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, although because teams usually have acting interns, the average number of patients you typically care for is closer to 6 or 7. Second-year residents generally lead teams that include an intern and an acting intern and care for a maximum of 14 patients. Third-year residents generally lead teams of 2 interns and 1 to 2 acting interns and 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, 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 physicians’ offices and transfers from other institutions.
You spend time on one of four medicine teams, each of 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 clinical focus—pulmonary, infectious disease, general internal medicine, and oncology. You round each morning with two attending 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. Formal teaching rounds with the supervising hospitalist occur daily. Second-year residents complete four weeks of acute medicine in the emergency department, a level 1 trauma center.
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, patients are veterans who seek 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 experience of conferring with the chiefs of different services on patient cases.
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.
At Tisch Hospital, Kimmel Pavilion, and the VA NY Harbor Healthcare System, the CCU rotation is combined with the ICU rotation. These rotations are separate at Bellevue. At the start of 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 primary care track and categorical track residents go through a formal ultrasound curriculum during their second year. There are opportunities to use point-of-care ultrasound (POCUS) during intensive care and other inpatient rotations. A POCUS elective is open to all house staff.