Internal Medicine Residency Curriculum
The Internal Medicine Residency program in NYU Langone’s Department of Medicine trains leaders in healthcare with comprehensive and outstanding clinical experiences for interns and junior and senior residents.
You acquire essential core clinical skills, as well as the confidence, independence, and professionalism you need to deliver compassionate, high-quality medical care to a diverse patient population.
Our residents have inpatient and outpatient training opportunities. As an intern, you care for a maximum of 10 patients, although because teams usually have subinterns, the average number of patients you typically care for is closer to 6 or 7. Second-year residents generally lead teams comprised of an intern and a subintern, and care for a maximum of 14 patients. Third-year residents generally lead teams comprised of 2 interns and 1 to 2 subinterns, and care for a maximum of 20 patients.
In addition to seeing patients, you complete a variety of formal teaching activities designed to enhance the learning that occurs during rotations. These include daily morning reports, seminars, conferences, morbidity and mortality rounds, weekly department grand rounds, and physical diagnosis rounds and “boot camps” in the intensive care unit (ICU).
During small group seminars, you learn self-awareness and develop reflective practices to bring to your teaching and critical appraisal skills. Conferences improve your understanding of medical care in clinical macro- and microsystems with topics such as data-driven medicine, quality improvement, and patient safety. Educational experiences range from case discussions to interactive seminars, bedside rounds, and didactic lectures.
The 4+2 Model
We use a 4+2 block scheduling model to minimize conflicts between inpatient and outpatient responsibilities and improve care transitions during ambulatory care training experiences.
The 4+2 model alternates four-week blocks of traditional inpatient rotations on the wards, on night float, and in the ICU with two-week blocks dedicated to ambulatory care, electives, and core components of the residency curriculum. This schedule continues throughout your three-year training experience.
This model prevents you from being pulled toward other patient care commitments during ambulatory blocks and allows you to focus more fully on continuity practice, ambulatory care, and electives.
Residents rotate on the inpatient wards at NYU Langone’s Tisch Hospital and Kimmel Pavilion, NYC Health + Hospitals/Bellevue, NYU Langone Hospital—Brooklyn, and the VA NY Harbor Healthcare System, providing patient care with real-time support from experienced physicians. Under the supervision of a hospitalist, second- and third-year residents lead teams composed of interns, medical students, pharmacists, and social workers.
Tisch Hospital–Kimmel Pavilion Inpatient Rotations
At Tisch Hospital and Kimmel Pavilion, residents manage the care of patients under the guidance of experienced internists, subspecialists, and hospitalists. Residents encounter patients with conditions such as congestive heart failure, bacterial infections, and complex hematologic and cardiopulmonary disorders. Most admissions come through the emergency room, with some direct admissions from private physicians’ offices and transfers from other institutions.
You spend time on one of three medicine teams, which consist of two residents and three interns, and collectively provide 24-hour care for all patients admitted to the service. Each team has a subspecialty focus—pulmonary, gastroenterology, and oncology. You round each morning with two attendings physicians, a hospitalist, and a subspecialist in your team’s area of focus. You also rotate on ward teams for the cardiology and hematology services.
Bellevue Inpatient Rotations
At Bellevue, residents treat patients with a range of conditions, including lupus nephritis, endocarditis, heart failure, and newly diagnosed adenocarcinoma. You are part of one of eight teams that cover the general medical service, providing patient care and planning patient discharges.
With supervision from senior residents and attending physicians, second-year residents complete one four-week block at Bellevue’s Level 1 Trauma Center. Formal teaching rounds with the supervising hospitalist occur daily.
NYU Langone Hospital—Brooklyn Inpatient Rotations
At NYU Langone Hospital—Brooklyn, residents on the community health and primary care tracks treat patients on the general medicine wards, medical ICU, emergency medicine, inpatient electives, medical consultations, and night rotations.
Residents gain experience in the transition of care as patients move through the hospital system to outpatient care. You may have opportunities to serve as a primary care provider in outpatient settings for patients who you treat during inpatient rotations.
Second- and third-year residents on the community health and primary care tracks also complete subspecialty rotations, including cardiology and hematology, at Tisch Hospital.
Likewise, physicians in some of our fellowship programs complete rotations at NYU Langone Hospital—Brooklyn, which allows us to offer inpatient electives with consult services and additional opportunities for subspecialty training.
VA NY Harbor Healthcare System Inpatient Rotations
At the VA NY Harbor Healthcare System, your patients are veterans seeking care for a mix of basic internal medicine conditions, including cardiovascular disease, congestive heart failure, cirrhosis, chronic obstructive pulmonary disease, and various malignancies. The hospital is a center of excellence for cardiac catheterization and is a referral hub for cardiovascular disease.
You rotate on one of three ward teams with supervision from two attending physicians—one internist and one subspecialist—who offer contrasting and complementary views on inpatient care. Unique to the VA NY Harbor Healthcare System is a staff of full-time, specialty attending physicians who are readily available to discuss and review cases. Few hospitals offer residents the ability to confer on patient cases with the chiefs of different services.
Attending physicians from various subspecialties typically attend resident conferences at the hospital and contribute to dynamic educational discussions. Multidisciplinary rounds occur daily with social workers and nurses.
