Program Structure

Administrative

The Residency Program of the Department of Medicine has the following structure:

Osler Firms and Other Patient Care Units

Overall, the medical service consists of 200 intermediate care, 30 acute care and 18 clinical research beds. The housestaff (48 interns, 39 junior residents and 36 senior residents) is divided into four (4) Osler Firms within the Department of Medicine. These include:

• Janeway
• Thayer
• Barker
• Longcope

Interns are assigned randomly to one of four Firms. There are four Assistant Chiefs of Service (ACS) who are attending physicians for patients admitted to their respective Firms. The ACS is a full-time faculty member who has completed his/her residency at Hopkins and generally a year or more of further training. They are selected by the Chairman of the Department of Medicine.

An intern, although assigned to a Firm, works in a variety of settings during the year. A typical rotation includes:

Medical patients who do not have a personal physician with admitting privileges and those who are admitted through the JHH Emergency Room/Clinic are assigned an ACS. The name of the Firms and the Units to which they most commonly admit are seen below, though patients can be admitted and boarded to any unit:

Firms Unit

When these patients are discharged, they are seen in the Firm clinic. Longcope/Barker patients are seen at the East Baltimore Medical Center (on Eager St. several blocks from JHH), while Janeway/Thayer patients are seen in the Johns Hopkins Outpatient Center 7th floor medical clinic.

The Firm Faculty are selected by housestaff and some of them admit their patients to the Firm. These faculty constitute the team of visiting physicians. Firm Faculty are assigned on a monthly basis to teach the housestaff three times per week. They sponsor social events for housestaff, assist them with clinical research projects and hold monthly Firm Grand Rounds that are attended by the Firm Faculty and Housestaff.

Nelson-Baker Service

The Nelson 4 and the Garrett services constitute two additional general medical inpatient services. The Nelson 4 and Garrett services are often called "the private" service since all of the patients have private attendings who are on the full-time and part-time faculty.

The Nelson 4 service affords an exposure to managed care as the great majority of patients on this service belong to a Hopkins-affiliated HMO. The Garrett Service is a general medical service, but many patients have gastrointestinal or hepatic disorders.

Other Patient Care Units Within the Department of Medicine

Out-Patient

Meyerhoff Digestive Disease Center (MDDC) located on Blalock 4: This unit specializes in inpatient and outpatient endoscopic/bronchoscopic procedures.

Cardiovascular Center (CVC) located on Blalock 5: This is a same day cardiac catherization unit and also a processing center for patients having CVDL procedures who will be admitted post procedure.

The Dialysis Unit located at 412 Bond Street: Provides chronic care for outpatients. On Harvey 4, inpatient dialysis is performed.