Curriculum & Academics

The preliminary internal medicine residency is designed for physicians who desire to have one year of internal medicine training prior to matriculating in an advanced residency position.

During the course of the academic year our preliminary interns care for patients with a wide spectrum of disease in the ICU and floor at both an urban and suburban hospital. This allows them to gain knowledge, skills, and confidence to become a caring subspecialist. Our preliminary interns are fully integrated into the residency program. They follow the same schedule as our categorical residents with the exception that they are not required to participate in the ambulatory/outpatient curriculum unless desired for their categorical program.

The Preliminary Internal Medicine Intern schedule is:

• 24 weeks of internal medicine floors (approximately 2-4 weeks as night float)
• 6 weeks medical ICU
• 2 weeks of emergency medicine
• 19 weeks of electives (including non-internal medicine electives with permission from the program director)
• 3 weeks of vacation

In our categorical internal medicine residency, we train physicians who are interested in becoming a hospitalist, general internist, or a medical subspecialist.

Our three-year program includes dedicated time in inpatient floors, ICU, and ambulatory clinic, caring for urban and suburban patients with a wide spectrum of disease. From day one of internship, we focus on the emerging role of the physician as a leader of interdisciplinary team of clinicians. Time on “classical” internal medicine services and complemented by dedicated rotations in observation medicine, systems-based practice, urgent care, and electives.

PGY1 (Intern) schedule

• 12-16 weeks internal medicine floors (approximately 1 block as night float)
• 3-6 weeks medical ICU
• 12-14 weeks ambulatory
• 21 weeks of electives

PGY2 schedule

• 14-16 weeks internal medicine floors (4-6 weeks as night float)
• 4-6 weeks medical ICU
• 4 weeks of AOD
• 12-14 weeks of ambulatory
• 12 weeks of electives (1 block of elective in either PGY2 or PGY3 year can be at a different hospital as an away elective)

PGY3 schedule

• 6-10 weeks internal medicine floors (4-6 weeks as night float)
• 4-6 weeks medical ICU
• 2-4 weeks of AOD
• 12-14 weeks of ambulatory
• 14-16 weeks of electives (1 block of elective in either PGY2 or PGY3 year can be at a different hospital as an away elective)
• 2 weeks dedicated board review
• 1 week of consultative medicine
• 2 weeks of observation unit hospital medicine
• 1 week geriatrics
• 2 weeks of emergency medicine

Internal medicine residents operate in a “shift” system, with residents on dedicated “night float” rotations caring for patients overnight. Our longest intern shift is 12 hours, with most shifts 10–11 hours and no overnight call. Interns will have 2-4 weekend ICU shifts during their elective rotation.

Daily Didactic Conference

All residents meet 5 days/week between 12 and 1 p.m. for a formal didactic conference. Conferences are streamed live via accessible platforms to ensure the safety of all learners. Residents can view presentations from anywhere on their own device. Conference material is immediately uploaded to an accessible electronic platform for residents to review

Core Internal Medicine Didactics

Faculty members provide didactic lectures in core internal medicine topics over an 18-month cycle. Lectures are firmly based in clinical medicine, applying basic and clinical sciences to understand the management of patients. These topics are supplemented by additional lectures in medicolegal aspects of medicine, ethics, biostatistics, and research methods.

Grand Rounds

Internal Medicine Grand Rounds are held weekly from September through June. Medical Grand rounds brings expert faculty drawn from Trinity Health hospitals, the Philadelphia area medical schools, universities, and beyond to lecture on cutting-edge topics drawn from clinical medicine.

Resident-led management conference

PGY2 and PGY3 residents are given the podium to present a management conference to practice their research and presentation skills. These lectures, precepted by a member of the Internal Medicine Residency Program leadership team, opens the floor for residents to discuss evaluation and management of both common and uncommon disease processes using a case-based approach. By leading these discussions, our residents become local experts, enriching both their own education as well as that of their peers.

Morbidity and Mortality Conferences

Residents participate in monthly interdisciplinary morbidity and mortality conferences in which the department of medicine, as a whole, learns from challenging cases.

Board Review

A formal topic-based board review curriculum has been integrated into our didactic conference schedule.

Interns meet once a week for intern report. During these sessions, current or recently discharged cases are discussed. These cases are used to help interns improve medical knowledge and sharpen clinical reasoning.

PGY2 and PGY3 residents meet once each week for resident report. Using a current or recently discharged patient, faculty preceptors guide the residents to consider the subtleties of evaluation and management, helping them to prepare for independent practice.

A few times each month, inpatient teams gather to discuss important aspects of the care they deliver. During antibiotic stewardship rounds, residents discuss appropriate use and discontinuation of antibiotics on their patients under the guidance of an expert infectious disease consultant. In ethics rounds, residents engage with a multidisciplinary team to review the bioethical and medicolegal aspects of patient care they manage on a day-to-day basis. During stroke rounds residents meet with board certified neurologists to discuss the management of complicated stroke patients.

Residents and faculty review recent journal articles on a regular basis. The journal club helps keep residents and faculty aware of the latest updates in internal medicine while simultaneously teaching about how to read and interpret articles from the medical literature.

Once weekly resident’s on their ambulatory spend 4 hours of deep learning on ambulatory medicine. These sessions mix traditional lectures, seminars, simulation, Yale Office-Based Medicine Curriculum, and learner-centered education such as “jeopardy” games.

The residency has integrated computer-based learning methods including ACP’s MKSAP, NEJM Knowledge Plus, Johns Hopkins Physician Education and Assessment Center, and the Virtual Critical Care Rounds, from the Society of Critical Care Medicine into its education. Through longitudinal assignments and quizzes residents enhance their board preparation and remain up-to-date with medical knowledge.