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Beth Israel Residency Program in Internal Medicine
Overview
Beth Israel Medical Center's residency program in Internal Medicine provides outstanding clinical training, research opportunities and preparation for a career in either academic or clinical practice. These endeavors are carried out in a humane, respectful and supportive environment for trainees with the delivery of compassionate, high-quality care a guiding principle.
The Chief Medical Residents are a major force on the medical service. In addition to accomplishing the miracles of scheduling and conferences, they are an invaluable resource for teaching, conducting rounds, disseminating medical literature and overseeing all educational aspects of the program. Through the initiatives of the chief medical residents, new programs are proposed and accomplished. Educational Program: The primary goal of Beth Israel's residency training program in Medicine is to provide the trainee with advanced medical knowledge, progressive experience in clinical decision-making and the opportunity to practice medicine in an environment of clinical excellence. Training occurs in an atmosphere of openness, where residents are encouraged to raise questions and contribute ideas. A written curriculum, which contains the program's educational objectives and the competencies to be demonstrated, exists for each rotation or major learning experience. House staff can access the curriculum on the hospital computer network's shared ResTrain Directory. Each team reviews the curriculum with their teaching attending at the beginning of each rotation and refers to it frequently throughout the rotation. In addition, various multidisciplinary conferences are held regularly, exploring a full range of topics in contemporary medicine. Residents' education also includes teaching rounds, clinical conferences, grand rounds, clinical pathology conferences, journal clubs and lectures. Major emphasis is placed on the residents' ambulatory practice and development of primary care skills. On the inpatient medical service, a team of hospitalists serve as the attending physicians for the majority of the patients. By encouraging the house staff to take a proactive role in the management of their patients and by welcoming questions and discussions, the hospitalists provide a great deal of clinical teaching. Patient Rounds: Residents start the day by leading bedside teaching and work rounds with the team. Team members review the progress of each patient, incorporating patient management with opportunities for informal medical discussion. Attending Rounds: Medical teams present and discuss patients during rounds with their teaching attendings. Case management is discussed within the context of pathophysiology and patient care, incorporating new developments. Chairman's Rounds: The Chairman rounds with one of the ward teams each week. House staff have the opportunity to present and discuss patients and philosophy with their Chief of Medicine. Residents' Morning Report: In a dynamic, interactive forum, house staff meet with the chief medical residents, Dr. Fleckman, Dr. Steinberg and Dr. Carey and select faculty to discuss interesting and instructive cases. Residents present patients, concentrating on the most challenging aspects, and chief medical residents incorporate the latest medical literature. Resident Case Presentation and Literature Review: Residents are mentored by a senior faculty member to present and discuss one case in depth, with emphasis on differential diagnosis, clinical problem solving and expert subspecialty discussion. The format of these conferences encourages their presentation at national conferences in abstract form. Primary Care Conferences: One conference per week for all residents is dedicated to the primary care curriculum. Outside speakers from many disciplines discuss topics that are important for the delivery of care to patients in the ambulatory setting in addition to presentations by the general medical and subspecialty medicine faculty that impact on outpatient care. Residents attend additional primary care conferences at the general medical clinic during their ambulatory block rotations. Noon Conference: Following the core curriculum lecture series on managing acute medical problems given each July and August, daily noon conferences are the forum for review of major topics in the curriculum, recent advancements, discussions of ethics, morbidity and mortality, and the weekly ambulatory medicine series. The following conferences further address the department's curricular goals. Interns' Core Curriculum: Using the Socratic method, the chief medical residents direct the interns through a twice-weekly seminar discussing physiology, pathophysiology and treatment in a relaxed environment. Major areas of internal medicine are covered in this year-long curriculum. Residents' Research Grand Rounds: Conferences are presented by the medical residents to the residents and senior faculty, constituting a research seminar by residents performing clinical or bench research or a comprehensive scholarly review including basic science background and future directions of a select research topic in clinical medicine that focuses on a major article. Residents' Board Review: Residents meet weekly throughout the year with the chief medical residents and/or faculty for an in-depth review of internal medicine topics with the goal of guiding study and maximizing preparation for the American Board of Internal Medicine certification examination. Our Board passage rate is superb. Evidence Based Medicine Journal Club: Residents present and analyze controversial and important journal articles from