Internal Medicine Residency Inpatient Training | NYU Langone Health

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Internal Medicine Residency Curriculum Internal Medicine Residency Inpatient Training

Internal Medicine Residency Inpatient Training

As part of inpatient training in NYU Langone’s Internal Medicine Residency, residents rotate on the 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.

Interns care for a maximum of 10 patients with a typical average of 6 to 7 patients per rotation. Teams are led by second- and third-year residents who manage two interns and may include an acting intern and two medical students. Teams at Tisch Hospital and Kimmel Pavilion care for up to 16 patients, while those at Bellevue and the VA NY Harbor Healthcare System care for a maximum of 20 patients.

Tisch Hospital–Kimmel Pavilion Inpatient Rotations

At Tisch Hospital and Kimmel Pavilion, residents manage the care of patients under the guidance of experienced internists and subspecialists. Attending physicians who work with house staff are part of the Firm System, NYU Grossman School of Medicine’s faculty mentorship program for medical students and residents, and have been selected to work with residents due to their particular passion and skill for teaching. Most admissions come through the emergency room, with some direct admissions from physicians’ offices and transfers from other institutions.

You spend time on one of five medicine teams, each of which consist of a second- or third-year resident and two interns, to collectively provide 24-hour care for all patients admitted to the service. Each team also receives assistance from a night resident–intern pair.

NYU Langone’s advanced specialty services make it a referral center for advanced diagnostics and therapeutics, so you can expect to see a wide variety of conditions that encompass both common complaints and rare disease presentations. Second- and third-year residents get direct specialty experience through dedicated rotations on the cardiology and hematology ward teams.

Bellevue Inpatient Rotations

At Bellevue, residents treat patients with a range of conditions, including lupus nephritis, endocarditis, heart failure, and newly diagnosed adenocarcinoma. As a second- and third-year resident, you receive supervision from a general internist while leading one of seven general medicine teams. Each team consists of the resident, two interns, and may include an acting intern and two medical students. Formal teaching rounds with the supervising hospitalist occur daily. The teams have night float coverage with three interns who are supervised by a nocturnist hospital attending. Second-year residents complete four weeks of acute medicine in the emergency department, a level 1 trauma center.

Medical Consultation Teaching Service

As a third-year resident, you complete a four-week rotation on the medical consultation service at Bellevue. Under the supervision of faculty, you are responsible for triaging patient flow through the Department of Medicine. You triage admissions from the emergency department and receive transfers from the ICU and outside hospitals who are referring patients for specialty care. You must assess the acuity of each patient and assign them to the various medicine care teams at NYU Langone. You are also responsible for running any rapid responses in the hospital and running codes outside of the ICU. One of the most highly-regarded rotations by our residents, this rotation helps you synthesize and apply the clinical reasoning skills you have learned throughout your time in residency.

NYU Langone Hospital—Brooklyn Inpatient Rotations

At NYU Langone Hospital—Brooklyn, residents on the community health residency track and primary care residency track treat patients on the general medicine wards, medical intensive care unit (ICU), and cardiac care unit (CCU). Residents additionally rotate on the medical consultation service, night float service, and in the emergency department, which is a level 1 trauma center. Each of the six general medicine teams comprises one teaching hospitalist, one senior resident, and two interns who provide care to patients with conditions ranging from common infections and exacerbations of chronic illnesses to complex diseases that require multidisciplinary management. Transition of care from the inpatient setting to the community is emphasized and many patients receive follow-up care in the resident continuity clinics.

VA NY Harbor Healthcare System Inpatient Rotations

At the VA NY Harbor Healthcare System, you care for veterans with 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.

Subspecialty attending physicians are easily accessible for in-depth case discussions. The ward team structure is similar to the other hospitals with full-time hospitalists working with second- and third-year residents to lead a team that consists of a single second- or third-year resident, two interns and depending on the time of the year, an acting intern and medical students. The teams are supported by a senior resident and intern on a night float system.

Attending physicians from various subspecialties typically attend resident conferences 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 and Bellevue CCU, 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 provides opportunities to discuss questions related to patient care or academics.

You rotate through the medical ICU at Tisch Hospital, Bellevue, and the VA NY Harbor Healthcare System. At the VA NY Harbor Healthcare System, the ICU is combined with the Cardiac Care Unit (CCU). At Bellevue, the CCU is a dedicated rotation. Each ICU rotation includes its own lecture curriculum. Patient-centered teaching takes place on rounds with participation from both fellows and attending physicians.

Fellows also run a daily morning teaching conference for house staff that covers core critical care topics. Residents provide input on teaching conferences to ensure areas of particular interest are covered.

Ultrasound Training

All primary care track and categorical track residents go through a formal ultrasound curriculum during their first and second years. Point-of-care ultrasound (POCUS) is integrated into regular inpatient conferences and there are opportunities to use POCUS during intensive care and other inpatient rotations. A POCUS elective is open to all house staff.