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Department of Internal Medicine What WE have accomplished Where We are going Department of Internal Medicine Full time Faculty 11 Divisions 18 Clinical Faculty 80 Adjunct Faculty 5 Program Director Lisa Staton MD Associate Program Director Cathy Payne MD

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department of internal medicine
Department of Internal Medicine

What WE have accomplished

Where We are going

department of internal medicine2
Department of Internal Medicine

Full time Faculty 11

Divisions 18

Clinical Faculty 80

Adjunct Faculty 5


Program Director Lisa Staton MD

  • Associate Program Director Cathy Payne MD
  • Program Coordinator Ms. Deborah Fuller
  • Clerkship Director Gary Malakoff MD
  • Research Director Victor Kolade MD
  • UMA Director Lisa Staton MD
  • Associate Director Victor Kolade MD
  • Chief Residents D Meadows MD/A BhushanMD

M Tveite MD/N Gupta MD

  • Administrative Assistant Ms. Laura Nihiser
  • Transitional Year Program Ms. Joyce Poke



Dr. BW Ruffner

  • President-elect of the TMA for 2009-2010

Dr. Charles F. Longer

  • Chairman, Board of Trustees
new faculty
New Faculty
  • General IM
  • GI
  • Endocrine
  • Cardiology
  • Hospitalists
  • Neurohospitalist
  • Neurology
administrative staff
Administrative Staff

New Administrative Assistant - Ms. Laura Nihiser

Electronic Completion of Evaluations via New Innovations by Faculty, Residents and Staff

Monthly Staff Meetings

Faculty Appointment System

(Notification of Final Appointment Completion)

Monthly UTCOMC sponsored New Innovation & Web Training Sessions

palliative care fellowship
Palliative Care Fellowship
  • Successful accreditation
  • Successful completion of first year
  • Successful recruiting

The Past Year

  • Medical Knowledge
    • Noon Conference Block
    • In-training Exam
    • Board Passage Rate
  • Patient Care
    • Home Visits
    • ACLS one-on-one
  • Practice Based Learning
    • Quality Data
    • Dedicated Case manager and Clinical documentation personnel
  • Interpersonal Skills and Communication
    • Ethics Quarterly
    • One on One mentoring

The Past Year

  • Professionalism
    • Transition to Residency – Chief Residents
    • Pharmaceutical Company Interactions- Bhushan and Grubb
    • Ethics Conferences
    • Esprit de Corp Activities
    • RRRnR sessions
    • 3 Alper Humanism inductees, IM resident received award
    • DOM established the UT campus wide Gold Humanism Society Chapter
  • Systems Based Practice
    • Recruiting
    • Inpatient Teams (core faculty and hospitalists)
    • Rotation updates (Inpatient Medicine, Critical Care, Night float, Private Office, Neurology)
    • Competency committee enhanced
    • Accountability committee
university medical associates
University Medical Associates

Dr Lisa Staton

Dr Victor Kolade

Ms M Calloway

  • Firm Assignments
  • Change in Continuity Clinic Hours
  • Changes in Cardiology Clinic
  • Staff Retreat
why firm assignments
  • To structure resident clinic as a group practice
  • To allow for shared responsibility for learning
  • To provide continuity of patient care
  • To promote an interdisciplinary approach to patient care
  • To encourage mutual support and collegiality
  • To help ensure mentoring and supervision during resident’s continuity experience
change in continuity clinic hours
  • Allow residents to be able to round on inpatients without interruption for clinic
  • Provides adequate time for conferences
  • Allows time for clinic staff to prepare for clinic
  • Allows time for clinic staff to handle calls and additional paper work
changes in cardiology clinic
  • Cardiology Clinic changed from two clinic a month to four clinics a month to allow for increase in patient volumes
  • Pacemaker Clinic implemented (1st Wednesday of each month)
  • Referral Form implemented to ensure that patient referred have specific test prior to appointment
  • New EKG machine purchased
  • Dedicated Medical Assistant for Cardiology Clinic
  • Proposal for onsite Chest X-Rays
staff retreat june 12 2009
  • Team building activities
    • To foster better communication between staff, residents and attending physicians
    • To improve staff morale
    • To improve patient flow
m3 clerkship accomplishments
M3 Clerkship Accomplishments
  • Restructured orientation to include
    • How to write notes
    • How to present to an attending
    • Professionalism
  • Instituted shelf reviews with faculty/chief residents
  • Moved several core lectures to beginning of the clerkship to avoid interruptions in clinical rotations
  • Physical diagnosis teleconference across all 3 campuses
  • First class of GHHS inducted
medical student accomplishments
Medical Student Accomplishments
  • Pulmonary/critical care as separate entities
  • Initiated student evaluation of clerkship/rotations
  • Secured palliative care experience in the ambulatory and specialty rotations
  • GME office organizing special interest groups for medical students rotating here
  • Total of 7 students completed their patient safety QI clerkship through our department
  • 4 of our 10 new IM interns rotated in our department
  • 1 of 6 new TY interns rotated in our department

