School of Medicine (Eastern)

WVU Rural Hospital Medicine Fellowship Program

HM Fellowship Application

HM Fellowship rotations & conference schedule
HM Fellowship FAQs
HM Fellowship goals and objectives
HM Fellowship key faculty and roles
HM Fellowship faculty publications

The WVU Rural Hospital Medicine Fellowship Program provides advanced training in clinical hospital care, patient safety and clinical performance improvement, and telemedicine skills critical for practice and leadership excellence in hospital medicine for rural and small hospital settings

Rural Hospital Medicine Fellowship Rotations

Rural Hospital Medicine Fellowship Conference Schedule

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FAQ’s (Frequently Asked Questions)

1. What is the mission of the fellowship program?

The WVU Rural Hospital Medicine Fellowship Program will provide advanced training in clinical hospital care, patient safety and clinical performance improvement, and telemedicine skills critical for practice and leadership excellence in hospital medicine for rural and small hospital settings.

2. Why is fellowship training needed in rural hospital medicine?

Hospital Medicine is the fastest growing specialty in the history of medicine.1 Nearly every hospital either has, or is actively planning a hospitalist program. Small and rural hospitals are no exception to medical community shifts toward ambulatory-only practices, and third-party demands for more efficient, cost effective, evidence-based hospital utilization. Currently, family medicine specialists comprise less than 10% of the hospitalists nationwide, with non-fellowship trained internal medicine specialists filling over 80% of the positions. The Society of Hospital Medicine-Family Medicine Task Force has identified the unique role that family medicine physicians can fill in our rural and small hospitals, who serve adult inpatients along with lower volumes of pediatric and obstetrical/gynecological inpatients. The versatility of family medicine certified and trained hospitalists will enable programs to serve the diverse patient populations that are common in small and rural hospitals. The Task Force has been charged with identifying a strategy to attract family medicine specialists into hospital medicine to address the projected manpower shortage. Currently there are only 5 family practice along with 15 internal medicine, and 5 pediatric  hospitalist fellowships posted on the Society of Hospital Medicine website. 2 The projected US need for hospitalists in 2010 is 30,000 3which dramatically exceeds the 13,000 hopsitalist workforce present in 2004.4 The increasing emphasis on ambulatory and other non-hospital location training for family medicine residents is expected to leave those interested in a hospital medicine career seeking hospital medicine fellowships to hone their hospitalists clinical skills, or to prepare for leadership or academic career paths.
1 Lurie et al. The Potential Size of the Hospitalist Workforce in the United States. Am J Med. 1999; 106:441-5
2http://www.hospitalmedicine.org/Content/NavigationMenu/Education/HospitalMedicinePrograms/Hospital_Medicine_Pr.htm. accessed 6/24/08.
3 Kralovec P, Miller JA, Wellikson L, Huddleston JM. The status of hospital medicine groups in the United States. Journal of Hospital Medicine. March/April, 2006; 1(2): 75-80.
4 The Society of Hospital Medicine 2005-2006 Survey: The Authoritative Source on The State of the Hospital Medicine Movement.

3. What are the strengths of the WVU Rural Hospital Medicine Fellowship Program?

• Fellowship training will occur in teaching hospitals the size of many rural and small community hospitals.
• The primary training site is a critical access hospital that has a 100 year tradition of family medicine hospital service
• The primary training site ACGME accredited family medicine residency program since 1995 that achieved a full 5 year accreditation cycle at the 2008 RRC site visit.
• The primary training site sister hospital in the WVUH-E system (City Hospital) has an Intensivist Program and a Hospitalist Program that will support clinical training and hospitalist quality and performance initiatives by the fellows.
• Faculty in leadership roles within the critical access hospital, and WVU Hospitals-East leadership team.
• Established program in teleradiology between Jefferson Memorial Hospital and WVUH-Ruby Hospital through the WVU Department of Radiology.
• Hospital leadership and Intensivist support for establishing a “Virtual ICU” telemedicine consultation service at JMH in conjunction with the Hospitalist Fellowship program.
• Opportunity for interaction with other fellows from the Geriatric Medicine Fellowship Program also based in the Eastern Division.

4. What resources are available at the fellowship training hospital?

As a part of the WVUH System, the new WVUH-East merger of City Hospital and Jefferson Memorial Hospital has enhanced the fiscal health and strategic resource planning of both local hospitals. JMH has adequate beds for teaching, as the FM service and the JMH Hospitalist services will effectively staff 90% of the legislated 25-bed critical access hospital capacity (although laboring mothers and newborns do not count in the 25 patient count). JMH maintains full Joint Commission accreditation, with appropriate operating rooms (3), endoscopy, anesthesia, lab, ICU (6 beds), diagnostic imaging (including CT, MRIU, Nuclear Medicine, Ultrasound), 24-hr Emergency Department, and a WVUH-E integrated electronic hospital medical record platform. The diagnostic imaging services are on a digital PACS platform, utilizing the WVU Department of Radiology teleradiology services to provide JMH with after-hours radiologist interpretation.  For a critical access hospital, JMH enjoys the academic and quality resources of the WVU School of Medicine regional campus with the Departments of Family Medicine, Surgery, Pathology, Radiology, and Emergency Medicine staffing their respective JMH hospital services with full-time faculty. These unique and robust WVU resources in a small critical access hospital make our Rural Hospital Medicine Fellowship possible, and uniquely positioned for success.

