Curriculum

Internal medicine residents at Mercy Catholic Medical Center

Mercy Catholic Medical Center offers two options in internal medicine, a preliminary program (one-year internship) and categorical (three-year residency). Our academic year is broken down up in 13 four-week blocks. Most resident rotations are four weeks long, although some are only two weeks. Each rotation is supervised by a member of the faculty.

Preliminary Internal Medicine Program

The preliminary internal medicine residency is designed for physicians who desire to have one year of internal medicine training prior to matriculating in an advanced residency position in Neurology, Dermatology, Ophthalmology, Radiology, Anesthesiology, Physical Medicine and Rehabilitation, or a surgical subspecialty.

During the course of the academic year our preliminary interns care for patients with a wide spectrum of disease in the ICU and floor at both an urban and suburban hospital. This allows them to gain knowledge, skills, and confidence to become a caring subspecialist. Our preliminary interns are fully integrated into the residency program. They follow the same schedule as our categorical residents with the exception that they are not required to have an ambulatory continuity clinic.


The Preliminary Internal Medicine Intern schedule is:

Categorical Internal Medicine Residency

In our categorical internal medicine residency, we train physicians who are interested in becoming a hospitalist, general internist, or a medical subspecialist.

Our three-year program includes dedicated time in inpatient floors, ICU, and ambulatory clinic, caring for urban and suburban patients with a wide spectrum of disease. From day one of internship, we focus on the emerging role of the physician as a leader of interdisciplinary team of clinicians. Time on “classical” internal medicine services and complemented by dedicated rotations in observation medicine, systems-based practice, urgent care, and electives.


PGY1 (Intern) schedule
PGY2 schedule
PGY3 schedule

Overnight Call

Internal medicine residents operate in a “shift” system, with residents on dedicated “night float” rotations caring for patients overnight. Our longest intern shift is 15 hours, with most shifts 10–11 hours and no overnight call. Interns will have 2-4 weekend ICU shifts during their elective, systems-based practice, or observation care rotation. Although most resident shifts are also 10–15 hours, there is one 27 hour shift during each floor block. In addition, residents have approximately 2-3 overnight calls per academic year during their ambulatory block.

Academics

Mercy Catholic Medical Center supplements its clinical teaching with a rich series of academic conferences and other activities. Structured conferences are held on weekdays at noon with a catered lunch. Conference material is archived electronically for residents to review at a later date. In addition, residents attend a series of reports, specialty rounds, and small group conferences designed to enhance their learning.

Noon-Time Didactic Conferences

Daily Didactic Conference

All residents meet 5 days/week between 12 and 1 p.m. for a formal didactic conference.

Core Internal Medicine Didactics

Dr Fleming and residents

Dr. Fleming and residents at a noon conference.

Faculty members provide didactic lectures in core internal medicine topics over an 18-month cycle. Lectures are firmly based in clinical medicine, applying basic and clinical sciences to understand the management of patients. These topics are supplemented by additional lectures in medicolegal aspects of medicine, ethics, biostatistics, and research methods.

Grand Rounds

Internal Medicine Grand Rounds, held weekly from September to June, brings expert faculty drawn from Mercy, the local area’s medical schools, and beyond to lecture on cutting-edge topics drawn from clinical medicine.

Resident-led management conference

A few times each academic year PGY2 and PGY3 residents are given the podium! In these didactic lectures, residents discuss evaluation and management of both common and uncommon disease processes using a case-based approach. By leading these discussions our residents become local experts, enriching both their own education as well as that of their peers.

Morbidity and Mortality Conferences

Residents participate in monthly interdisciplinary morbidity and mortality conferences in which the department of medicine, as a whole, learns from challenging cases.

Tumor Board

A few times each year residents participate in Mercy’s interdisciplinary tumor board during which evaluation and treatment of patients with newly diagnosed cancer is discussed by experts from surgery, oncology, radiation oncology, pathology, and radiology. During these combined tumor boards residents are placed “front and center’ and are asked to present the patients to the group.

Reports

Interns meet once a week at each hospital for intern report. During these sessions, current or recently discharged cases are discussed. These cases are used to help interns improve medical knowledge and sharpen clinical reasoning.

PGY2 and PGY3 residents meet twice each week at each hospital for resident report. Using a current or recently discharged patient, faculty preceptors guide the residents to consider the subtleties of evaluation and management, helping them to prepare for independent practice.

Subspecialty Rounds

A few times each month, inpatient teams gather to discuss important aspects of the care they deliver. During antibiotic stewardship rounds, residents discuss appropriate use and discontinuation of antibiotics on their patients under the guidance of an expert infectious disease consultant. In ethics rounds, challenging cases are discussed with a multi-disciplinary ethics teams. Expert cardiologists and pulmonologists meet with our ICU team to discuss finer points of management of these patients.

Ambulatory Didactics

Residents are asked during each ambulatory block rotation to present a didactic presentation based on common problems or scenarios from ambulatory medicine.

Journal Club

Once each week residents and faculty review recent journal articles. The journal club helps keep residents and faculty aware of the latest updates in internal medicine while simultaneously teaching about how to read and interpret articles from the medical literature.