Rotations and Curriculum — Internal Medicine Residency at The Jewish Hospital

Facilities

Residents have 24/7 access to state-of-the-art simulation lab which includes a lifelike patient simulator. Simulation bootcamp is provided to all residents during orientation, with subsequent sessions scheduled periodically throughout the year. Simulation sessions include ACLS, BLS, Central Lines, Point of Care Ultrasound, lumbar puncture. 

Block Schedule

Academic year is divided into 13 blocks. Each block is four weeks long. PGY-1 residents have half day clinic every week while on GMF and electives. PGY-2 and PGY-3 residents have a full day in clinic while on electives. To enhance the clinic experience, residents are exempt from inpatient duties while in clinic. 

PGY-1

 GMF  4 to 5 blocks
 ICU  3 blocks
 ED  1 block
 Night Float  1 block
 Elective  3 to 4 blocks

*Categorical residents rotate in ED during PGY-2.

PGY-2

 GMF  2 blocks
 ICU  2 blocks
 Geriatrics  1 block
 Neurology  0.5 block
 Night Float  0.5 block
 Elective  7.5 blocks

PGY-3

 GMF  2 blocks
 ICU  1 block
 Night Float  0.5 block
 Elective  9.5 blocks

Electives

Cardiology Elective

At the completion of a one-month elective in Cardiology, each resident will be able to demonstrate a basic understanding of the general principles of consultative cardiology, understand patient management problems, as well as techniques employed in cardiac evaluations, and effectively interpret clinical and laboratory findings.

Dermatology Elective

At the completion of a one-month elective in Dermatology, the resident will have been exposed to general dermatological problems and will be capable of making diagnostic and therapeutic management decisions appropriate for a general internist. The indications for obtaining a dermatology consultation will be emphasized.

Emergency Medicine Rotation

Upon completion of a one-month rotation in Emergency Medicine, each resident should demonstrate an understanding of common medical emergency problems and demonstrate an ability to expeditiously evaluate a patient and formulate a plan for treatment and disposition.

Endocrinology Elective

Upon completion of a one-month rotation in Endocrinology, each resident will be expected to demonstrate an understanding of the initial diagnosis and management of the patient with an endocrinological problem. Each resident will be exposed to a variety of clinical conditions, including diabetes mellitus and pituitary, thyroid and adrenal abnormalities.

Gastroenterology Elective

This rotation familiarizes the resident with common GI disorders, including GI bleeding, peptic ulcer disease, hepatic cirrhosis, chronic liver disease, inflammatory bowel disease, chronic pancreatitis, GI malignancies, biliary tract disease and functional bowel disorders. Each resident will be expected to be able to obtain a complete history and perform an appropriate physical examination focusing on specific GI complaints, formulate a diagnostic plan and execute a reasonable treatment plan. In addition, the resident will become familiar with the diagnostic and therapeutic endoscopic modalities available in Gastroenterology and will obtain hands-on practical experience in flexible sigmoidoscopy.

General Medical Wards

Exposure of the resident to the non-critically ill hospitalized patient is essential at all levels of training. Each resident will be expected to assume increasing responsibility for patient care during his or her training. Exposure to all medical pathologies and age groups will be stressed. Interactions with general internists and medical subspecialists will occur daily to enhance the learning experience.

Geriatrics Elective

Upon completion of a one-month rotation in Geriatrics, each resident will be expected to have developed an awareness of specific medical concerns of the geriatric population and how they differ from those of younger patients as well as an understanding of the special syndromes in the geriatric population.

Hematology/Oncology Elective

During the one-month rotation in Hematology/Oncology, each resident will be exposed to the diagnostic evaluation and treatment of various hematologic and oncologic diseases, including the use of chemo-therapeutic agents and their side effects.

Infectious Disease Elective

Upon completion, the resident should have an understanding of the pathophysiology, clinical presentation and appropriate treatment of common clinical syndromes such as HIV/AIDS, meningitis, head and neck infections, pneumonia, gastroenteritis, intra-abdominal infections, genito-urinary tract infections, bone and soft tissue infections, treatment of the neutropenic patient and an understanding of immunizations. The resident will also demonstrate knowledge of the appropriate use of a microbiology laboratory.