5. How are fellows selected?

Applicants who respond to the WVU Hospital Medicine Fellowship posting in the AAFP Fellowship Directory, the Society for Hospital Medicine Fellowship Directory, journal classified ads, or WVU SoM webpage or Department of Family Medicine webpage will be sent an application. Before entering the fellowship program, applicants must have successfully completed an ACGME accredited family or internal medicine residency program and must be either Board Certified or eligible. The following selection factors will also be assessed (1) ABFM certification exam scores (if available) , (2) In-service exam scores, (3) Letters of recommendation from hospitalist and hospital service attendings, (4) Professionalism and communication skills demonstrated in a personal interview.

6. How are the rural hospital medicine fellows evaluated?

The supervising faculty are sent the evaluation forms and rotation goals and objectives before each rotation. They are encouraged to submit their evaluation of the fellow immediately upon the fellows completion of the block/clinical learning experience Preceptors are urged to give the resident verbal feedback at mid-rotation (especially if there are deficiencies) and to review their evaluation form with the fellow upon completion of the rotation. Fellows have at least 2 formal, scheduled feedback sit-down sessions with the Program Director during which all evaluations are reviewed, and feedback is both given and solicited. 360 Degree evaluation of the fellows will be performed annually.
The Rural Hospital Medicine Fellowship Program Director shall present the fellow’s evaluations and curriculum completion status to the Department of Family Medicine-Eastern Division GME Committee for approval of the fellow’s successful completion of the program. Final written evaluations speak to the completing fellow’s ability to practice using the six ACGME competency parlance, in the WVU GME format, and shall specifically state the ability of the fellow to practice hospital medicine competently and independently.

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Key Faculty and Roles in Rural Hospital Medicine Fellowship Program

Mark Cucuzzella, MD- Rural Hospital Medicine Fellowship Director. Experience as
Chief of Hospitalist Services for University of Colorado and FM Clerkship Director RCBHSC-Eastern Division
Konrad C. Nau, MD-  VPMA Jefferson Memorial Hospital, member Society of
Hospital Medicine Family Medicine Task Force 2008-present. 26 years experience in rural hospital medicine.
Lloyd Tracy, MD- Medical Director Cardiopulmonary Department Jefferson Memorial
Hospital. Director Medical Simulation Laboratories, WVU RCBHSC-Eastern Division.
David Baltierra, MD- WVU Rural Family Medicine Residency Program Director. Over
10 years experience in family medicine hospital attending and advanced OB.
Jennifer Janus,MD- Board Certified Internal Medicine and Pediatrics. Chair Pharmacy
and Therapeutics Committee Jefferson Memorial Hospital. Hospital attending.
Sarah Moerschel, MD- Board Certified Pediatrics. Chief of Pediatrics Service Jefferson
Memorial Hospital. Hospital attending.
Robert Bowen,MD- Board Certified in Internal Medicine and Critical Care. WVUH-
East Intensivist Group
Jan Kletter, MD-Board Certified General Surgery. Chief of Surgery and Chief of
Critical Care Jefferson Memorial Hospital.
Vishal Malpani, MD- Board Certified in Family Medicine and Geriatric Medicine. Over
5 years experience in rural critical access hospital medicine.
Angela Oglesby, MD- Board Certified Family Medicine and OB fellowship trained.
Hospital attending.
Shannon Bentley, MD- Board Certified Family Medicine and OB fellowship trained.
Hospital attending.
Yi Wang,MD-Board Certified Family Medicine, Director Skilled Care and
Rehabilitation Unit Jefferson Memorial Hospital. Hospital attending.
Michael Frederich, MD-Board Certified Family Medicine and Hospice & Palliative
Care, Medical Director Hospice of the Panhandle. JMH paliative care consultant.
Jason Harah,MD- Board Certified Family Medicine. Associate Medical Director,
Hospice of the Panhandle.JMH palliative care consultant.
Paul Welch, MD-Board Certified in Internal Medicine and Nephrology. Jefferson
Memorial Hospital nephrology consultant.
Fred Ammerman,DO-Board Certified Radiology, Chief Radiologist Jefferson Memorial
Hospital.
James Walker,MD-Board Certified Emergency Medicine. Chief Emergency Medicine
Services Jefferson Memorial Hospital.
Neal Gaither, MD- Board Certified Internal Medicine and Cardiology. WVUH-E
cardiology consultant.
Jonathan Kline, PharmD-Dept Family Medicine-Eastern Division, Jefferson Memorial
Hospital consultant hospital team pharmacist.
Gary Matthews, PharmD-Director Jefferson Memorial Hospital Pharmacy Services.
Consultant hospital team pharmacist

