Internal Medicine Residency Program

A message from the Program Director

I am honored to be the program director for the Health Quest Internal Medicine residency program during this exciting time. We are in the midst of a transformation from a collection of community hospitals to an academic health system with multiple residency programs, a new patient pavilion at Health Quest’s Vassar Brothers Medical Center and a state-of-the-art allopathic medical school.

The Internal Medicine residency program is an integral part of setting the academic standard here at Health Quest. The program has all the components to set our residents up for success whether they choose to pursue primary care or a subspecialty.

The curriculum, faculty, resources and diverse patient population provide an ideal environment for residency training. The curriculum allows residents to learn from hands-on experience balanced with structured didactics and participation in board review, journal clubs and morning report. We are fortunate to have dedicated and knowledgeable faculty and staff who are committed to the success of the residents.

Our organizational REACH values of respect, excellence, accountability, compassion and honor are reflected in everything we do here at Health Quest and are at the core of what we look for and expect from our residents. Providing excellence in patient care guides all of our actions.

I encourage you to apply to our residency. The Mid-Hudson Valley is a beautiful place to live and Health Quest is a wonderful environment in which to train.

Sincerely,

Susan Eckert Collins, MD
Program Director Health Quest Internal Medicine Residency

Program Structure

As an ACGME-accredited internal medicine residency program, our curriculum and clinical training experiences will prepare graduates to be not only independent practitioners or candidates for fellowship training, but also leaders in the field of medicine. By graduation, all residents will receive approximately the same exposure listed below in terms of weeks:

 

 

 

The 4+1 Schedule

The Health Quest Internal Medicine Residency Program structure is a three-year program in which our residents spend 2-4 weeks on a given assignment, then one full week in the ambulatory setting, including dedicated continuity clinic time to see an assigned patient panel, geriatrics clinic and select internal medicine subspecialties. The graph below demonstrates this concept for an eight-week period.

In the above example, Dr. Adams begins his academic year with a four-week rotation on the inpatient medicine orange team. When the fourth week is over, Dr. Adams spends one week rotating in the continuity clinic and in various other internal medicine subspecialty clinics. Dr. Adams then changes to the next rotation, emergency medicine.

Note that as Dr. Adams is leaving the continuity clinic week, Dr. Berkley is coming into her continuity clinic week; and the pattern continues with Dr. Catanese and Dr. Deighton. These four individuals together comprise the continuity clinic “firm.”

Firms are a second benefit to our program’s structure. First, each firm has a designated continuity clinic faculty member assigned for the duration of their three years of training to guide and mentor their practice development. Second, each firm’s cohort of residents acts as practice partners for one another, mimicking the structure of most private group practices. This real-world experience reinforces the skills and competencies required to be fully prepared to successfully practice medicine by the end of training.

The third benefit is rotating through subspecialty clinics both within and outside of internal medicine. The aim is to develop a well-rounded primary care physician. Prior to the start of each academic year, the resident will develop, with the mentorship of a faculty member, a rank list of preferred subspecialty elective continuity clinic experiences. The program director and chief resident will do their best to accommodate the top requests for periods of up to six months.

Continuity Clinic Week Schedule

Below is a sample schedule for the continuity clinic week. It is comprised of five internal medicine continuity clinic sessions and 5 ambulatory subspecialty clinics. For first year, these subspecialty clinics are comprised of ENT, ophthalmology, wound care, gynecology and dermatology.

 

Academic Offerings

Inpatient Medicine Morning Report
Morning Report is a case-based conference which allows residents and faculty to discuss patient care in an organized and efficient manner. Residents will present cases to faculty and members of the patient care team in attendance with a faculty member selected as the facilitator. The facilitator will use the information in the resident’s presentation as a springboard for robust conversation and discussion to develop medical knowledge, clinical skills, professionalism, and identify system resources or improvement initiatives pertinent to the case discussed.

Continuity Clinic Conference
Health Quest Continuity Clinic Conference is founded on the Yale Office-based Medicine Curriculum and facilitated by continuity clinic faculty and/or a chief resident. The cornerstones of this curriculum are the realistic, challenging cases and related questions prepared by Yale faculty, which emphasize practical aspects of diagnosis or management. These exercises prompt not only information recall, but also higher order cognitive skills, such as solving problems, evaluating new information and making judgments. Topics range from “bread and butter” internal medicine – such as chronic management of diabetes, hypertension and prevention – to subspecialty areas, such as orthopedics, rheumatology and dermatology.

Residents in the continuity clinic present patient cases including visit criteria, diagnosis, initial management, plans for care and possible procedures/tests. The focus of the discussion is selected by the presenting resident. For example, certain cases may be presented to discuss differential diagnoses, while others may be presented to discuss specific case management issues. Each semester, residents receive a six-month syllabus covering 24 cases with related questions, and one or more high quality, peer-reviewed articles. Over three years of training, residents will be exposed to a compendium of 144 different topics as part of the rotating syllabus of six volumes, one per semester.

Each semester also includes chapters relevant to current practice, such as coding, ethics and professionalism, or economic aspects of medicine. Each volume also includes recent therapeutic advances and, if relevant, areas of new controversy.

Internal Medicine Grand Rounds
Grand Rounds conferences use a variety of formats for presenting material including topic review, clinical pathological conferences, case of the month, etc. Topics for Grand Rounds Conferences vary from week to week, but include patient cases, ethical topics, professionalism discussions and additional competency-based topics.

