7 AM Study Sessions:

The study of internal medicine requires deep and extensive reading of basic and clinical sciences while applying those principles at the bedside. Most residents become proficient in managing the most common medical conditions such as acute coronary syndrome, heart failure, exacerbation of COPD and asthma, acute kidney injury and GI bleeding. However, residents are often pressed to find time to study the pathology, pathogenesis, pathophysiology, pharmacology, and epidemiology of these conditions. In addition, less common conditions such as Chron’s disease, vasculitis, restrictive lung disease, amyloidosis etc. are only rarely encountered. As a result, many residents have a large gap in knowledge at the time of graduation. They try to “catch up” by extensive study just before the certifying examination. Such a situation results in a resident practicing as an apprentice for three years without developing the essential cognitive framework of clinical science. More importantly, residents train for three years without acquiring the core knowledge required to be a scholarly internist.

To improve this set of circumstances, our program offers a daily study session (“Board Review”) every morning at 7 AM. The Medical Knowledge Self-Assessment Program (MKSAP) of the American College of Physicians serves as the curriculum. The program director presides over the sessions and discusses approximately 1300 MCQs every year. This exercise is highly interactive and forces everyone to be prepared for a limited portion of the curriculum. Besides achieving a 100 percent board pass rate, residents can apply solid knowledge early in their training. This is the 36th year of this program.

Medicine Grand Rounds

Grand Rounds are held every Tuesday at noon. Grand Rounds emphasize clinical medicine and present important new developments in biomedical sciences. International, national, regional, and local scholars make presentations. There is a rich diversity of presentations. A resident-run Morbidity and Mortality (M&M) conference occurs monthly as part of the Grand Rounds conference.

Morning Report

The morning report (MR) is a highly valued and time-honored tradition in American Medical Education. It was originally designed for the department chair to monitor the quality of care provided to patients. The format has changed over time and varies from program to program.

The MR is held four days a week. The MR is highly interactive. To stimulate thinking, the Socratic method is used. This is a pedagogical technique in which a teacher does not give information directly. Instead, a series of questions are asked, with the result being that the student comes either to the desired knowledge by answering the question or to a deeper awareness of the limits of knowledge.

Two cases are presented during each MR. Faculty members are present and engage the residents in discussion.

PGY-1/PGY-2 Management Course

For our PGY-1 and PGY-2 residents, we provide lectures focused on inpatient management. The lectures occur after MR ~ 3 days per week. Faculty in Internal Medicine as well as sub-specialties provide lectures on specific topics. There is a weekly session with focus on bedside medicine that often includes a standardized patient.

Chairman’s Rounds

The program director conducts Chairman’s Rounds weekly at the bedside to review history and physical examination findings with a designated resident team. The rounds provide a unique teaching opportunity with a master clinician at the bedside.

Journal Club

Journal Club occurs monthly as part of our research curriculum. Faculty members with expertise in research oversee resident-run critical reviews of published studies of interest.

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