Internal Medicine Residency
Program Director/Division Chief: Alan Yeung, MD, Ronald Witteles, MD, John Schroeder, MD
Duration: 1 Month Block Rotation PGYI and PGYII
The rotation is a month long block of time with one PGYII as the lead together with 2 to 3 PGYI. The team admits and manages all inpatients cardiology patients with close coordination with the CCU/heart failure service.
General cardiology rotation remains part of the “bread and butter” core of internal medicine inpatient rotations. Together with the CCU/heart failure (PGY II) and the cardiology consult service (VA and Stanford), these rotations form the foundation of the cardiology knowledge base of the internal medicine trainees. Advances in diagnostic imaging, rapid bedside testing and evidence based clinical trials have allowed us to deliver coordinated complex care to our patients with ample opportunities for teaching and learning for the internal medicine residents.
The development of the skills and knowledge required for the practice of cardiac vascular medicine is an essential part of the educational process of internal medicine training. Cardiovascular diseases affect millions of Americans and now we have tools and drugs to treat and/or prevent this problem. It is an essential large component of a daily internal medicine practice.
PGY I residents receive Cardiology training primarily in the inpatient setting on the Cardiology ECG monitored wards including D-1, D-2, B-2, B-3. The residents are part of a physician team including the Attending physician, a total of two PGYI residents, 1-2 medical students. They are assisted not only by nursing staff, but patient care managers in order to facilitate scheduling of tests, obtaining outside records and developing appropriate discharge planning.
The educational content is provided in the following ways:
- Individual responsibility for assigned patients and their 24 hour progress for review with the attending of daily AM rounds, usually 8 or 9 am.
- Teaching sessions on the Inpatient Unit before and during inpatient rounds by the Attending physician and ancillary staff.
- New Patient presentations daily at 9:00 am to the attending
- Medical Grand Rounds on Wednesdays at 8:00 am,
- Reading Materials (see References below)
- Review of all imaging studies related to the patient. This may include participation of radiologist, echocardiographers and interventional cardiologists.
- Student and/or resident presentations on clinical a issues (e.g. Pericarditis or anticoagulants, etc.)
- Bedside rounds of every patient on a daily basis with the attendings and general cardiology team.
According to Accreditation Council of Graduate Medical Education (ACGME), training and evaluation must include the following competencies: Patient Care, Medical Knowledge, Practice – Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and System-Based Practice.
- Patient Care will be evaluated by global assessment of the attending physician and additional information from nursing staff. Procedures performed will be documented.
- Medical Knowledge will be evaluated by global assessment of the attending physicians, and peer-reviewed chart audit.
- Practice-Based Learning and Improvement will be evaluated by peer-reviewed chart audit.
- Interpersonal and Communication Skills will be evaluated by global assessment of the attending physicians and additional information from nursing staff, other ancillary staff, patients and families.
- Professionalism will be evaluated by global assessment of the attending physicians and additional information from nursing staff, other ancillary staff, patients and families
- System-Based Practice will be evaluated by global assessment of attending physicians, and peer-reviewed chart audit.
Evaluations are reviewed with the residents for formal feedback. Face to face interaction between the attending physician and the resident is the required method. At the midway point of the rotation, the resident is encouraged to approach the attending to assess and discuss performance. In addition, ongoing feedback is provided related to residents’ patient care responsibilities and activities.
In addition, residents provide feedback to the Attending Physicians and Program Director regarding the rotation to add input on deficiencies in the experience.