress in residency; will concentrate on a literature review of some specific aspects of the residency training process, primarily role definition …

Should Psychotherapy Be Taught To Psychiatric Residents? A Debate., Donald W. Black, Md, John Ascher, Md, Hal Cash, Md, John Markowitz, Md, Paul Hamburg, Md, Jeffrey Satinover, Md, Alan Mellow, Md

Jefferson Journal of Psychiatry

Much of this discussion was inspired by a debate held at the 1984 APA Annual Meeting, entitled " Does Psychodynamic Theory Have Little Relevance to Contemporary Psychiatric Care?" We saw the need for a debate, resident generated, that would address a corollary issue in residency training.

Our program will include an introduction, a debate involving statements for the affirmative, that is, that psychotherapy should be taught to psychiatric residents, and two statements for the negative, that psychotherapy should not be taught to psychiatric residents. Concluding remarks will follow.

If our title is provocative , if what we have to say …

Faculty Advisor's Column, Harvey J. Schwartz, Md

Jefferson Journal of Psychiatry

The season during which this issue of the Journal is being assembled is Autumn. It is a time of change, of growth, of new development.

For a small group of psychiatrists around the country, this period has an additional special meaning-it is recruitment season. For program directors and faculty it is this time every year that the mating ceremony known as the 'match' is prepared for . The mutual cueing and seductiveness, and indeed the ceremonies of courtship itself, are set in motion as faculty and soon-to-be medic al school graduates begin their unique dance.

Faculty Advisor's Column, Harvey J. Schwartz, Md

Jefferson Journal of Psychiatry

This second issue of our resident journal enlarges our educational effort s in two important ways. The first is obvious . As you can see, we have published this forum in an attractive new form at. This is highlighted by the new cover designed by Dr. Jeffrey Sarnoff. The second piece of progress is our enlarged audience. In addition to our own Jefferson faculty and residents, the Journal is now being distributed to psychiatrists throughout Pennsylvania. For both of these improvements in form we are indebted to the Mead Johnson Pharmaceutical Division for their generous sponsorship.

Download Entire Issue-The Medicine Forum, Volume 12, 2010

The Medicine Forum

Download entire issue-The Medicine Forum, Volume 12, 2010

Disruptive Innovation, Peregrine Dalziel, Mbbs, Tina Shah, Md

The Medicine Forum

Introduction

“Disruptive innovation” (DI) has recently been heralded as a tool to mitigate out of control health care spending in the UnitedStates,1,2,3 however few doctors are familiar with the concept. Overall, there is a tendency in medical culture to regard changes to established treatment and management models with some reticence, increasing the difficulty for reform. In this article we will introduce readers to the concept of DI as a means to reduce costs in the American health sector. We will illustrate current uses of DI in health care, using the particular example of the expanding role of nurse practitioners (NPs). …

From The Desk Of The Residency Program Director, Gregory C. Kane Md, Facp, Fccp

The Medicine Forum

In September 2010, the ACGME Board of Directors voted to implement work rules which would among other things limit intern shifts to 16 hours effective July 2011. At Jefferson, our leadership team began working on our program’s process and specific plans in attempting to rapidly adapt to the new ACGME mandates even before they were formally adopted. Together with our Chief Residents, Drs. Doug Guggenheim, Dina Halegoua, and Emily Stewart, we planned a retreat for October 22, 2010. It was held at the Union League with assembled residents from all three levels, senior administrators, and faculty that we forged our …

Download Entire Issue-The Medicine Forum, Volume 11, 2009

The Medicine Forum

Download entire issue-The Medicine Forum, Volume 11, 2009

From The Desk Of The Residency Program Director, Gregory C. Kane Md, Facp, Fccp

The Medicine Forum

To Friends of the Department of Medicine:

The Thomas Jefferson University Hospital Internal Medicine Residency Program wasinformed this past February by the RRC that it has received Continued Accreditationwith a 5 year cycle length – the longest cycle length awarded for compliance withessential elements of training in Internal Medicine as mandated by the ACGME.The program’s next visit will be in 2015. This is the third straight highly successfulaccreditation review for the program and the third straight 5 year cycle awarded.

Download Entire Issue-The Medicine Forum, Volume 10, 2008

The Medicine Forum

Download entire issue-The Medicine Forum, Volume 10, 2008.

From The Editors, Tamara Solitro, Md, Anthony Lanfranco, Md, Ankitkumar Patel, Md, Anastasia Shnitser, Md, Andrew Foy, Md, Claire Raab, Md, Tina Shah, Md

The Medicine Forum

Argentina, California, Kenya, Alaska — these are just a fewof the places visited by our internal medicine residents andcaptured in breathtaking photographs that are exhibitedthroughout this issue of The Jefferson Medicine Forum. It iseasy to appreciate the beauty of nature when taking in thesepictures of stunning aerial views and colorful landscapes.Their display in this journal is fitting amongst the academicarticles that speak to the intellectual curiosity of our residentsand the diversity of pathology seen at Thomas JeffersonUniversity Hospital.

From The Desk Of The Residency Program Director, Gregory C. Kane Md, Facp, Fccp

The Medicine Forum

To Friends of the Department of Medicine:

Earlier this academic year, The Institute of Medicine(IOM) issued their most recent report, “Resident DutyHours: Enhancing Sleep, Supervision, and Safety,” whichrecommends changes to medical residents’ duty hours andworkloads to “promote conditions for safe medical care,improve the education of doctors in training, and increasethe safety of residents and the general public.” While theIOM simply makes recommendations, the AccreditationCouncil for Graduate Medical Education (ACGME) makesthe actual rules that a residency program must follow inorder to maintain accreditation. Under the leadership ofthe ACGME, one of the Residency Review Committees(RRC) establishes these accreditation guidelines for internalmedicine residency …