Medical Intensive Care Unit (ICU) Rotation

Upon completion of the ICU rotations, each resident will be expected to be able to manage the critically ill medical patient, as well as counsel family and patients on medical and ethical issues. Ventilator care and management of sepsis, respiratory failure, acute renal failure, hemorrhage, oncological emergencies and central nervous system pathology will be stressed.

Nephrology Elective

Upon completion of a one-month rotation in Nephrology, each resident should be able to demonstrate an ability to evaluate and manage both acute and chronic renal failure of various etiologies. There will be exposure to both inpatient and outpatient management problems, including chronic hemo- and peritoneal dialysis.

Neurology Elective

Upon completion of a one-month rotation in Neurology, each resident will be expected to demonstrate proficiency in the neurological examination and correlation of the patient’s symptomatology with neuro-imaging studies and neuro-physiology. There will be exposure to both common and uncommon neurological diseases including CVA, neuromuscular disorders, neuro-ophthalmological problems, etc.

Sports Medicine Elective

During the elective in orthopedics, each medical resident will learn the office management of various musculo-skeletal disorders. Emphasis will be placed on the medical management and the appropriateness of an orthopedic consult.

Otolaryngology Elective

Upon completion of the rotation, each resident should have an understanding of the initial evaluation and treatment of specific disorders involving the head and neck. Common clinical problems encountered will include head and neck neoplasms, chronic sinusitis and various middle and inner ear pathology.

Palliative Care Elective

Upon completion of this elective, the medical resident will develop an understanding on how to evaluate and counsel patients to help work with end-of-life decisions.

Primary Care Outpatient Rotation

Upon completion of this unit, which will usually consist of half-day sessions in a private physician's office throughout the second and third years of training, each resident will have developed a better understanding of primary care practice. The resident will be exposed to office management and business decisions as well as having primary responsibility for patient care while at the office, outpatient and inpatient pre-operative evaluations and medical consultations.

Pulmonary Elective

Upon completion of a one-month rotation in Pulmonary Medicine, each resident will be expected to demonstrate an overall understanding of acute and chronic lung disorders. The focus will be on COPD, asthma, carcinoma of the lung, various lower respiratory tract infections and adult respiratory distress syndrome (ARDS).

Radiology Elective

The purpose of this elective rotation is to acquaint the medical resident with a wide variety of procedures performed in the Department of Radiology. Selection of the appropriate imaging procedure to solve a specific clinical question is stressed. Interpretation of plain radiographs is emphasized. Residents are also instructed on the basic principles of imaging techniques such as ultrasound, computerized tomography and magnetic resonance imaging.

Rheumatology/Immunology Elective

Upon completion of a one-month rotation in Rheumatology/Immunology, each resident will be expected to demonstrate a basic fund of knowledge of the diagnosis and treatment of rheumatologic disorders. Common disorders encountered during the rotation will include mono- and polyarticular-arthritis, connective tissue diseases, osteoporosis, vascular disease, back pain, fibromyalgia and chronic fatigue syndrome.

Didactic Curriculum

 Noon Conference  12:15 to 1 p.m. daily
 Grand Rounds  Semi-annually
 Journal Club  Monthly
 Quality and Patient Safety Conference  Quarterly
 Resident Wellness Events  Monthly
 Morbidity and Mortality Conference  As Needed

Research and Scholarly Activity

Residents are encouraged present posters at local and national conferences. Residents are also provided with guidance and resources to assist with publishing case reports. Categorical residents are required to partake in a quality improvement project and are encouraged to present their findings at hospital’s quality and patient safety conference. 

Publications and Presentations

Kathleen McCabe, Imran Naqvi. A Curious Case of Churg-Strauss. ACTA Scientific Clinical Case Reports. 2020, August. Pub-Status: Accepted for September 2020 

Antic M., Ansah K., Harcha J. Bilateral chylothorax in patient with catheter-induced superior vena cava stenosis presenting as SVC syndrome. Submitted to: Chest Annual Meeting, April 2021

Harcha J., Antic M., McCabe K., and Brook B. Melanoma of unknown primary disguised as thromboembolic disease. Submitted to: ACP 2021 Ohio/Air Force Scientific Meeting, April 2021

Antic, M., Ruiz Aguinaga S., Bloomer J. Painful fingers and toes reveal a case of non-small cell lung cancer. Accepted as poster presentation for the Virtual Chest Annual Meeting, October 2020.