The program's goal is to promote, teach, evaluate and certify all components of clinical competency, namely, Patient Care, Practice-Based Learning and Improvement, Medical Knowledge, Interpersonal and Communication Skills, Professionalism, and System-Based Practice.

The Art of Medicine, the Science of Medicine and the Business of Medicine

Our curriculum is designed to teach the Art of Medicine, the Science of Medicine and the Business of Medicine. We balance didactic teaching with the experiential aspects of training to enable the resident to master these essential elements of our profession. Mastery of the competencies is integrated throughout the curriculum.

The Art of Medicine

The Art of Medicine is practiced daily on the wards in all didactic sessions. This is where the Science of Medicine and the Art of Medicine are integrated to elevate the level of care delivered to the patients.

• Learning by doing
  Education on the wards is achieved through graded responsibility and clinical oversight. Our teams are constructed with one attending physician, one resident, one intern and one student. There is 24/7 attending faculty supervision of patient care and resident education. We also have faculty rounds with our night float teams, on the floor and in the intensive care rotations. This is the core of practice-based learning.
  
  
• Humanism and Professionalism Committee
  Saint Peter's University Hospital was one of the participating sites in the American Board of Internal Medicine's Project Professionalism. We have a Humanism and Professionalism Council. This council of faculty, peer-nominated residents, students, clergy and nurses organizes a lecture series on ethical issues. It meets monthly to facilitate voluntary resident-initiated activities that promote Humanism and Professionalism. The council also arbitrates violations of Humanism and Professionalism by attending physicians, residents or other health care personnel.
  
  
• OSCE
  The Objective Skills Clinical Exercise is a valid, reliable and practical instrument to teach and evaluate clinical skills of students, residents and practicing physicians. In an OSCE, the clinical competency to be tested is broken down into its various components. For example, taking a history, examining a particular organ system, communicating specific information to a patient and coming to a conclusion on the basis of the findings. Each component is assessed in turn and is the objective of one of the stations in the exercise. During the examination, the resident rotates through a number of stations. At the end of this task, the examiner gives instant feedback about the performance to the resident. Both positive and negative feedback is given, and if necessary, corrective technique is demonstrated by the examiner. The standardized patients are trained to evaluate critical aspects of the resident's performance in interpersonal skill and to provide feedback. Residents participate in six OSCEs in the three-year program.
  
  
• Residents as teachers
  Teaching is an integral part of the Art of Medicine. All residents are expected to teach fellow residents, medical students and other health care personnel. The program provides formal seminars to enhance the teaching skills of residents. An elective in Medical Education is also available. The program conducts monthly grand rounds in Medical Education (Teaching the Teachers). National and international authorities on medical education participate. Residents are required to attend this important faculty development program.

The Science of Medicine

• Board Review
  The program director conducts a study session with the residents for 45 minutes every day 12 months a year. Daily board review is in its 19th year. It is well received by our residents, as well as residents from neighboring institutions who attend the sessions regularly. The Medical Knowledge Self-Assessment Program (MKSAP) of the American College of Physicians serves as the curriculum for these particular sessions.
  
  
• Morning report occurs daily and is attended by students, interns, residents and faculty. It is run personally by the program director.
  
  
• Bedside to Bench Program:
  To improve the understanding of basic sciences and their application to clinical issues, a new curriculum known as Bedside to Bench has been developed. The faculty will bring up issues of basic sciences while they provide clinical care (e.g., It is better to learn about Starling's law when you are caring for a patient with heart failure). This occurs at morning report and on ward rounds.
  
  
• Daily Noon Conferences
  Noon Conferences are taught by the full-time faculty. They follow a 12-month curriculum cycle. The year begins with an emergency medical series. Throughout the year all internal medicine specialties are covered, as well as statistics, ethics and the Business of Medicine.
  
  
• Subspecialty Educational Objectives
  Each elective has outlined educational objectives designed to ensure a quality learning experience. A pretest and a posttest are performed by the elective director to guarantee that the residents assemble a learning portfolio for their elective experience.
  
  
• Grand Rounds
  We have an excellent grand rounds series. Nationally and internationally known speakers are brought in to discuss clinically relevant advances in medicine.

The Business of Medicine

The Business of Medicine is integral to becoming proficient in system-based practice. During daily educational activities, costs of medications and laboratory testing are incorporated into teaching. Lectures on how to establish a practice are provided. Seminars with legal and financial experts are offered to provide knowledge on negotiating postgraduate contracts and to understand the issues related to medical malpractice.

• Elective on hospital administration
  We have an elective on hospital administration. Residents gain knowledge on establishing business plans, negotiating with insurance companies, and implementing quality assurance and utilization.
• M.P.H./M.B.A.
  Residents desiring to initiate an M.B.A. or M.P.H. are encouraged to do so. We are establishing these opportunities at Drexel University.

Evaluations

Evaluation of residents is uniquely done. We establish a training portfolio for each resident. In addition to the monthly evaluations of residents given by faculty, also included are copies of histories and physicals and consults written by residents with faculty feedback. Reports from OSCEs, research achievements and achievements in system-based practice initiatives are included. These portfolios reflect the resident's mastery of the curriculum and competencies better than test scores do alone.

Typical Resident Rotation Schedule