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Key Faculty and Recent Publications/Presentations/Scholarly Projects

Peer-Reviewed Publications
Cucuzzella, M. Interventions for Pediatric Obesity: accepted Evidence-Based Practice 2008
Cucuzzella M. Dynamed (online medical text). Author, reviewer for Exercise Asthma section
Cucuzzella, M. Should we prescribe bed rest for hypertensive disorders of pregnancy?
Evidence-Based Practice 2007; 10(3): 5.
Cucuzzella M. Family Medicine Digital Library Resources (fmdrl.org): “Exercise as Medicine”, “Pharamcoeconomics”
Preston J, Cucuzzella MT. “What is the best treatment for exercise induced bronchospasm in children”. Family Practice Inquiries Network, Journal of Family Practice.March 2006
Cucuzzella, MT “Nausea and Vomiting in Pregnancy”; for PEPID online/PDA. Fall 2005
Cucuzzella, MT “Radiation Effects in Pregnancy”; for PEPID online/PDA. Fall 2005
Cucuzzella, MT. When should we treat hypertriglyceridemia? Family Practice Inquiries Network, Journal of Family Practice. March 2004, p 142-3.
Janus JL. Hamstra S, Colletti L. and Lipson M. A postgraduate orientation assessment. At the University of Michigan. ACGME Bulliten April 2006:13-15.
Green GB, Dai JL, Bessman ES, Cox(Janus) JL, Gabor DK and Chan DW. The Prognostic significance of troponin I and troponin T. 1998. Academic Emergency Medicine 5(8):758-67.
Moerschel S, Tracy L, Cianciaruso L. A practical approach to neonatal jaundice. AFP;77(9) May 1, 2008.
Nau K, Que C, Kletter J. Perioperative Care. AFP Essentials accepted for publication 2007.
Nau K, Lewis W. Multiple Myeloma. American Family Physician, accepted for publication 2007.

Textbook Publications
Cucuzzzella M. Contributor and test question writer: Essentials of Family Medicine 5th Ed.
Nau, KC, Congdon H. Chapter 35 “Diabetes mellitus in the Elderly” in Primary Care Geriatrics: A Case-Based Approach, Ham,Sloane,Warshaw editors, for fifth edition.2006.
Nau KC. “Chapter 4.5 Memory Impairment”.  in The 10 Minute Diagnosis Manual , Robert B. Taylor editor, Lippincot Williams &Wilkins. ISBN 0-7817-2094-X. June 2000.

Training Manual Publications
 Nau K. Managing Editor, AGES™ – Advanced Geriatric Educator Skills © An 18 module, 4 workshop certification course/program for teachers and practitioners of clinical geriatrics. Modules are evidence-based and peer reviewed and contained in AGES Binder

• 1. The accompanying PowerPoint presentations are contained in AGES Binder
• 2. Program includes a multiple choice written test, and a practical  OSTE (Objective Structured Teaching Exam) that participants must pass to earn AGES Certification. Editons 2005, 2006, 2007, 2008

Nau,KC author of Delirium in the Geriatric Patient; Preoperative assessment and Perioperative Care of the Geriatric Patient; The Geriatric Electrocardiogram Workshop; MEGAFALL OSTE
Nau,KC , Ham R, Cannarella R – Microskills:One Minure Precepting Workshop
Malpani V. Olney G. – Endocrine and metabolic disorders in the elderly
Kline J. Congden H.Elliot D. - Polypharmacy Workshop

Nau,KC, Resident-as-Teacher Training Program , Editor, scenario and PowerPoint author
and Principle Inverstigator for the HRSA Grant Supported production with co-investigators Nath,C , Cannarella,R , Baltierra,D , Deci,D,Donovan,C., Asher,L.
Electronic Training set includes DVD trigger films, and companion CD PowerPoint Lectures and supporting teaching handouts, and Objective Structured Teaching Exams (OSTEs) for the clinical scenario:teaching concept diads of

• 1. Cultural Sensitivity and Socratic Teaching with Adult Learners,
• 2. Domestic Violence and Teaching in the Difficult Patient Encounter, and
• 3. End of Life Care and Teaching with One Minute Precpting. Filmed and produced by WVU TV. 2005
       
  

Peer-Reviewed Poster Presentations
Kline J. Contrast Induced Nephropathy in the Pediatric Patient. Poster Presentation at ASHP Midyear Clinical Meeting: Dec 2007.
Kline J. Nasal MRSA Colonization Rate in Patients Admitted to the Medical Intensive Care Unit of a University Hospital. Platform presentation Eastern States Residency Conference: May 2007.
Kline J. Utilization of Vancomycin Therapeutic Drug Monitoring in a University Hospital. Poster Presentation at ASHP Midyear Clinical Meeting: Dec 2006.
Moerschel S. Committee on Medical Students in Pediatrics Annual North American
Meeting “Innovations in Education: A Rural, Longitudinal Pediatric Clerkship”Salt Lake City,Utah. March 2006.

