Internal Medicine Student Information
Current market, cultural, and political forces have increased the need for training programs to produce high-quality general internists. Graduating residents should be prepared to enter practice as primary care physicians, or to use their excellent foundation in general internal medicine as the basis for subsequent training and practice in one of the subspecialties of internal medicine. The Department of Medicine is meeting this need both by a strong emphasis on ambulatory care of medical patients, and by providing fellowship-training opportunities for its house staff.
We are dedicated to instruction in all aspects of internal medicine: medical knowledge, humanistic qualities, clinical skills, decision analysis, evidence based medicine, research, computer skills, and medical economics.
The Department of Medicine has approximately 265 service and private beds plus intensive care, coronary care, respiratory care, and telemetry units. Admissions to the Department of Medicine alone exceed 15,000 per year, generating a wide spectrum of patients and pathology.
Full-time, board-certified physicians head the divisions of Ambulatory Medicine, Cardiology, Endocrinology, Gastroenterology, Geriatrics, Rheumatology, Hematology/Oncology, Infectious Diseases, Nephrology, and Pulmonary/Critical Care. Consulting physicians are available in the areas of allergy, dermatology, immunology, and Genetics. All of these physicians play a major role in the teaching program. There are over 40 full-time physicians available for resident education. Both the full-time physicians and the large voluntary faculty are committed to the teaching of medical residents and students. The voluntary staff of over 250 physicians in the fields of general internal medicine and medical subspecialties admits the patients that our residents care for on the in-patient service. The depth and quality of the general internists and subspecialists in the Department of Medicine ensure an excellent educational experience for our house staff.
Program Curriculum and Structure
The three-year residency program meets the requirements of the American Board of Internal medicine and is fully accredited by the ACGME. It includes bedside teaching rounds, weekly medical grand rounds, a weekly morbidity-mortality conference, weekly director's rounds with the program director and chairman of the department, weekly subspecialty conferences during which cases are discussed in depth, an extensive noon-lecture series, morning report on weekdays, and regularly scheduled divisional conferences. In addition, Journal club is held twice monthly and stresses critical review of the literature.
Each of our inpatient teams has a general internist assigned to take care of service patients, i.e. patients who have no physician of their own or who are followed by the medical house staff in the medical clinic. These internists are on the teaching faculty of the department and they make daily rounds with the house staff to discuss appropriate management. One team is dedicated to the management of geriatric patients and another is dedicated to hematology and oncology patients. Whether patients are "private" or "service", residents write all the orders for their patients and are intimately involved with the attending staff in every level of patient management, including diagnostic and therapeutic procedures.
All the teams on the in-patient services have bedside teaching rounds with an attending physician at least three days each week. Patients are discussed with careful attention to clinical skills, decision analysis, sharing of medical knowledge, and the relationship of paramedical issues to the patients (e.g., ethics, socioeconomic considerations, psychological, and family issues).
The bulk of training in intensive care takes place in the second year of training. There are daily rounds with fellows and attending physicians from the cardiology or pulmonary medicine divisions in the critical care units: the cardiac-care unit (CCU), the respiratory-care unit (RCU), and the intensive-care unit (ICU).
New York Methodist has a close affiliation with Memorial Sloan-Kettering Cancer Center, which is widely recognized as the premier center for the treatment of cancer in the United States. First and second year residents spend a total of two months at Sloan-Kettering, where they participate in providing state-of-the-art cancer therapy for their patients. This rotation affords our residents the opportunity to gain valuable experience in the fields of hematology, oncology, radiation therapy, nutrition, pain management, and infectious diseases of the immuno-compromised host. Because this rotation is highly regarded among our host staff, it should come as no surprise that many residents choose to return to Sloan-Kettering for electives in their third year.
An interest in research is a vital component of the well-rounded, modern physician. New York Methodist Hospital is committed to helping all of our residents to develop research skills during their training. To this end, we have a full time director of medical research, numerous ongoing study projects, facilities for basic science work, and clinical mentors for investigation. We are proud of the many important discoveries made right here at New York Methodist and of our respected record of publication in peer review journals. Our residents are frequently invited to present their work at both regional and national conferences and have been honored with both national and local awards for their research.