Youth Health Forum

    • M3 and M4 students, IM and TY residents and Dr Malakoff and Panda participated
  • Mentoring of 4 UTC premed students
future of medical student rotations
Future of Medical Student Rotations
  • Possible neuro/psych rotations
  • Increased class size = more students in Chattanooga in 2 years
    • Actively involved in selection process for these students
quality improvement projects
Quality Improvement Projects
  • Initiated chapter of IHI Open School
  • Improving inpatient glycemic Control
  • Evaluating the global trigger tool to identify adverse events in the hospital
  • Evaluating and improving inpatient VTE prophylaxis protocol
  • Evaluating successful implementation of the national patient safety goals in regards to anticoagulation medications
  • Review of internal medicine admissions daily to assure equitable distribution between hospitalists and teaching service
quality improvement projects25
Quality Improvement Projects
  • Ambulatory Geriatric Screen & chart audit
  • Consultation form
  • Code committee
  • Inpatient Medicine Scorecard
  • Transfer of Care
  • Pneumonia Core Measures
  • CHF core measures
  • AMI core measures
  • Antibiotic Stewardship
  • Hand Hygiene
quality improvement projects26
Quality Improvement Projects
  • VAP bundle
  • Sepsis protocol
  • Patient flow
  • Mortality reduction
department of medicine scholarly activity update

Department of MedicineScholarly Activity Update

Publications, Lectures, Meetings,

Research, QI,

UMA, Education, Scholarships


Patel V, Yalavarthy U, Desbiens NA. Does reporting estimated glomerular filtration rate affect ordering of timed urine collections? Am J Med Sci. Mar 2009;337(3):185-187

  • Li HY, Grubb M, Panda M, Jones R. A Sore Throat-Potentially Life-Threatening? J Gen Intern Med. May 10 2009
  • Gupta N, Patel C, Panda M. Hepatitis following famotidine: a case report. Cases J. Jan 27 2009;2(1):89
  • Rahman AA, Panda M. Locked lung by looped hernia: a case report. Cases J. Jan 8 2009;2(1):29

Pai S, Panda M. Limited Wegener's granulomatosis presenting as lung nodules in a patient with rheumatoid arthritis: a case report. Cases J. Dec 23 2008;1(1):417

  • Estrada C, Panda M, Landry M. Why Should I Write a Case Report or Clinical Vignette? SGIM Forum December 2008; 31(12):5, 9
  • Gray ER, DeVersa R. Hereditary Multiple Exostoses. Hospital Physician. November 2008;44(11):8
  • Navaid M. Perception of hospice/palliative medicine: a fellow's narrative. J Palliative Med. Apr 2009; 12(4):385-6

Tumlin JA. Lupus nephritis: histology, diagnosis, and treatment. Bull NYU Hosp Jt Dis. 2008;66(3):188-194

  • Desbiens NA. A departmental experience in promoting oral and poster presentations. Teach Learn Med Jul-Sep 2008;20(3):254-260
  • Heath GW. Recommended Levels of physical activity and health-related quality of life among overweight and obese adults in the US. Journal of Physical Activity & Health 2008;JPAH-2008-0028.R1

Tindni A, Gaurav K, Panda M. Non-healing painful ulcers in a patient with chronic kidney disease and role of sodium thiosulfate: a case report. Cases J. 2008;1(1):178