Select National and Regional Presentations
Baltierra D. Nau K. “360-degree Evaluations: Assessing AGME Competencies” Workshop for Directors of FP Residencies Kansas City, MO. May 31-June 3, 2003.
Baltierra D. Duck R. “Reducing the Incidence of Cesarean Deliveries” Obstetrics and Gynecology Update: West Virginia AFP Charleston,WV April 18, 2002
Cucuzzella M. “Pharamcoeconomics” STFM Annual Conference for Patient Education, Denver, Colorado. November 2006
Cucuzzella M. “COPD”Capital Conference Family Medicine Board Review Course. Andrews Air Force Base, Maryland. June 2007
Cucuzzella M. “Abdominal Pain in Primary Care”. Capital Conference Family Medicine Board Review Course. Andrews Air Force Base, Maryland. June 2007
Cucuzzella M. “Hypertensive Disorders of Pregnancy”. University of Colorado Annual Family Medicine Review Course, Denver, Colorado. Nov 2004
Cucuzzella M. “Congestive Heart Failure Update 2004”, Capital Conference Family Medicine Board Review Course. Andrews Air Force Base, Maryland. June 2004
Cucuzzella M. “Smallpox: The Disease, The Vaccine, and Recent Lessons Learned”. Colorado AFP Annual Meeting. Keystone, Colorado. July 2003
Cucuzzella M. “Medical Interpreters- Why Bother”. University of Colorado School of Medicine Outreach Program. Multiple Rural Sites: Haxton, Holyoke, and Fort Morgan, Colorado. 2002-2003
Cucuzzella M. “Contemporary Management of Unstable Angina”. University of Colorado School of Medicine Outreach Program. Multiple Rural Sites: Pagosa Springs and Meeker Hospitals. December 2000 Frederich M. “Practical use of Methadone”. National Hospice and Palliative Care Organization 8th Clinic Team Conference, New Orleans, La. Nov 2007.
Frederich M. “Pain management”, “Adjunctive pain management”, “Breaking Bad News”. UCLA EPIC Course. Los Angeles, Ca. 2007.
Frederich M. “Medical Ethics in End of Life Care”, “Practical use of methadone”. National Hospice and Palliative Care Organization 7th Clinical Team Conference, San Diego, Ca. April 2006.
Frederich M. “Symptom management”. National Hospice and Palliative Care Organization 6th Clinical Team Conference, Atlanta,Ga. April 2005.
Moerschel S. Advanced Nursing Practice Conference “Emergency Topics in Pediatrics” Philadelphia, PA ,May, 2002.
Nau K. DeVine T. “Designing patient safety education in primary care”. STFM , Pittsburgh, Pa. Nov 2007
Nau K. Tracy L. Exercise Stress Testing for Family Physicians. Pennsylvania Academy of  Family Practice. Williamsburg, Va. June 2006.
Nau K. “Curriculum in Patient Safety”. ADFM Annual Meeting, Savannah,Ga. Feb 2007.
Nau K. “Adopting physician error reporting systems”. Quantros Safety Conference, St Louis, Mo. Oct 2005
Nau K, Cannarella R. “Objective Structured teaching Exams (OSTE) to develop resident-as-teacher competency”. STFM, Albuquerque,NM. Jan 2005.

National Education Projects and Grants
Baltierra D. AAFP P4 Program. WVU Rural Family Medicine Residency Program selected as one of only 14 programs to participate in national project to transform residency training. WVU proposal includes hospital transition and patient safety elements. 2007-2012.
Nau K. Principle Investigator. Baltierra D and Cannarella R. Co-PI HRSA Primary Care Residency Training Grant   Objectives

• 1. Pediatric Oral Health
• 2. Hispanic Outreach /Cultural Competency
• 3. Patient Safety. Approved and Funding Awarded - $444,488. 2005-2008.
  

Nau K. Principle Investigator. HRSA Primary Care Residency Training Grant Objectives

• 1. Developing Resident-as-Teacher curriculum,
• 2. Developing Public health curriculum.
• 3. Developing Rural physician leadersip curriculum. Approved and funding awarded- $380,000. 2002-2005.
  
  

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