Length of Elective: 4-weeks or 8-weeks

Prerequisite:  Internal Medicine Core Course

Course Coordinator: Caterina Minniti, M.D.

Course Description:

The medical student will be involved in the care of sickle cell patients on both standard of care and investigational treatment protocols at the Clinical Center of the National Institutes of Health.  The sites of care involve the inpatient hospital unit and intensive care unit, as well as the outpatient clinic and day hospital.  This includes the provision of ambulatory care, care of acute complications, and clinical trials of investigational drugs.  The patients predominantly have vascular complications, such as pulmonary hypertension, leg ulcers, and stroke.  The student will directly interact with hematologists, pulmonologists, and palliative care consultants.  The student will have the opportunity to observe right heart catheterization, patient-controlled analgesia, simple transfusion, erythrocytapheresis and iron chelation therapies.

Course Objectives

a) Gain didactic knowledge and practical experience with the natural history of sickle cell disease in adults, including alterations in baseline physiology, and management of acute complications such as vaso-occlusive pain crisis, infection, acute chest syndrome, priapism, splenic sequestration and stroke. 

b) Gain didactic knowledge and practical experience with the chronic cardiopulmonary complications of sickle cell disease in adults, especially pulmonary hypertension, including standard and investigational therapies; also  with other chronic complications, including retinopathy, cholelithiasis, sickle nephropathy, impotence, leg ulcers, and avascular necrosis of bone.

c) Gain didactic knowledge and practical experience with the standard therapies for sickle cell disease, including hydroxyurea, red cell transfusion, manual exchange transfusion and erythrocytapheresis, as well as chelation therapy of transfusion-induced iron overload.  Gain facility with management of high dose opioid therapy, oral and parenteral, including patient-controlled analgesia.

d) Gain practical experience with psychosocial challenges posed to patients with a chronic illness, and exposure to minority health issues.

e) Gain exposure to basic and clinical research in sickle cell disease currently being conducted at the NIH and to recent research findings being presented at weekly research conferences and journal club presented by the sickle cell research groups at the NIH.

List of professional staff: 

Caterina Minniti, M.D. (Course Coordinator)
               
Other professional staff: 

Gregory Kato, M.D.
James Taylor VI, M.D.
Shoaib Alam, M.D.
Joseph Fontana, M.D.
Johns Tisdale, M.D.
Matthew Hsieh, M.D.