Advanced Hospital Medicine

Advanced Hospital Medicine

The Advanced Hospital Medicine Fellowship Program operates under the direction of Dr. Jennifer Ashley on the First Hill Campus of Swedish Medical Center

Purpose: This is a one year program sponsored by the Swedish Hospital Medicine Team and designed for Family Medicine graduates who seek advanced training in the acute care of the adult inpatient.



Description: Available to Family Medicine graduates of an ACGME-accredited program, this is a year long fellowship offered to two graduates per year. Fellows will join the Swedish Hospital Medicine Team in managing complex adult inpatients and follow them throughout their hospital course. Fellows will also be required to participate in a Quality Improvement project during the year. Fellows will master techniques and demonstrate knowledge of a set of Core Competencies, based on those published by the Society of Hospital Medicine.

The goal will be to solidify skills needed for Family Medicine graduates to comfortably practice as a solitary inpatient provider in a rural hospital setting or as a traditional Hospitalist on a large team. Fellows will be exposed to a diverse array of complicated inpatients both on the hospital floor as well as in the intensive care unit. Areas unique to hospital medicine will be emphasized including perioperative medicine, documentation, resource utilization, and surgical service co-management. Importance will also be placed on proficiency at medical decision making, time management, communication skills, and working effectively on a multidisciplinary team. Fellows will have the opportunity to perform bedside procedures including thoracentesis, paracentesis, lumbar puncture, and arthrocentesis. Further training will be available, if desired, in the areas of basic ventilator management as well as advanced airway management.

Fellows will mirror the Swedish Hospital Medicine Team schedule and will work seven twelve hour day shifts followed by seven days off. After experience is gained, some swing or nighttime shifts may be offered for a varied experience. On weeks off, it is expected that the Fellows will share some of the back-up responsibilities with the team.

Learning Objectives:
  • Demonstrate knowledge in the Core Competencies of Hospital Medicine, based on those published by the Society of Hospital Medicine including:
    • CHF
    • Sepsis
    • Community Acquired Pneumonia
    • Hospital Acquired Pneumonia and Ventilator Acquired Pneumonia
    • Glycemic Control
    • DVT Prophylaxis
    • Venous Thromboembolism
    • Perioperative Consultation
    • Acute Coronary Syndrome and Risk Stratification
    • Alcohol Withdrawal
    • Cellulitis and Deep Soft Tissue Infections
    • Delirium
    • COPD
    • Asthma
    • Atrial Fibrillation and Common Arrythmias
    • GI Bleeding
    • TIA/Stroke
    • UTI
    • Pain Management
    • Palliative Care
  • Demonstrate knowledge in areas of professional development including:
    • Joint Commission National Patient Safety Goals
    • Malpractice Prevention
    • Billing, Coding, and Documentation
    • Communication
    • Handoffs
    • Multidisciplinary Care
  • Develop technical skills in the following areas:
    • EKG Assessment
    • Basic Radiologic Assessment
    • Lumbar Puncture
    • Arthrocentesis
    • Thoracentesis
    • Paracentesis
    • Optional Areas of Central Line Placement, Basic Ventilator Management and Advanced Airway Management
  • Participation in a Quality Improvement project
Achieving Objectives:
  • Direct attending supervision of the fellows with observation and evaluation of clinical decision making, techniques, and knowledge
  • Daily morning rounds with discussion of cases with the designated teaching attending
  • Informal didactic sessions covering the Core Competencies and access to a Reading Library with the most updated articles covering these diagnoses
  • Direct attending supervision of bedside procedures
  • Ongoing informal feedback by attending physicians
  • Formal performance evaluations every quarter reviewed with the fellow by the Program Director
  • Final performance review with completion of a letter from the Program Director as well as a Fellowship Certificate






For more information about this program, please contact David Thomas:                             



Elisha Yaghmai, MD


Adm. Director:

Rob Seader



Swedish Medical Center

First Hill campus