Internal Medicine Residency and Fellowship Information
The Department of Medicine sponsors a fully Accreditation Council Graduate Medical education (ACGME) accredited 3 year Internal Medicine Categorical Residency Program, a fully ACGME accredited 1 year Preliminary program. The Department of Medicine sponsors seven ACGME accredited fellowships that include Cardiovascular Diseases including General Clinical Cardiology, Interventional Cardiology and Electrophysiology, Infectious Disease, Nephrology, Pulmonary Critical Care, Sleep disorders, Oncology and Gastoenterology.
The Internal Medicine Residency Program underwent major changes in the last five years. In April 2008, Ragheb Assaly, M.D. was promoted from Associate Program Director to the Internal Medicine Program Director. In August 2013, Edith Reynolds, Residency Coordinator transitioned into Pediatrics and Tiffany Cantu became the Residency & Curriculum Coordinator. In addition Thomas Sodeman, M.D and Dinkar Kaw, M.D., Bryan Hinch, M.D. joined as associate program directors replacing Rekha Chaudhary, M.D. who relocated at the University of Cincinnati January of 2010 as an Associate Program director, and Anand Mutgi, M.D. who stepped down as Associate Program Director in July 2007. In July 2012, Dr. Joseph Shapiro, M.D. who has been the Chairman of Internal Medicine for 12 years, left for a Deanship at another Institution and Dr. Christopher Cooper, M.D. was made the Interim Chairman of Internal Medicine.
In addition to the above changes in the administrative personnel, major restructuring and improvements in the curriculum, rotations design and scholastic environment took place during the last three years. With the help from the faculty from both the University of Toledo College of Medicine and St. Vincent Mercy Medical Center we have successfully completed our first 18 month cycle for the core-curriculum didactics delivered during a half day protected time for residents education.
We have developed advising groups, designed to support our residents in their patient care, medical knowledge, interpersonal and communication skills, professionalism. The residents are divided into 12 groups, each group consists of one attending who volunteered to be an advisor and 3-4 residents scheduled to meet once weekly. Each group meets once per month to discuss various issues from career development to board review. Additionally, each resident may pick his or her own mentor, a faculty member who they connect with on a personal level who may help the resident with a host of issues from scholarly activities to offering guidance to the residents in their career plans and in any other matter of relevance to their professional and personal lives.
An enormous and organized effort is been focused on quantifying the six educational competencies. These efforts resulted in establishing the score card with expectations based on the PGY level.
To help assess the resident's medical knowledge in addition to the monthly feedback and global assessment (new innovations) we introduced another tool of measuring this competency. We introduced a monthly test which covers the topics of the core curriculum discussed the previous month. This test allows us to measure the medical knowledge competency in a prospective and dynamic way. The following week after the test, two of the third year resident's one from UT Medical Center and one from St Vs present a critique session of the questions included in the test.
We use several tools to assess patient care competency. In addition to the New Innovations, we employed, the procedures log performed successfully, the Mini-CEX, and the attendance at the simulation lab exercises.
Significant effort was made in restructuring the admitting rotation and the interaction with emergency department. Given the busy nature of the ED now the admitting resident covers only 15 days a month while the rest of the days both senior admitting residents collaborate to work on a practice based learning project.
In addition to the resident's wellbeing, in the restructuring of the schedule, emphasis is placed also on patient safety and transition of care. This is all detailed in a different section of the manual. To advance the mission of educating lifelong learners (residents) a tremendous emphasis was placed on incorporating the Practice based learning (PBL) competency in resident's education.
Each senior (PGY2/PGY3) during their admitting month are required to collaborate to complete a PBL project. Examples of completed projects are available in this manual. Finally, in June of each year the residents will present their PBL projects and compete for the William Sodeman Jr. PBL award. Another tool to measure PBL is chart auditing and self-reflection when completing the autopsy forms where the residents summarize how the information learned from autopsy changes their practice.
To quantify system based learning competency we introduced care coordinator daily morning meetings to discuss the patients disposition and challenges in placing these patients. In addition the residents are encouraged to participate in the hospital committees such as pneumonia committee, congestive heart failure committees to get exposed to the quality benchmarks the hospital and all the health care systems strive to achieve.
We also use several tools to assess professionalism: Attendance, timely completion of medical records, logging duty hours. Tracking the time lapsed of patient dictation alter discharge.
In addition to the supervising faculty, communication skills are assessed by clinic nurses and medical intensive care unit clerks.
The residents and the faculty are educated on signs of fatigue and stress. Emphasis is placed on making sure that transition of care is done in an efficient way. To achieve this goal a schedule design has been established with emphasis on hand off and tools to assess this process is introduced to the global assessment (new innovations). Finally, the residents teaching skills are always evaluated by faculty, peers and medical students.
The core internal medicine program works very closely and guides our six fellowships. This is accomplished through regular quarterly meetings between the fellowship PDS and coordinators with the residency committee of the core program on the education level. The core program, organized three fellow symposia named after the late cardiology program director Dr. Thomas Walsh.
With the leadership of our new chairman and with the help of our internal medicine faculty, and the guidance and the support of the graduate medical education office as well as the college of medicine our Internal Medicine residency accomplished several important milestones. Our rolling average for the ABIM pass rate is 86.66% with more than 98% of the graduates taking the exam between 2009 and 2012. An amazing record of peer reviewed publications, national meetings abstracts, local and national awards all detailed in the other sections of the website.