Internal Medicine Residency Curriculum

Medical Teaching Service (MTS)
There are four teaching service teams called MTS 1-4. Each team has one senior resident, an intern, medical students, observers, a clinical pharmacist, and a supervising attending physician. As per the current schedule, each team takes call every fourth day. Over weekends, the non-on-call teams work from 7AM to 1PM, while on weekdays, they work from 6:30AM to 4PM. The on-call team works from 6:30AM to 7PM. The MTS team carries a maximum of 14 patients with additional patients diverted to the Hospitalist Service. To allow sufficient time for transition, each team has two interns for the first quarter of the academic year. The interns and senior residents have scheduled off days from Monday to Thursday, and during that time, another senior resident provides coverage on the team.

ICU
There are three teams in the ICU at the start of the academic year where one team is comprised of a PGY-3 and an intern. The other two teams have one PGY-II resident each. This allows the intern to work with PGY-III in the beginning of the academic year and for the PGY-II to focus on strengthening management skills. After the transition period is over, there are two teams in the ICU with each team comprised of a senior resident and an intern. Everyone gets two days OFF per week during ICU rotation. There are also medical students, physician assistant students, and clinical pharmacists participating in the morning rounds. During the nighttime, there is a senior admitting resident and an intern providing cross coverage.

Continuity Clinic
Residents develop a continuous, long-term therapeutic relationship with a panel of general internal medicine patients at the Saint Peter’s University Hospital Adult Multispecialty Health Center (AMHC), located in the Saint Peter’s Family Health Center a few miles from the hospital. 

At the AMHC, each resident serves as the primary physician for a panel of patients, with responsibility for chronic disease management, acute health problems, and preventive health care for their patients. There is direct supervision by faculty. However, progressive autonomy is extended to residents as their training advances. Nurses, social workers, and ancillary staff work alongside the residents to ensure excellent patient care is provided.

The patient population cared for is from diverse ethnic groups and present with various acute and chronic medical conditions. Cultural sensitivity and social determinants of health training are integral to providing excellent care. Senior residents also rotate in subspecialty outpatient practices for endocrinology, gastroenterology, geriatrics, pulmonary and others.

We follow a model of 6 + 2 which means residents are scheduled to rotate every 7th week, for two weeks, in their longitudinal continuity clinic. There are four clinic cohorts labeled as White, Red, Orange and Yellow with each cohort comprised of on average 12-14 residents representing all classes on equal basis. Each cohort is sub-divided into three teams where each attending physician is responsible for supervision of 3-4 residents.

During the two-week continuity clinic rotations, all residents participate in academic conferences or wellness events on Tuesday. The morning session is dedicated to a simulation session in The Nayan K. Kothari MD Simulation Center for Interprofessional Learning. A critical care attending physician instructs residents on various procedures with the safety of mannequin-based simulations. In addition to this session, there is a designated topic reviewed by a resident based on an online learning module from the Johns Hopkins Internet Learning Center. In the afternoon, there are ACCESS (Advanced Communication, Clinical Examination, and Simulation Skills) sessions. These are specifically designed for interns to learn the art of hypothesis-driven history and physical examination. The seniors focus on management skills and are tasked with teaching responsibilities.  

Night Float
Night float starts at 7PM and ends at 7AM. There is one senior resident and one intern on the admitting team and there is an additional senior resident for cross coverage. The night float admitting team cap is 8 patients. The residents get two days off per week while on night float.

Electives
Residents get an opportunity to rotate on different sub-specialties during their elective weeks. In-house electives are available for cardiology, gastroenterology, pulmonary, infectious disease, hematology-oncology, psychiatry, emergency medicine, palliative care, endocrinology, rheumatology and geriatrics. Residents can choose a preferred subspecialty for electives for a maximum of 12 weeks over the course of residency training.

Additionally, the program supports residents for away rotations according to individual goals, citizenship criteria, and overall good standing. As there are excellent electives already in place at our institution, the away elective should be requested if that experience is not provided within our hospital.  

Senior residents also get an opportunity for POCUS and radiology rotations where they also serve as back-up residents. During the same rotation, they are expected to complete POCUS modules and work with an ICU attending on developing skills for ultrasound-guided procedures as well as optimizing ultrasound views with clinical interpretation. Our program uses Medmastery modules to complement the educational curriculums of the electives.