Quality & Process Improvement
Quality & Process Improvement (Q&PI) Conferences, formerly Mortality and Morbidity – M&M, occur on a monthly basis and are presented by residents with faculty mentors’ guidance. Topics are decided by residents and faculty based on current/past patient care cases where a significant system error occurred. Q&PI provides a forum for resident interaction and discussion with attending physicians regarding care that could have been improved, and the opportunity to identify system errors. The faculty mentors facilitate the discussion based on the topic.

Noon Conference Series
Our General Internal Medicine Curriculum is the core of our academic and didactic series. Taught by board-certified internists and subspecialists, the curriculum is designed to provide residents to exposure to a wealth of topics and cases which span the care continuum. There is an initial core curriculum series to make sure that all of the residents learn the typical medical conditions. Other regular conferences include cost conscious care, the business of medicine, board review, CPC and wellness.

Residents’ Journal Club
Each resident will be presenting at Journal Club. He/she will partner with a subspecialist/internist for development of the topic review and with our associate program director Dr. Valerie Cluzet to be able to discuss the study design and epidemiology.

Tumor Board
The purpose of the Health Quest Tumor Board is to educate multidisciplinary physicians and ancillary staff who treat or manage cancer patients. Cancer conferences improve the care of cancer patients by contributing to the patient management process and outcomes, and by providing education to physicians in attendance. Residents will review and discuss diagnostic studies and learn the most evidence-based processes for implementing treatment plans, which will:

  • Optimize outcomes
  • Differentiate between diagnosis and follow-up modalities for various cancer types
  • Assess available clinical trials
  • Review new procedure guidelines, technology and treatment for cancer patients.

MKSAP 18 Board Review
Monthly quizzes are assigned, and challenging topics are reviewed during a monthly presentation. Residents are provided with free access to MKSAP 18. Board review electives are offered for graduating residents, and some residents choose to attend board review conferences offered nationally.

Health Quest Residency Joint Program Lecture Series
The Joint Program Lecture Series will occur on a quarterly basis in conjunction with the general surgery and internal medicine residency programs. The lecture series covers GME-wide topics such as resident fatigue, burnout, resident wellness and other issues. Sessions will be hosted by the GME office and invited speakers will present. Topics include, but are not limited to:

  • Fatigue
  • Stress and depression
  • Substance abuse
  • Disruptive behavior
  • Burnout
  • Boundary violations
  • Impairment
  • Instructive feedback

ABIM In-Service Training Exam
Residents’ medical knowledge and clinical reasoning will be benchmarked for measuring longitudinal growth through the results of the annual American Board of Internal Medicine In-Service Training Examination. All internal medicine residents will complete the exam. Results will be reviewed with the program director to inform discussions and individualization of curriculum and clinical training (e.g., reading material, board prep and electives).

Research and Quality Improvement Opportunities

All residents in the Health Quest Internal Medicine Residency Program are provided opportunity for, and are fully supported in, scholarly activity/research and quality improvement pursuits. Additional research and QI participation by residents above the minimum requirements are highly encouraged. Residents are paired with a faculty mentor for all scholarly activity and quality improvement projects. This mentor is tasked with assisting residents in background research, feasibility, Institutional Review Board (IRB) approval, study design, implementation and analysis.

The goal of the internal medicine scholarly activity curriculum is to advance each resident’s knowledge of the basic principles of research, including how it is conducted, evaluated, explained to patients and applied to patient care. Residents will be provided with a variety of resources to facilitate involvement in scholarly activity projects throughout their training, both in the continuity clinic and inpatient settings.

Residents will present all research either within the department, locally, regionally or nationally. Each year, the Health Quest Graduate Medical Education Department will sponsor a Resident Research Day wherein residents can present posters and oral presentations on ongoing or completed research topics.

Residents will also receive a month-long rotation in research/quality improvement during their PGY3 year. Rotation-specific curriculum is provided to residents with goals and objectives, requirements and expectations for the rotation. Topics for research projects completed during this time are subject to approval by the program director.

Continuity Clinic Data – Internal medicine residents will be provided with access to the clinical data for their Continuity Clinic patient panel. This data will allow them to develop quality improvement and research projects on issues with which their patients are diagnosed (for example: diabetes, hypertension, obesity).

How to Apply

The Health Quest Internal Medicine Residency Program thanks you for your interest in applying to our program. We accept all applications through the ERAS only and participate annually in the NRMP Match Program. We hope you choose to join us.

Requirements

The following items are required for consideration of interview. All items must be received through ERAS application portal:

  • Personal Statement
  • Current CV
  • 3 Letters of Recommendation
  • USMLE Step 1 CK Score
  • USMLE Step 2 CS Score
  • USMLE Step 2 CK Score
  • MSPE (Dean’s) Letter

Important Dates

We will interview candidates during select dates in November, December and January. Exact dates will be provided to the invited residency applicants via email notification. The annual schedule generally includes:

  • Mid-September: NRMP registration opens
  • Early October: MSPE (Dean’s) letters released through NRMP
  • Late November: Standard registration deadline for applicants
  • Late February: Rank order list deadline
  • Mid-March: Match week
  • Mid-March: Email notification of “You’ve Matched”
  • Mid- March: MATCH DAY CELEBRATION