  • Ross MA, Amsterdam E, Peacock WF, et al. Chest pain center accreditation is associated with better performance of centers for Medicare and Medicaid services core measures for acute myocardial infarction. Am J Cardiol. Jul 15 2008;102(2):120-124. (F Fesmire)
  • Jones R, Panda M, Desbiens N. Internal medicine residents do not accurately assess their medical knowledge. Adv Health SciEduc Theory Pract. Nov 2008;13(4):463-468

Roux L, Pratt M, Tengs TO, Yore MM, Yanagawa TL, Van Den Bos J, Rutt C, Brownson RC, Powell KE, Heath G, et al.  Cost effectiveness of community-based physical activity interventions.  Am J Prev Med. Dec 2008;35(6):578-588

  • Bhattarai N, Panda M. Uremic Frost. Mayo Clin Proc. December 1, 2008;83(12):1309
  • Dutta G, Panda M. An uncommon cause of lower gastrointestinal bleeding: a case report. Cases J. 2008;1(1):235
  • Conner C, Paydar A. Intradural Extramedullary Arachnoid Cyst Presenting as Arteriovenous Malformation in the Thoracic Spinal Cord. Radiology Case Reports 2009;4:263

Cecil WT, Kasteridis P, Barnes JW, Jr., Mathis RS, Patric K, Martin S. A meta-analysis update: percutaneous coronary interventions. Am J Manag Care. Aug 2008;14(8):521-528

  • Edlow JA, Panagos PD, Godwin SA, Thomas TL, Decker WW, (Fesmire FM, et al), American College of Emergency Poisoning.  Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with acute headache.  Ann Emerg Med.  Oct 2008;52(4):407-436
  • Cardiel MH, Tumlin JA, Furie RA, Wallace DJ, Joh T, Linnik MD. Abetimus sodium for renal flare in systemic lupus erythematosus: results of a randomized, controlled phase III trial. Arthritis Rheum. Aug 2008;58(8):2470-2480

Scherer K, Gupta N, Caine W, Panda M Differential Diagnosis and Management of a Recurrent Hepatic Cyst:  A Case Report and Review of Literature JGIM

  • Navaid M Power of presence and compassion J Palliative Med
  • Makdsi F, Brit M A Case of SclerosingMesenteritis With Rheumatoid Arthritis South Med J
  • Makdsi M, Fall M Acute Renal Infarction J Hosp Med
  • Dutta G, Panda M Bands of cacophony Cases J
  • Scherer K, Panda M, Johnston J Dural Based Mass Journal of Radiology
  • Makdsi F Acute Pancreatitis with Eruptive XanthomasJ Hosp Med
book review
Book Review
  • Mathis R. Cause And Coincidence In Autism. Health Aff. May 1, 2009;28(3):916-917
  • Makdsi F Transient Thyrotoxicosis as an Initial Presentation of Rheumatoid Arthritis, accepted Cases J
  • Makdsi F Inflammation of Actinic Keratosis with Combination of Alkylating and Taxane Agents, Cases J
  • Staton L, Rybolt A, Panda M, Jones R Achieving the AAA's of Ambulatory Medicine - Aptitude, Appeal and Appreciation J GME, in review
  • Panda M, Desbiens N Life long learning after residency J GME, in review
  • Increased frequency and nocturia in a middle-aged male may not always be due to Benign Prostatic Hypertrophy (BPH): a case report Gaurav, Panda JCRin review
submissions pending decisions
Submissions Pending Decisions
  • LeucocytoclasticvasculitisJGIM
  • AVM Cases J
  • DKA and PneumomediastinumCases J
  • Subacute Combined Degeneration With Normal Vitamin B12, submitted to Cases J
manuscripts in preparation
Manuscripts in Preparation
  • Catastrophic Antiphospholipid Antibody Syndrome Jacobson
  • Scrofula Kafle
  • Extragonadal Germ Cell Tumor Hadgu, Tindni, Panda
  • How much is too much Grubb, Gaurav, Panda
  • Clonidine overdose Tveite
  • A Rare Cause of Acute Seizure in a Young Man  Krummert, Scherer, Whitley, Dixon, Sirelkahtim, Panda
  • Diabetes Insipidus Chhakchhuak, Tumlin
  • Pulmonary LCNEC Kaako
local and distant conferences
Local and Distant Conferences

