Barnes-Jewish Hospital is part of the BJC Health System which serves residents of Missouri and Southern Illinois through a network of more than 100 ambulatory care delivery sites as well as 13 hospitals, six nursing homes, and alliances with 31 other health care organizations throughout the region. It controls more than 4,400 beds in the St. Louis area, and provides home care throughout a large network. Barnes-Jewish Hospital is the primary teaching hospital for Washington University School of Medicine.

Barnes-Jewish Hospital is a teaching hospital with 1,227 licensed beds, of which almost half are allocated to the medical service. The North and South Campuses of the Hospital are located approximately 100 yards apart and are connected to each other and St. Louis Children's Hospital by enclosed pedestrian bridges. The hospital supports 927 house staff and fellows and has 1,748 faculty members. In 2006, there were 53,907 admissions, 94,669 outpatient and emergency department visits.

In addition to Internal Medicine, Barnes-Jewish Hospital sponsors highly regarded residencies in Emergency Medicine, Surgery, Cardiovascular Surgery, Thoracic Surgery, Orthopedic Surgery, Otolaryngology, Ophthalmology, Plastic Surgery, Urology, Anesthesiology, Dermatology, Obstetrics and Gynecology, Neurology, Neurosurgery, Psychiatry, Laboratory Medicine, Anatomic and Clinical Pathology, Diagnostic Radiology, Physical Medicine and Rehabilitation, Radiation Oncology and related subspecialty fellowships.

Barnes-Jewish Hospital is one of the most active tertiary care centers in the midwest; referrals come from across the country and internationally. There are many active transplant programs including hearts, heart-lung blocks, livers, bone-marrow, pancreas, and corneas. The renal transplant service recently completed its 2000th kidney transplant, and the lung transplant service is the most active in the country.

The Alvin J. Siteman Cancer center at Washington University and Barnes-Jewish Hospital is an international leader in cancer treatment, research, prevention and community outreach. It is the only cancer center in Missouri and within a 240 mile radius of St. Louis to hold the prestigious Comprehensive Cancer designation from the National Cancer Institute and membership in the National Comprehensive Cancer Network. Siteman offers the expertise of more than 300 Washington University research scientists and physicians who provide care for nearly 6,000 newly diagnosed cancer patients and more than 32,000 follow-up each year. The scientists and physicians currently hold $130 million in cancer research and related traiing grants. Siteman is ranked among the top cancer centers in the country. Jump to Top

MEDICAL INFORMATION RESOURCES

Computers are reserved for resident use in the Department's house staff library-lounge as well as each firm's conference room. These allow 24-hour access to online searches and over 8,000 medical journal and book titles, 29 databases, and thousands of images without cost to the house staff (the Department of Medicine pays for the password for each house staff member's proxy account). The lounge also has a copy machine which is free to house staff. In addition, the Bernard Becker Medical Library, with a staff of 50 employees, contains over 100,000 current volumes, and a rare books collection of 22,000 volumes. The informational media and audiovisual departments also are available to Barnes-Jewish Hospital house staff. The Rothschild Medical library on the North Campus contains a complete collection of internal medicine texts and all the major medical journals, as well as computers with free internet access. Hospital computers allow accession of discharge summaries, laboratory data, pathology reports, and other diagnostic study results both in the hospital and medicine clinic. There is a fully integrated electronic medical record system in the Residents clinic. Jump to Top

SUPPORT SERVICES

Medical training can be rigorous and demanding, but it should not require excessive hours of labor which exhaust rather than educate. To alleviate excessive continuous hours of work, a night float system on each inpatient Firm and at the VA Medical Center provides care for admissions and manages acute problems on the teaching service at night. After the house staff reach their daily admission limits, subsequent patients are admitted to the non-teaching "Gold Service." On this service, full-time internists provide daily inpatient care instead of house staff. In addition, non-physician personnel perform ancillary services, such as phlebotomy and IV line placement, enabling house staff to meet the needs of their patients and their educational goals. The Mallinckrodt Institute of Radiology has radiologists in-house for 24-hour coverage and for consultation regarding radiologic studies and procedures.

The private non-teaching services are a valued resource at both campuses. After house staff reach their daily admission limits, subsequent patients are admitted to the private non-teaching service by the attending physicians. On this service, full-time board eligible or board certified internists provide daily inpatient care similar to that provided by house staff.Jump to Top

EDUCATIONAL OPPORTUNITIES

There are more than 422 full and part-time faculty at or above the assistant professor level in the Department of Medicine. Barnes-Jewish Hospital house staff are taught at the bedside by full-time faculty and selected voluntary faculty on ward/firm medicine, at John Cochran VA Hospital, and within the Department of Medicine clinics and faculty practice.