Intensive Care Training
Residents rotate through the ICUs at all four hospitals, performing procedures such as central venous and arterial line placement, cardiac monitoring, diagnostic and therapeutic paracentesis and thoracentesis, and ventilator management.
You manage the care of patients with supervision from critical care attending physicians and fellows and train with the latest tools and devices. Residents round independently each morning and again with critical care attending faculty and fellows. This gives you the opportunity to discuss questions related to patient care or academics.
At Tisch Hospital, Kimmel Pavilion, and the VA NY Harbor Healthcare System, the coronary care unit rotation is combined with the medical intensive care rotation. Those rotations are separate at Bellevue.
Before starting select critical care rotations, residents attend sessions that include case-based discussion of shock and resuscitation, an interactive introduction to mechanical ventilation, and critical care ultrasound.
All residents go through a formal ultrasound curriculum during their second year. There also opportunities to use point-of-care ultrasound during intensive care and other rotations.
Ambulatory Care Medicine Training
Because most medical care occurs in ambulatory settings, an essential component of our Internal Medicine Residency is the training of residents in all aspects of office-based practice. We ensure that residents are comfortable caring for patients with both acute complaints and chronic conditions outside of hospital settings.
During ambulatory care blocks, you spend 70 percent of your time in continuity clinics, acute care settings, and specialty care clinic sessions; 20 percent in conferences; and the remaining 10 percent on administrative work.
You are responsible for all aspects of patient care, with supervision from a preceptor. This includes disease screening and prevention, diagnosis and management, and patient referrals to specialty clinics.
During conference time, you are expected to reflect on the knowledge, patient care, and teaching abilities you’ve developed during your ambulatory care experience and translate them into skills you can apply over the course of your career.
You study ambulatory care topics, present solutions to clinical questions, facilitate conferences on core foundational topics, provide short updates on evolving topics, and participate in quality improvement and patient safety initiatives.
Specialty Teaching Rounds
Medicine residents participate in twice-weekly subspecialty teaching rounds with ward teams at all four hospitals.
As part of a ward team, you witness high-level decision and collaboration among hospitalist attending physicians and subspecialty faculty. Through these exchanges, you become familiar with subspecialists, receiving mentorship and gaining exposure to a wide range of medical fields, which may inspire your career choices.
The rounds, conducted in conjunction with an assigned hospitalist, are case based, occur at the bedside, and include critiques of house staff presentations and diagnostic skills.
The Saul and Doris Farber Bedside Teaching Service
The Saul and Doris Farber bedside teaching service is an intensive two-week inpatient rotation at Bellevue that features structured evaluations in a learning environment with a limited number of patients per day.
Teams consist of one resident, two interns, and a hospitalist. During morning rounds, experienced clinicians moderate team case presentations and engage residents in the process of clinical reasoning to avoid diagnostic errors. Physical examination skills are taught at the bedside each afternoon, with residents observing and practicing core elements of cardiac, pulmonary, musculoskeletal, neurologic, and dermatologic examinations.
Interns are given extensive feedback and learn the essential skills of effective case presentation, writing notes for the medical record, and documenting the patient handoff.
Cardiology Teaching Service
During teaching rotations with the cardiology service at Tisch Hospital, you are part of a team of four residents, a fellow, and two attendings. Together you care for up to 16 patients with cardiac conditions. You gain experience diagnosing, evaluating, and treating patients with acute coronary syndrome, angina, atrial fibrillation, aortic dissection, congestive heart failure, hypertension, and ventricular arrhythmia.
Hematology Teaching Service
As part of the ward team on Bellevue’s hematology service, interns and residents participate in teaching rounds with an attending and a fellow to manage the care of 14 patients with blood disorders and cancer.
Your patients include those with newly diagnosed cancers and those with acute blast crisis, as well as patients undergoing routine chemotherapy and transfusions. You discuss issues related to pain management, psychosocial needs, the goals of care, and the overall medical management of malignancies.
At Tisch Hospital, there are separate hematology and oncology services. On rotations with the hematology service, residents work with a senior hematologist and a fellow to care for up to 10 patients with both benign and malignant blood disorders, including conditions that affect red blood cells, white blood cells, platelets, and the clotting system. The patients in your care actively receive chemotherapy or require immunosuppression for treatment in the Rita J. and Stanley H. Kaplan Stem Cell and Bone Marrow Transplant Center, an inpatient unit within Kimmel Pavilion.
Medical Consultation Teaching Service
As a third-year resident, you complete a four-week rotation on the medical consultation service at Bellevue, caring for patients recently released from the emergency department and managing patient flow throughout the medical service. Working under the supervision of faculty, you run codes, work with rapid response teams, and participate in acute care events throughout the hospital.
Residents at Bellevue and VA NY Harbor Healthcare System have targeted 30-minute specialty teaching sessions called OpenConsult. You are part of a team that uses the OpenConsult system to choose a subspecialty, topic, or patient that the team wishes to learn more about and schedule a session with the attending of record for a particular service. Through OpenConsult, instead of receiving teaching from a specialist who is not directly involved in the care of a particular patient, you can discuss the rationale for specific patient care decisions.