Posters and Oral Presentations

panel discussions
Panel Discussions
  • Approaches to Interactions with Industry: A Multidisciplinary Panel Discussion to Educate Residents In Training
    • Dr Malakoff
    • Robin Grant, R.Ph.
    • Dr Mathis
    • Dr Fore
    • Sylvia Friedl
  • Physician Stress & Burnout” at the Departmental Residency RetreatCohen, Barker, Panda
research week research abstracts
Research Week Research Abstracts
  • RAPID RESPONSE TEAMS: Their Impact on the Rate of Cardiac Arrests at the Baroness Erlanger Hospital (BEH) of the University of Tennessee at Chattanooga Jacobson, Tindni, Panda, Staton (2nd place poster)
  • The Frequency and Significance of Incidental Thyroid Nodules (ITNS) on Chest CT Scans,  a retrospective study:  Scherer, Means, Chijioke, Karmin, Panda (3rd place poster)  
  • Clinical Decision Making for Pulmonary Embolism: Are Physicians Using the Latest Evidence? Makdsi, Staton, Panda
research week case reports
Research Week Case Reports
  • A Rare Cause of Acute Seizure in a Young Man  Krummert, Scherer, Whitley, Dixon, Sirelkhatim, Panda (3rd place poster)
  • Painful Ophthalmoplegia as the first Manifestation of Lung Carcinoma Mocanu, Obaid, Kolade
  • Late-Onset Asthma and Stridor; Think about Adenoid Cystic Carcinoma! Kaako, Stansell, Kolade
  • The Persistent Parasite, Patient, and Physician Scherer, Gupta, Caine, Panda (also presented at Internal Medicine 2009)
ssgim 2 09
SSGIM, 2/09
  • 3 workshops
  • 9 oral presentations
  • 13 posters
presented at national sgim
Presented at National SGIM
  • Numbness in a 39 Year-old Man Makdsi F, Kadrie H
  • Common shortness of breath for uncommon reason: Rahman A, Kolade V
  • When A Piece Of Heart Hurts The Brain. Kafle P, Dutta G, Yium J
  • Painful Ophthalmoplegia as the first Manifestation of Lung Carcinoma Mocanu B, Obaid B, Kolade V
  • Late-Onset Asthma and Stridor; Think about Adenoid Cystic Carcinoma! Kaako A, Stansell K, Kolade V
  • Oral: A Case of LeukocytoclasticVasculitis with Rare Complications Finch T, Brit M, Panda M
  • Workshop: Getting your vignette published, a step wise approach

Panda et al

international humanities in medicine posters
International Humanities in Medicine (Posters)
  • Chijioke C, Scherer K, Panda M

Relaxing, rejuvenating and rejoicing in residency: RRR in Residency

  • Kaako A, Panda M Taking care of the Muslim patient: How culturally aware are our health care providers?
international conference of the american thoracic society may 15 20 2009
International Conference of the American Thoracic Society, May 15-20, 2009
  • Food and Particulate Aspiration Pneumonia Gupta N, Enjeti S
  • Dr YiumLead Toxicity: Lead and Moonshine Nephropathy
    • North American Society for Dialysis and Transplantation,
    • July 12-16, 2009; Kapalua-Maui, Hawaii
  • Dr Tumlin
  • Bilateral Symmetry in Chronic Uremic Pruritus: The Brain-Skin Connection
  • A Phase III, Randomized, Double-Blind, Placebo-Controlled Study of Tenecteplase for Improvement of Hemodialysis Catheter Function: TROPICS 3
    • American Society of Nephrology Meeting
    • October 27 - November 1, 2009; San Diego
current projects
Current projects
  • Kyle, Stansell, Rahman, Anower, Tumlin, Boldt, Gunter, Shome: PRESSURE Trial
  • Gupta, Strelnikova, Boldt, Panda: VIPP study
  • Kaako, Panda: Care of Muslim Patients
  • Todd, Payne: Vaccine history and pneumococcal sepsis in alcoholics
  • Hawkins, Malakoff, Chhakchhauk: C. difficile Colitis
  • Navaid: Quality of life in hemodialysis patients
  • Bhushan, Payne: Patient handoffs
bringing back the black bag
Bringing Back the Black Bag
  • Drs Rybolt, Panda and C. Cunningham; begun March 09
  • This 3-year project promotes improving humanism in medicine through the use of House Calls
  • Internal medicine residents do house calls in teams of two residents, attending physician and nurse and/or home care agency/other community care provider
  • We expect residents will develop stronger physician-patient connections and have more interaction with the multidisciplinary team caring for their patients
  • Residents will be taught skills needed to make house calls
  • Surveys of physicians, patients and caregivers will explore attitudes toward and benefits of house calls
h a i r scherer chijioke waterhouse cunningham kramer mai fore panda
H.A.I.R Scherer, Chijioke, Waterhouse, Cunningham, Kramer-Mai; Fore, Panda,