Didactic teaching occurs in a variety of settings including weekly grand rounds, clinical-pathological conferences, firm conferences, journal clubs, core curriculum conferences, ambulatory care conferences and morbidity and mortality conferences. Senior residents participate in grand rounds, core conferences, firm conference, and clinical-pathologic conference. Senior residents also have opportunities to participate in reviews of manuscripts for The Washington Manual of Medical Therapeutics, and its new companion, The Washington Manual of Ambulatory Therapeutics. In addition, residents are invited to write chapters in the 11 book Washington University Subspecialty Series and the Intern Survival Guide. Barnes-Jewish Hospital house staff may attend all subspecialty conferences offered at the Medical Center.

Scholarship is an important part of Internal Medicine training. Residents are encouraged to submit abstracts to regional and national meetings. Financial support is available for presentation of their work. Residents also are encouraged to participate in research projects with the subspecialty divisions and the Division of General Medical Sciences. We are particularly proud of the unique scholarly opportunities we have created for our residents. For applicants with an MD-PhD or MD and a strong record of biomedical research experience, we offer the Physician Scientist Training Pathway. This program provides 2 years of outstanding clinical training as a categorical internal medicine resident, one or two years of clinical fellowship training in a subspecialty of internal medicine, then rigorous scientific training in the world-renowned laboratories at Washington University. The Clinical Scientist Training and Research and the Mentors in Medicine Research Grants Program provide protected time, funding and structured training for other categorical residents with a research interest. We also invite our residents to write the book chapters for the Washington University Subspecialty Consult Series and Intern Survival Guide. These opportunities, coupled with our exceptionally rich learning environment, superb house officers and medical students, and internationally renowned faculty, make our residents highly competitive for the most desirable subspecialty fellowships.

The Department's commitment to education is exemplified by the formation of a Division of Medical Education, which oversees the education of house staff and students. Excellence in Internal Medicine requires the development of teaching skills. Barnes-Jewish Hospital is the primary teaching hospital for the Washington University School of Medicine. Medical students are part of each house staff team and the junior and senior assistant residents are an integral part of the clerkship experience for the medical students. Seminars to develop teaching skills and team leadership are conducted by the Department of Medicine for the residents. Senior residents may take an elective teaching rotation with didactic and practical instruction on teaching techniques.Jump to Top

Clinical Excellence and Cutting Edge Research in the Department of Medicine

CLINICAL ACTIVITIES

The Medical Service at the South Campus has approximately 325 beds on the teaching service, including all general medicine teaching beds. Inpatient oncology services and Bone Marrow Transplantation are on the adjacent North Campus. The North Campus is also the site of a new Cancer Center, a state-of-the-art Ambulatory Care Center, and a Geriatric Center of Excellence.

The Medical Service provides care for patients of full-time faculty, physicians in private practice and indigent patients whose care is managed by residents supervised by a single attending physician.

Because of the reputation of its medical staff, the excellence of its teaching program and its location in a major Midwest commercial center, patients with interesting and complex medical problems are referred from a wide geographic area. Barnes-Jewish Hospital also functions as a community hospital with private patients admitted by the full-time faculty and physicians in private practice.

All Department of Medicine divisions have outstanding research programs and excellent clinical programs. House staff are taught by physicians who are leaders in their fields; for those electing subspecialty fellowship training, excellent programs are available in all areas. Jump to Top

RESEARCH ACTIVITIES

The Washington University Medical Center has more than 60 buildings on 135 acres. The Medical School is fourth in the nation in total NIH research funding with $377 million in 2005.

The Department of Medicine accounts for about 30 percent of the University's research enterprise. There are about 250,000 square-feet of space dedicated to basic scientific and clinical research that encompass a wide spectrum of fields in biology and medicine.

The Department of Medicine ranks 4th in the nation among Internal Medicine Departments in its ability to compete for federally funded grants. Corporate sponsorship of research, clinical trials and technology development represent areas of active growth.

The more than full-time faculty have written thousands of scholarly and scientific articles which have led to national and international recognition for the quality of their teaching and research.

The Department is well represented in prestigious medical and scientific societies and faculty receive numerous honors and awards and serve on many editorial boards of journals and advisory councils. Four current faculty have been elected to the National Academy of Sciences and seven to the Institute of Medicine, while 29 belong to the Association of American Physicians and 54 to the American Society for Clinical Investigation. Department of Medicine faculty are involved in teaching and in pre- and postdoctoral training activities through the Medical Scientist Training Program and the Division of Biology and Biomedical Sciences. Approximately 70 faculty members have joint appointments in one or more of the basic science departments. Seventy of the 500 Ph.D. and M.D./Ph.D. students train in laboratories supervised directly by Department of Medicine faculty. Jump to Top