Curriculum - Internal Medicine

Morning report is a crucial learning activity for residents. However, it is very important to have a robust and interactive morning report to avail this learning opportunity best. Our morning report format makes sure that night float gets to participate a couple of times per week in this important educational activity as well. 
Morning report happens Monday-Friday from 8 a.m. to 8:30 a.m. This is a team led effort. The first part consists of arriving at the working diagnosis, using clinical reasoning and interactive questions from learners. The second part is a review of that working diagnosis where the teams can share quick learning points, a recent paper, or a podcast link to drive the learning points home. 
Our Vice Chairman, Dr. Shawn Chillag is always present at morning report and has learning points for everyone. These sessions are a critical component of resident education in learning how different patient cases present, how to work them up and formulate treatment plans.

Goals of Morning report

1. To relay important pieces from history and physical exam to derive an evidence based differential diagnosis (presenter).
2. To ask hypothesis driven questions from history and physical to derive a robust differential (Audience).
3. To accurately sum up and interpret labs/imaging. Focus on high value care. 
4. To come up with a formal diagnosis if available/possible. 
5. Spend 10 mins reviewing the case with focus on diagnosis and treatment and link to any interesting articles/findings/podcasts etc. 
6. Resident/Intern should be able to summarize the case in 2-3 minutes.
7. Team effort.

We select didactic curriculum based on the in-training exam topics and American Board of Internal Medicine certification blueprint. We strive to reinforce and highlight the most board relevant topics. Didactics are given Monday-Friday. Our didactics include a wide range of topics, not only covering the ABIM blueprints, but also: journal club, quality improvement patient safety, pharmacy lectures, as well as subspecialist lectures.

Our residency program has a robust Quality Improvement and Patient Safety program. The program involves a mix of didactics including introducing the key concepts of quality improvement and patient safety such as QI methodology, change management and Just culture etc.  
The residents apply this learning to the ongoing QI projects and work step by step through the DMAIC methodology with support from a designated faculty member.  
Our current QI projects are focused on providing efficient, high quality and evidence-based care to our patients as well as trying to address healthcare disparities. Some of the ongoing residents’ projects are as follows: 

1. Improving the accurate code status documentation in patients with stroke, CHF, and COPD.  
2. Increasing the number of patients with the AMD in the resident clinic.
3. Increasing the compliance of CHF discharge bundle in the patients admitted to the resident service. 

In addition to this, residents are given opportunities to participate in different hospital committees working on various QI projects on a system wide level.

Sample Block Schedule (will vary year to year according to complement)

4 weeks of Emergency Medicine Rotation as a senior resident.

Behavioral Medicine, Cardiology, Endocrine, Emergency Medicine, Gastroenterology, Geriatrics, Hematology-Oncology, Infectious Disease, Nephrology, Neurology, Palliative Care, Pulmonology, Rheumatology

Allergy/Immunology, Anesthesia, Cardiac ICU, Dermatology, ENT, PMR, Hospitalist, Inpatient Psychiatry, Ophthalmology, Office Gynecology, POCUS, Radiology (diagnostic and intervention), Research, and subspecialities of Neurology including: Dementia, Epilepsy, Stroke, Headache, Movement Disorders, Palliative Medicine and Multiple Sclerosis

We have monthly grand rounds with CME which focus on subspecialty topics as well as DEI related topics for interdisciplinary learning.

At our new simulation center, we will be holding monthly workshops to provide our residents hands on experience with POCUS and different procedures to provide robust experience for their learning.

The primary aim of the CET is to provide training that enables internal medicine residents with a career interest in medical education to develop the skills necessary to succeed as future clinician-educators. 

The objectives for track participants are to: 

• Advance the knowledge and skills for effective clinical teaching.
• Learn to design new curricula.
• Understand how to give feedback to learners and programs.
• Develop the skills needed to become a capable administrator, leader and change agent; and
• Master the skills necessary to investigate educational topics and disseminate scholarly work. 

The primary aim of the Hospitalist Track is to provide additional clinical and educational training and mentorship to internal medicine residents who are interested in a Hospital Medicine career.

The objectives for track participants are to: 

• Rotate through clinical experiences designed to help prepare residents for Hospital Medicine careers such as Point of Care Ultrasound (POCUS)
• Design and implement inpatient quality improvement projects
• Participate in a didactic curriculum focused on topics and metrics specific to Hospital Medicine
• Develop leadership and teamwork skills by participating in hospital committees
• Receive dedicated mentorship from experienced Hospitalists