  • Explore the influence of breast cancer treatment associated side effects (including alopecia) in patients diagnosed with breast cancer, their spouses/significant others, and health-care providers
  • Provide a structured opportunity to teach and role model the concept of “taking ownership” and “getting to know” the patient as a complete human being
  • Study the influence of journaling in coping strategies of breast cancer patients undergoing treatment, spouses/significant others, and their health-care providers
  • Evaluate potential resident outcomes as they relate to fatigue and resource recovery
  • Provide financial and cosmetic support to patients as needed
rrr in r chijioke scherer c cunningham panda
RRR in RChijioke, Scherer, C Cunningham, Panda
  • Pilot study to address the following aims:
  • To provide and promote an encouraging environment in which information is shared among residents, faculty, and healthcare workers from different spiritual and cultural backgrounds
  • To facilitate discussion regarding issues about cultivating good human interactions, improving well-being of health care providers, achieving personal growth and becoming sensitive to the needs of fellow human beings
  • To evaluate the effectiveness of the RRR in R sessions as a mechanism for recovery and fatigue/burnout prevention for residents, as indicated by scores on the Need for Resource Recovery Scale, the Fatigue Assessment Scale and Burnout scale as well as more qualitative questions about RRR in R sessions
  • To assess and monitor stress/fatigue/burnout amongst resident over a three year period and evaluate the effectiveness of RRR intervention
  • To begin to develop a process for identifying residents at the highest risk of developing burnout and a connected process to train these individuals in the necessary techniques to prevent these negative outcomes from developing
grant submissions
Grant Submissions
  • Hi-TECH project: Technology Enhanced Code team Help
    • Dr Kolade, Panda, Dart
    • Submitted to NIH
  • Controlling Diabetes Among Low-Income Patients:  Physical Activity, Dietary Assessment and Counseling Coupled with Community Navigation
    • Collaboration with Family Medicine and community physicians
    • Staton, Heath, Kolade, Panda
    • Submitted to CDC/CTSI
grants received
Grants Received
  • Arnold P Gold Foundation

BBBB project

Gold Humanism Honor Society


  • Hulbert Foundation
  • DCI
pressure trial kyle stansell rahman anower tumlin boldt gunter shome
PRESSURE trialKyle, Stansell, Rahman, Anower, Tumlin, Boldt, Gunter, Shome
  • Hypothesis: Primary ventilatory therapy using Airway Pressure Release Ventilation (APRV) will improve recovery from Acute Lung Injury (ALI) or Adult Respiratory Distress Syndrome (ARDS), and reduce all cause mortality at 28 days compared to conventional ventilation using low tidal volume-cycled ventilation
grand rounds
Grand Rounds
  • Designation as an ACP educational event means attendance counts towards participation in College activities
  • Topics included
    • Psoriatic Arthritis
    • Can One Patient Teach It All?
    • Renin-Angiotensin-Aldosterone Axis in Chronic Kidney Disease
    • Acute Renal Failure: Pathogenesis, New Definition and Role of Cytokines
grand rounds62
Grand Rounds

Papadakis M, et al.

Ann Intern Med. 2008;148:869-876.


