Internal Medicine Residency

Curriculum and Training

The curriculum was shaped by the following principles and values:

  • Primary care internists must be well trained in all venues of general internal medicine.
  • The practice of primary care must be learned in realistic settings with progressive responsibility and expert mentorship.
  • The knowledge base of primary care internal medicine is deep and broad and allows internists in both primary care and the medical specialties to obtain proficiency in caring for patients with complex disease.
  • Primary care training requires a dedication to lifelong learning.

The Primary Care residency is comprised of clinical rotations, outpatient experiences, specialty practice opportunities, and dedicated seminars and conferences. Clinical rotations are carefully chosen so as to contribute to the education of well-rounded generalists. The following is a brief explanation of the schedule for each year:

INTERNSHIP (PGY-1)

The majority of the internship year is spent gaining the knowledge and skills necessary to be an excellent inpatient physician and team leader. Primary Care interns have approximately five inpatient ward months, one inpatient geriatrics month, and 2 ICU months. They work side by side with traditional track interns, and rotate between all three inpatient sites (Hospital of the University of Pennsylvania, PPMC, and the Philadelphia VA Medical Center).

Both the Categorical and Primary Care interns are scheduled in a “6+2” format that allows for six weeks of inpatient rotations followed by two weeks on dedicated ambulatory time. This “block-scheduling” model allows dedicated time in each arena and decreases conflicts between inpatient and outpatient educational time. The two-week ambulatory blocks are spent increasing knowledge and skills in outpatient medicine. Interns spend extra sessions in their own continuity practice, rotate through specialty clinics, and have seminars and conferences dedicated to physical diagnosis, prevention, patient-doctor communication, and office practice.

Four weeks of the internship year are spent in a community practice, at the office which will then become a second continuity practice site. The community practice sites are chosen from the large Penn primary care network. Many of the supervising physicians have won teaching awards and all are highly regarded as teachers and clinicians.

PCPC_intern

INTERN ADVISORY GROUP (PGY-2)

At the beginning of your intern year, your class will be divided into two Advisory Groups. Each group will consist of three interns, a PCPC faculty member, a PGY-2 & a PGY-3 member. The purpose of this group will be to give you an instant peer group for information, support, and mentorship as you are learning the place and job. There will be several outings arranged by the group as well as informal meetings.

PCPC1PCPC2

A Night Out at the Philadelphia Museum of Art

JUNIOR RESIDENCY (PGY-2)

During this year, residents gain further experience in inpatient care with 4 additional ward months, 1 ICU month, and 1 month of emergency medicine. Residents are maintained in the block-scheduling pattern that alternates at 4 week intervals. Residents complete four weeks of a traditional rotations (e.g. wards, ICU’s, Consults) followed by four weeks on an ambulatory block. During this time, residents have two ½-days of ambulatory didactics, two sessions of their continuity clinic at the PCPC, one session of the second (community-based) continuity clinic, one ½ day session of administrative time and four ½-day sessions in various ambulatory specialty practices. Such experiences include dermatology, orthopedics, cardiology, endocrinology, geriatrics and community medicine. The amount of time spent in ambulatory training expands to five months of the year spent on outpatient rotations. Time is also available for residents to design their own clinical or research experiences.

During each ambulatory block rotation, there is a specific curriculum of didactic topics taught by clinical and research faculty, and by the residents themselves. Topics include general medicine topics, outpatient orthopedics, women's health, physical exam, dermatology, Quality Improvement, and psychiatry. When residents return for their ambulatory block, they maintain continuity with their patients and their colleagues. Residents practice together, have clinic conferences together, and take part in an ongoing seminar series.

A sample ambulatory week block schedule is provided below for a PGY-2 on their Ambulatory Endocrine Rotation:

Monday, 11/26 Tuesday, 11/27 Wednesday, 11/28 Thursday, 11/29 Friday, 11/30
AM Endo Clinic, Dr. Flood, Heart ad Vascular Pavilion, 2nd Floor Didactics Administrative Time Didactics Endo Clinic, Dr. Flood, Heart ad Vascular Pavilion, 2nd Floor
12:00-1:00 Resident Report Medical Grand Rounds Resident Report Resident Report Resident Report
PM 2nd Continuity Clinic - King of Prussia Internal Medicine Endo Dietician Training, Linda Sartor, 4 PCAM PCPC Clinic Diabetes Clinic, Dr. Schutta, 4 PCAM PCPC Clinic

SENIOR RESIDENCY (PGY-3)

During the senior year, there is an increasing emphasis on ambulatory and primary care. There is increased time available for both inpatient and outpatient electives. Also in this year, time spent at your outpatient practice experience at the PCPC and your community clinics expand. On the ambulatory blocks, senior residents have an increased amount of latitude to design and customize their ambulatory experience to include various clinical, administrative, and research experiences. Residents continue to serve as teachers to medical students on the wards and also as part of the “Introduction to Clinical Medicine” Course. Senior residents take a more active role in the didactic curriculum and also have the opportunity to function as “junior preceptors” to the interns in continuity clinic. This is also the time in residency when residents expand their research portfolio and develop projects to improve the effectiveness of the care delivered at the PCPC and in the community. The program director and other DGIM faculty are available to serve as advisors and mentors for career planning.

A sample ambulatory week block schedule is provided below for a PGY-3 resident with an interest in Global Health:

Monday, 11/26 Tuesday, 11/27 Wednesday, 11/28 Thursday, 11/29 Friday, 11/30
AM Research time for Refugee Clinic Didactics Administrative Time Didactics ID Clinic, Dr. Norris, Heart ad Vascular Pavilion, Suite 1B
12:00-1:00 Resident Report Medical Grand Rounds Resident Report Resident Report Resident Report
PM Refugee Clinic Travel Medicine, Dr. Gluckman, 2 PCAM PCPC Clinic 2nd Continuity Clinic - Chinatown Medical Services PCPC Clinic

PRIMARY CARE AMBULATORY DIDACTIC SCHEDULE
Block 2A/2B (7/17-8/13)

18-July 8:30 Marie Uberti-Benz, MD Dermatology Lecture Series #1
10:15 Rachel Miller, MD The Geriatrics Assessment
11:45   Assign Journal Club, Weekend Call, Case Conferences, etc.
23-July 8:30 Sami Khella, MD Evaluation of Peripheral Neuropathy & EMG/NCS
10:15 Jack Ende, MD Cardiac Auscultation -
Fox Learning Center
11:45   Review Weekend Calls
25-July 8:30 Kyle Holsinger, Psy D Motivational interviewing
10:15 Joshua Uy, MD Goals of Care/Making a Hospice Recommendation
30-July 8:30 Anne Marie Holmes Billing, Documentation and Compliance
10:15 Pharmacy Students Opioids
11:45   Review Weekend Calls
1-Aug 8:30 Ambulatory M&M Gary Weissman, MD
10:15 Barb Westerhaus, MD Journal Club #1
6-Aug 8:30 Paul Tapino, MD The Red Eye
10:15 Matt Rusk, MD Telephone Medicine
11:45   Review Weekend Calls
8-Aug 8:30 Aba Barden, MD Preconception Counseling
10:15 Zach Smith, MD Journal Club #2
13-Aug 8:30 Anita Lee, MD Intro to the USPSTF Recs - Nuts and Bolts of Women's Health
10:15 John Stein, MD Treatment of Depression and Anxiety
11:45   Review Weekends Calls