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Internal Medicine

Curriculum


What does a typical workday involve?
A typical day might be structured as follows:

7:00 - 8:00 AM     Patient Handover
8:30 - 10:30 AM Ward Rounds
10:30 AM - 12:00 PM     Teaching Rounds or Patient Care    
12:00 - 1:00 PM Conference
1:00 - 2:00 PM Teaching Rounds or Patient Care
2:00 - 4:00 PM Patient Care
4:00 - 4:30 PM Sign-out

OR

1:00 - 5:00 PM Outpatient Clinic

What is the on-call system for house officers?
PGY-1 residents are responsible for call every fourth night until 9:00 PM.  There are only three ward rotations in our entire program that do not utilize a night float system. These exceptions occur only in the PGY-1 year, and include the MICU and CCU at Albany Medical Center Hospital.  There is no overnight call for interns.  Interns work in the wards during their night float rotation or in the MICU during their night shifts. PGY-2 and PGY-3 residents average every fourth night on call until 9:00 PM and one Saturday per month while on medicine ward rotations. All PGY-2 and 3 rotations are covered by our night float system.

A meal allowance, redeemable at the hospital cafeteria, is provided to on-call residents at Albany Medical Center Hospital; at VAMC, meals are provided free of charge in the cafeteria.

What is the night float system?
We are fortunate to have a house staff program that is large enough to allow for a night float system at all levels of training. The night float house officer works Sunday through Friday, from 9:00 PM to 8:30 am (this includes morning report).

PGY-1 residents are assigned to 1.5 months of night float and upper level residents do 1 month per year. Two night float PGY-1 residents and 2 PGY-2 and -3 residents are assigned to Albany Medical Center Hospital; 2 night float PGY-1 residents and 1 PGY-2 or -3 resident are assigned to VAMC.

Are ancillary services available to the on-call resident?
Both hospitals have extensive ancillary services, including phlebotomists and I.V. teams, available 24 hours a day, 7 days a week. Laboratory results are accessible via computer on all wards.

How is the outpatient ambulatory care experience structured?
Albany Medical Center's program has been approved as a Primary Care Residency by the New York State Department of Health and as such residents in our categorical program spend at least 20% of their training in their outpatient continuity clinic. Trainees spend 1/3 of their overall time in outpatient settings.

Our outpatient experience is designed to prepare residents for careers in both general internal medicine and ambulatory aspects of specialty practice. Faculty preceptors are assigned to each resident and patient continuity is stressed throughout the three-year experience. Clinics are scheduled in one-week blocks (every 3rd week).

LEARNING EXPERIENCE
The Residency Program in Internal Medicine is one that provides exceptional opportunity to cultivate strong clinical skills, develop patient relationships, and interact with faculty and other residents and health care professionals.

Some frequently asked questions about our Internal Medicine Residency Program at Albany Medical Center include the following:

What is the overall educational experience of the resident?
The educational experience is a multi layered one that complements academic study and teaching opportunities with clinical and patient care experience. The experience follows the objectives outlined in our curriculum.

  • During ward rotations, small group (less than 10 learners) teaching sessions with the attendings are held 4.5 hours each week. This valuable teaching experience occurs independently of rounding responsibilities.
  • Elective rotations provide an intense educational experience, with residents interacting with attendings on a one-to-one basis. Electives may incorporate subspecialty clinics, consultations, and, when applicable, time for research.
  • All residents attend a daily noon conference, where a broad range of case discussions and specialty topics are presented by department faculty.
  • Subspecialty attendings give Board Review Sessions.
  • Journal Club occurs once a month, during which recent research papers from the literature are presented.
  • Morbidity and Mortality Conference is held twice a month. A cross-section of departmental faculty, and invited faculty members representing radiology, pathology, and other medical specialties attend this conference.
  • Morning Report occurs 5 days per week. One session is dedicated to PGY-1 report and is attended by house officers on ward rotations. The remaining 4 sessions are attended by the PGY-2 and PGY-3 ward residents.
  • Medical Grand Rounds is held once per month. This academic medical lecture series highlights recent topics in basic science and clinical medicine; presentations are given by full-time Albany Medical Center faculty and guest lecturers from other academic health science centers.
  • Attending physicians participate in work rounds, providing bedside teaching and case-specific discussion.

Residents rotate through Albany Medical Center Hospital and the Samuel S. Stratton Department of Veterans Affairs Medical Center (VAMC). In addition to housing a state-designated Level I regional trauma center, a state-designated Level III regional perinatal care center, and a state-designated regional AIDS treatment center, Albany Medical Center maintains a Bone Marrow Transplantation program, Organ Donation and Transplantation program, and a Children's Hospital. The VAMC is located adjacent to the Medical Center and provides educational experiences in all specialties.

Albany Medical Center

Stratton VA Medical Center

South Clinical Campus

Internal Medicine Group

 

EDUCATIONAL OPTIONS

What elective experiences are available during the residency?
Categorical residents are allocated 5 months of elective time during their PGY-2, and 5 months of elective time during their PGY-3 residency. Of those 10 months, 2 must be spent in Ambulatory Care Block rotations, 2 in Neurology and non-IM specialties and 1 in Geriatrics, which includes a two week experience in home-based health care. In the remaining 5 months, residents can select subspecialty experiences as well as experiences in "outside" disciplines such as radiology, obstetrics and gynecology, anesthesiology, otolaryngology, ophthalmology, and dermatology. Internal medicine subspecialty electives include:

Allergy and Immunology Dr. Jocelyn Celestin
Cardiovascular Diseases Dr. Edward Philibin
Clinical Nutrition Dr. Sharon Alger
Endocrinology and Metabolism Dr. Matthew Leinung
Gastroenterology Dr. Catherine Bartholomew
Geriatrics Dr. Molly Shulan
Hematology/Oncology Dr. Peter Burkart
HIV Medicine Dr. Douglas Fish
Infectious Disease Dr. Cynthia Carlyn
Medical Oncology Dr. Peter Burkart
Nephrology Dr. George Eisele
Pulmonary/Critical Care Medicine Dr. Marc Judson
Rheumatology Dr. Ludovico Cavaliere

Can residents pursue research interests during their training?
The residency in Internal Medicine is designed to accommodate the personal goals of all residents. Research interests are encouraged and supported; residents may elect to complete up to 2 months of research in the second and/or third year of training. At the present time, a variety of clinical and basic research is being conducted in the Department of Medicine, including specific research in our Clinical Pharmacology and Molecular Biology divisions.

How are residents evaluated during postgraduate training?
Using the American Board of Internal Medicine (ABIM) evaluation scale, the Internal Medicine residency program generates monthly evaluations through an electronic evaluation software for each resident. PGY-1 residents are evaluated by the attending faculty and supervising resident. PGY-2 and PGY-3 residents are evaluated by the attending faculty and the PGY-1 residents they supervise.

At the end of each rotation, written performance feedback is provided to each house officer. The program director meets with each resident on a semi-annual basis to review evaluations. A Clinical Evaluation Exercise (CEE) is conducted during the first year of training, and multiple times during the second or third postgraduate year. The in-service examination is a nationally administered examination that is mandatory for all PGY-2 Internal Medicine residents and optional for PGY-1 and 3 residents.

We also value information from residents about their experience in our program. Residents are asked to evaluate their attending faculty and clinical rotation on a monthly basis. Each year, a House Staff Council is appointed with representation from all three years of training; the council provides feedback on the training program and meets monthly with the program director and chief residents.

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