J Cohen MD “Stress Management in Residency: First Line Medications with Psychiatric Disorders,” at the Family Medicine Update 

  • J Cohen MD “Psychological Aspects of Coping with Chronic Kidney Disease,” Chattanooga Renal Symposium
  • J Cohen MD “Treatment of the Agitated Dementia Patient” Geriatric Medicine-Phoenix, Arizona
  • J Cohen MD “Adapting to Change,” Jewish Community Federation of Greater Chattanooga
  • J Sizemore MD Antibiotic Stewardship
  • J Boldt MD Interpreting PFTs Tennessee ACP
bcbst lunch learn
BCBST/Lunch & Learn
  • Vitamin D deficiency - Harmful, but preventable and treatable: Kolade
  • ARDS: Kyle
  • Bariatric Surgery – Criteria, Outcomes and Pitfalls : Payne
hhp 597 introduction to epi methods kolade
HHP 597: Introduction to Epi. MethodsKolade
  • Cigarette Smoking and Lung Cancer
  • Clinical Applications: Vitamin D, the Sunshine Vitamin
  • Mohammed Anower, MD and Brett Krummert, MD received scholarships from the Ochsner Clinic to attend a resident symposium titled ‘Clinical Updates in Cardiology,’ November 2008 in New Orleans
  • Molly Tveite, MD received a scholarship from Boston University to attend ‘AddictionMedicine: Improving Clinical and Teaching Skills for Generalists - A Chief Resident Immersion Training (CRIT) Program’ from May 6-9 in Cape Cod, Massachusetts; Faculty Mentor - Dr Kolade
  • Andrew Todd, MD received a scholarship from the American Pain Society to attend its 28th Annual Scientific Meeting and a pre-course entitled ‘Fundamentals of Pain Management: A Primer for Residents and Fellows’ May 5-9 in San Diego, California
  • Amanda Grubb, MD has been awarded a scholarship by the Mayo Clinic for its Internal Medicine Board Review scheduled for July 17-23 in Rochester, Minnesota
scholarly points policy
Scholarly Points Policy
  • Expected total - 21 or more points, obtainable through
    • Manuscripts
    • Medical Images publications
    • Research: Proposal approval, data collection
    • Posters/oral presentations
    • Workshops
    • IHI modules
summary 2008 2009
Summary 2008-2009
  • >20 peer-reviewed publications on file
  • >11 oral and 32 poster presentations
  • 6 workshops
  • Several intramural and extramural lectures
department of medicine72

Department of Medicine

Esprit de corps Activities


Community Service

esprit de corps activities 2008 2009
Esprit de corps Activities 2008-2009
  • Chambliss Shelter and Audobon Acres Service Project
  • Annual Canned Food Drive/Design Competition
  • Recruitment Dinner and Match Day Celebration
  • Ocoee River Rafting Trip
  • Boy Scout Medicine Merit Badge
  • Race for the Cure
  • Halloween/Fall Festival Celebration
  • Trunk or Treat/Chili Party
  • Multicultural Lunches

Thanksgiving Canned Food Drive

  • Holiday Musical Performance
  • UMA patient sponsorship for Christmas
  • Transitional Year and Internal Medicine Holiday Party
  • Sporting Activities (Basketball and Soccer)
  • Chattanooga Girls Leadership Academy Service Project
  • Eagle Scout Service Project Phase 1 and 2

Mutia Health Center Fundraiser/Bowling

  • April Day of Service Activity in coordination with Weed and Seed
  • Tour de Cure in coordination with Erlanger and American Diabetes Association
  • YMCA “BIG” Project
  • “Press Out” Domestic Violence Bench Press Competition
  • RRR in R Sessions
  • IM/TY Retreat
  • Gold Humanism Honor Society

Minority Health Fair

  • Women's Health Fair
  • US Xpress Health Fair
department of internal medicine77
Department of Internal Medicine

What WE have accomplished

Where We are going


The Upcoming Year

  • Medical Knowledge
    • New MKSAP available in July
    • John Hopkins Ambulatory Curriculum
    • In Training Exam Dates
  • Patient Care
    • Intern Clinic Orientation
    • Additional Clinics
    • Resident Chart Simulated Recall
  • Practice Based Learning
    • Scholarly Point Assignments
    • Revise Evaluations
  • Interpersonal Skills and Communication
  • Professionalism
    • Abstracts (professionalism and multicultural)
  • Systems Based Practice
    • Site Visit 2010
    • New Program Guidelines
  • Continue to improve the education, patient care, faculty structure
  • Journal club
  • M & M
  • Recruitment for Divisions of Endocrinology, GI, Cardiology, Critical Care
  • Faculty Practice Plan will improve primary care
  • Standardization based on new CMS requirements
  • WW6 renovation
  • Departmental expansion
department of internal medicine80
Department of Internal Medicine

TEAM = Together Everyone Achieves More