Walter Kernan, MD Professor of Medicine Director, Ambulatory Component of the Internal Medicine Clerkship 333 Cedar Street P.O. Box 208025 New Haven, CT 06520 Phone: 203-688-2984 Fax: 203-688-4092 e-mail: walter.kernan@yale.edu

Training

BA, 1978: Harvard University
M.D., 1984 Dartmouth Medical School
Residency: Johns Hopkins Hospital
Fellowship: Robert Wood Johnson Clinical Scholars Program

Research Activities

The major focus of my research has been on the clinical epidemiology of cerebrovascular disease and the interface between primary care and stroke treatment. With colleagues in our section and in the Department of Neurology, this research has included clinical trials of new therapies for prevention of recurrent stroke (estrogen, thiazolidinediones), cohort studies of prognosis, case-control studies of risk factors, and cross-sectional examinations of quality of care. My current work includes several studies on the prevalence and course of impaired glucose metabolism among patients with a recent stroke. In addition to work on cerebrovascular disease, my research includes efforts to measure and improve clinical instruction of medical students in the ambulatory setting.

Clinical & Teaching Activities

As founding director of the Ambulatory Component of the Internal Medicine clerkship, I oversee the curriculum and clinical resources of this required course. We are very fortunate to work in a community where over 125 internists in 53 private or hospital practices have volunteered enormous amounts of time to teach students during this activity. In addition to the clerkship, I see personal patients and precept residents in the Primary Care Center at Yale New Haven Hospital, and attend on the medicine service at Yale New Haven Hospital.

Selected Recent Publications

1. Kernan WN, Horwitz RI, Brass LM, Viscoli CM, Taylor KJW. A prognostic system for transient ischemia or minor stroke. Ann Int Med 1991;114:552-557.
2. Kernan WN, Viscoli CM, Makuch RW, Brass LM, Horwitz RI. Stratified randomization in clinical trials. J Clin Epidemiol 1999;52:19-26.
3. Kernan WN, Lee MY, Stone SL, Freudigman KA, O’Connor PG. Effective teaching behaviors for ambulatory preceptors. Am J Med 2000;108:499-502.
4. Kernan WN, Viscoli CM, Brass LM, Makuch RW, Sarrel PM, Horwitz RI. Blood pressure exceeding national guidelines among women after stroke. Stroke 2000;31:415-9.
5. Kernan WN, Viscoli CM, Brass LM, Makuch RW, Sarrel PM, Roberts RS, Gent M, Rothwell P, Sacco RL, Liu, RC, Boden-Albala B, Horwitz RI. The Stroke Prognosis Instrument II (SPI-II): A clinical prediction instrument for patients with transient ischemia and non-disabling ischemic stroke. Stroke 2000;31:456-62.
6. Kernan WN, Viscoli CM, Brass LM, Broderick JP, Brott T, Feldmann E, Morgenstern LB, Wilterdink JL, Horwitz, RI. Phenylpropanolamine and the risk of hemorrhagic stroke. N Engl J Med 2000;343:1826-1832.
7. Viscoli CM, Brass LM, Kernan WN, Sarrel PM, Suissa S, Horwitz RI. A clinical trial of estrogen-replacement therapy after ischemic stroke. N Engl J Med 2001;345:1243-1249.
8. Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Horwitz RI. Insulin resistance and risk for stroke. Neurology 2002;59:809-815.
9. Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Shulman GI, McVeety JC, Horwitz RI. Impaired insulin sensitivity among nondiabetic patients with a recent TIA or ischemic stroke. Neurology 2003;60:1447-1451.
10. Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM, Shulman GI, McVeety JC, Horwitz RI. Pioglitazone improves insulin sensitivity among non-diabetic patients with a recent TIA or ischemic stroke. Stroke 2003;34:1431-1436.