Hands-On Patient Care Experience with Structured Didactic Sessions
The core of the learning experience in the internal medicine residency program is to combine supervised “hands-on” patient care experience with structured didactic educational sessions and simulation.
When rotating in the departments of Emergency Medicine and Gynecology, the resident attends the weekly Education Day for each department. Education day is a half-day weekly session that includes core conferences on the discipline, journal club, morbidity and mortality review, board review, grand rounds and tumor board.
When rotating on the general medicine service, the medical subspecialties, ambulatory selectives and elective rotations, the resident attends the conferences in the Department of Medicine. One to one-and-one-half hours daily are devoted to conferences. Below is a brief synopsis of the programs offered.
Medical Grand Rounds
This is a weekly forum, the purpose of which is to discuss new developments in the field of internal medicine and related disciplines. Speakers include program faculty and visiting professors of national reputation.
Noon Case Report
Residents present cases that are actively discussed by the house staff and attending faculty. The emphasis is on developing a differential diagnosis and a cost-effective diagnostic work-up and treatment plan. As a part of these case presentations, the resident also formulates three to four important clinical questions and leads an interactive discussion of the answers based on best evidence.
Journal Club/Evidence-based Medicine
This conference is held monthly to review new developments in the medical literature and to teach the principles of interpreting and applying this information. The director of the Research Institute attends to assist in the statistical analysis of the articles.
Subspecialty Conferences
These daily conferences, held over the lunch hour, review a planned curriculum for each of the medical subspecialties, including allergy and immunology, cardiology, critical care, clinical pharmacology, nephrology, pulmonary medicine, geriatrics, hematology/ oncology, rheumatology, infectious disease, gastroenterology, neurology and general medicine. Adolescent medicine, behavioral medicine, community health, dermatology and ethics topics also are reviewed in this forum.
Board Review
This weekly conference systematically reviews questions related to various disciplines of medicine. The general medicine faculty leads the discussion.
Morbidity and Mortality Review
This monthly conference, conducted by the general medicine faculty, reviews the deaths and morbidity on the general medicine teaching services. Emphasis is placed on the teaching points from each case, a review of evidence-based treatment and a review of autopsy findings by a pathologist.
ACGME Core Competency Conferences
Residents from all training programs attend these monthly conferences, during which medical law, patient safety, cultural diversity, ethical and profession-specific issues. Presenters include community and business leaders, attorneys, hospital staff with special expertise and faculty.
Acute Care Conferences
These are daily conferences held in the month of July to review inpatient urgent and emergent medical problems likely to be encountered during night call or admissions. Presenters of these interactive case-based discussions are the faculty and senior medical residents.
Ambulatory Care Conferences
These are conferences held in August to review common ambulatory conditions and their diagnosis, management and treatment. These sessions given by the faculty also introduce the residents to prevention and health screening, immunization recommendations, and quality improvement.
Procedural Workshop
During our new resident orientation, the critical care faculty conducts a simulation procedural workshop involving a review of the indications, contraindications, equipment, complications and anatomy related to performing: chest tube insertion, central line placement, intubation, nasogastric tube insertion, urethral catheterization, peripheral line insertion, cardioversion/defibrillation, transthoracic pacing and needle decompression.
Senior Resident Orientation
During the spring of each year, the faculty presents a series of interactive conferences to teach important elements of the role of senior resident as teacher, supervisor and evaluator. Topics include teaching techniques, and the elements of effective feedback and evaluation. In addition, the faculty discusses how to prepare and give oral presentations, abstracts and poster preparation.