the recent literature and are joined by faculty members with expertise in the area. Clinicopathologic Conference (CPC): Each month, residents present current cases of extraordinary interest, with outstanding CPC-style discussion by attendings from medicine, pathology and radiology. Grand Rounds: Each week, Beth Israel faculty and invited speakers discuss or lecture on topics of major interest, cases from the Beth Israel service or current advances in the field. Basic and Clinical Research Series: In the summer full time faculty present basic science background and principles of informed consent, rights of research subjects and fundamentals of clinical research. This series is reinforced throughout the year with talks by invited speakers and with activities designed by the resident-faculty Research Committee including "Research Fairs" and poster presentations. Subspecialty Conferences: In addition to the above conferences specifically given for the residents, each division holds weekly subspecialty conferences, frequently including prestigious outside speakers. Computerized Simulation Training: Using a computerized patient simulator, house staff receive instruction in emergency airway management as well as code leader and code team training. RESEARCH: The training program is committed to providing the scientific foundation for residents to understand the therapies and care of their patients in the 21st Century. We also provide excellent opportunities to perform basic research (most often pursued by those residents interested in academic subspecialty training) and clinical research for residents interested in primary care outcomes research or clinical trials. The vast majority of residents conduct productive research projects, ranging from case reports or retrospective reviews to prospective clinical and laboratory studies. Departmental faculty members are available to provide consultation and collaboration in residents' research projects. Elective rotations can be grouped to allow significant blocks of research time. There are approximately 100 research projects under way in the department. Residents are co-authors on more than 40 publications and abstracts each year. Various competitive grants sponsored by the Medical Center are available to support resident research. The Department also provides funding and educational leave time for resident to present their research at national meetings.
In addition to our traditional residency training program in internal medicine, Beth Israel Medical Center offers a parallel approach to internal medicine training. This approach is a combination work-study program, which we call our Learn and Earn program. Training begins with the standard medicine categorical internship. Following the internship, the two years of a medical residency are distributed over three years, eight months each year. The participant spends four months of each year (after the internship) working as a physician in a Beth Israel Medical Center-affiliated inpatient or outpatient facility. A New York State license is required for this role. Therefore, applicants must be eligible for licensure in New York State after their internship. During training months, the resident is paid at the house officer rate corresponding to his or her total months of training. During working months, the resident is paid at the augmented rate of a full-time house physician, resulting in over $100,000 in incremental income over that provided by the residency. The resident continuously receives house officer benefits throughout the four years, including housing and disability, as well as health and malpractice insurance. This approach accomplishes several goals for Beth Israel, such as increasing the number of high-quality physicians providing primary care in non-training settings and providing new avenues for recruiting residents. However, the Learn and Earn program also offers advantages to residents. Their quality of life is greatly improved and residents may emerge debt-free from training. The resident matriculating in the Learn and Earn program will be joining a well-established, accredited residency training program in Internal Medicine. Timing and financial rewards are the only real differences in training between this program and Beth Israel's traditional training program in Internal Medicine.
Sabbath Program
Japanese Medical Residency Program GENERAL INFORMATION Beth Israel has dealt innovatively with the New York State requirements for reduced residents' hours, implementing a plan, which assures the provision of resident education in all clinical activities and the continuity of high-quality patient care. House staff are on call until 9:00 pm every fourth day. Night float teams relieve the on-call day teams at 8:00 pm. Interns and residents spend one month each year (in two-week blocks) working on the night float medical team. Each morning, members of the night float team join their respective medical teams to present patients they have admitted the previous night and to give a detailed sign-out to ensure smooth continuity of care. Night float periods are usually scheduled before or after vacation. The year is divided into 13 four-week blocks with elective time each year. Elective rotations can be used to pursue research projects or to gain extra clinical experience in an area of the house officer's choice Sample House Officer Yearly Schedule
* Inpatient units include night float (4 weeks per year) and general medicine, as well as specialty units such as cardiology, infectious diseases, oncology and pulmonology
Library, Informatics and Computer Access
The Patient Care Team FOR MORE INFORMATION
Cynthia Dominguez |
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