Internal Medicine Program Structure
St. Vincent’s Medical Center Graduate Medical Education programs offer a variety of settings and opportunities for residents to practice, including Ambulatory Care, In-patient Services and Intensive Care.
Our residents work in a variety of ambulatory care settings, including the Family Health Center (FHC), subspecialty clinics including Geriatrics, Urgent Care Centers and private offices of physicians in the community.
Primary Care Practices
Categorical residents have a weekly continuity clinic which includes episodic care, returning telephone calls and following up on all tests. They spend an average of half a day per week in the FHC throughout their three years of training.
Categorical Residents have an ambulatory care rotation in addition to their regular continuity clinic. A portion of their time is spent at an urgent care clinic, which allows them to perfect their skills in managing medical problems in the ambulatory setting.
Senior residents spend time learning the business aspects of medicine and how to run a medical office while rotating through community private practices.
Preliminary residents have an ambulatory care rotation in their schedules.
During electives, residents work in private practices and in the sub specialty clinics at the FHC. Residents get extensive exposure to outpatient management in the fields of rheumatology, infectious disease, cardiology, nephrology, gastroenterology, neurology, endocrinology, psychiatry, dermatology and the surgical sub-specialties.
Second year residents participate in a rotation at the Jewish Home for the Elderly. Residents learn comprehensive care of the elderly, including geriatric assessment and the importance of a multi-disciplinary approach. They work within the community and accompany geriatricians to patients' homes, learn how to deliver care to the homebound, and gain experience applying healthcare services outside of the traditional medical establishment.
Inpatient Medicine Service
St. Vincent's Medical Center is an acute care community hospital. Patients are admitted to the teaching services with a full spectrum of medical illnesses. Teams consist of one or two medical students, one or two interns, one resident and a supervising attending. There is a night float service for evening and night coverage. Residents are responsible for the diagnostic and therapeutic management of their patients, work closely with the attending staff, and are responsible for choosing therapy, consulting specialists and ensuring patients get appropriate, cost-effective care from admission through discharge.
St. Vincent's has excellent ancillary services, with diagnostic and therapeutic procedures being performed quickly and appropriately. Sub-specialists, Clinical Pharmacologists, Radiologists and Pathologists are available to discuss patient management and to help interpret test results. Though developing proficiency in common bedside procedures is essential, interns and residents are not responsible for routine procedures, such as drawing blood or starting IVs and thus have more time to concentrate on managing their patients and learning.
Didactics during these months include weekly Intern Report and daily Morning Report for senior residents, in addition to noon conference and teaching done during rounds.
Intensive Care Unit
The Intensive Care Unit consists of two residents, one intern, and one supervising intensivist. All of the house staff round with an Intensive Care Specialist every morning and afternoon, with clinical pharmacologists and fellows often participating in these rounds. There is also a night medicine team for the ICU.
Patient care is conducted through a multidisciplinary approach with consultants from Surgical and Medical subspecialties participating in the management of patients.
Residents manage critically ill patients with multi-organ system disease and use a full range of state-of-the-art technology for treatment, with the expectation that they become experts with ventilators, hemodynamic monitoring and central lines.
In the Intensive Care Unit, residents perform intubation, arterial line placement, central line placement, pleurocentesis and paracentesis.
Our residents have ample opportunity to do electives in their areas of interest. St. Vincent's Medical Center offers the following electives:
- Diagnostic Radiology
- Geriatric Medicine
- Infectious Disease
- Orthopedic Surgery
- Pain Management
- Palliative Care
- Wound Care
Residents arrange for rotations at other medical centers including international, research or clinical electives. Our residents have made medical mission trips to underserved nations and have provided adults and children with both medical and psychological care.
Teaching & Conferences
Our residency program has a comprehensive curriculum incorporating didactic sessions, case-based discussions, supervised patient care, and resident involvement in interdisciplinary conferences and other activities. Each rotation has an individual curriculum and there is a curriculum for those areas which are continuous throughout residency such as Ethics, Scholarly Activity, and Ambulatory Care.
The didactic curriculum covers clinical medicine, including internal medicine, subspecialty topics, the practice of medicine with emphasis on the American healthcare system, the economics of medicine, interpersonal skills, the importance of the patient-physician relationship, and research methods. Lectures are given by faculty from Columbia University, Yale University, and Quinnipiac University.
Some of our teaching venues are listed below:
July Medical Emergencies Series
Morning Report case and clinically relevant question review and discussion
Medical Grand Rounds
Multispecialty Conference with Radiology and Surgery
Morbidity and Mortality Conference
Intern Case Conference