Introduction
Hospital Medicine is a growing and dynamic field of Internal Medicine. Expertise in Inpatient Medicine includes efficiency of care for hospitalized patients, broad-based knowledge in the management of acute medical conditions, and the ability to manage and succeed in a team environment to improve patient care.
In order to meet these goals, the Internal Medicine Residency Program offers an Inpatient or Hospital Medicine Track to give this increased focus to your training. As an adjunct to the Categorical medicine training, you will have a dedicated 2 month Inpatient Medicine block in both your second and third years (similar to the structure of the Primary Care Track). You will be exposed to concepts of quality and patient safety, care transitions, risk management, infection control, and effective consultative practice. You will also get direct leadership training and be introduced to medical business practices.
This track is designed for residents who are interested in Hospital Medicine careers as well as those who plan Fellowship training (particularly fellowships with a strong inpatient focus).
The clinical Hospital Medicine rotation will include one-to-one mentorship with a Hospitalist, following a Hospitalist work schedule. There is also a proposed clinical rotation at Hillcrest Hospital to provide exposure to community inpatient practice. The track will include didactics and learning sessions to address many of the competencies of effective inpatient care.
Program Details
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. The Hospital Medicine track is designed to help physicians become effective agents of change in the complex hospital environment by training them to be leaders in coordinating and participating in the assessment, development and implementation of system improvements. Residents will also become proficient in the care of complex hospitalized patients.
- Increased experience in both consultative general medicine and perioperative assessment and care.
- Palliative medicine experience.
- Dedicated experience in hospital system-based competencies such as patient safety, quality improvement, and risk management.
- Dedicated experience in leadership skills including team approaches, multi-disciplinary care, management practices, and professionalism.
- Exclusive one-on-one time spent with experienced academic hospitalists.
First Year
Introduction
Residents will choose to enter the Hospital Medicine track during their PGY-1 year. The Hospital Medicine track includes mandatory Palliative Medicine ward experience, two modules of Internal Medicine Consults, Emergency Department experience, and a 2 module Hospital Medicine block in bot h PGY-2 and PGY-3 years.
Typical PGY-1 Schedule (combination of 13 modules)
- Cardiology Teaching Service: 1 module
- Consult/Outpatient Clinic including Longitudinal Clinic Block: 3 modules
- Coronary Intensive Care Unit: 0 – 1 module
- Emergency Department: 0 – 1 module
- General Medicine Teaching Services (Kimball, Tucker): 1 – 3 modules
- GI/Hepatology Service (Green): 0 – 1 module
- Hematology/Oncology Service: 1 module
- Longitudinal Continuity Clinic (1/2 day per week; clinics for
Primary Care Track residents vary in frequency)
- Medical Intensive Care Unit: 0 – 1 module
- Nephrology: 0 – 1 module
- Neurology (or in GL-2 year): 0 – 1 module
- Palliative Medicine: 0-1module
- Psychiatry: 0 – 1 module
- Vacation: 1 module, includes a float week
Second Year
Second-year residents act as supervising residents for three or four modules, including one module on a General Medicine Service and one module as a Night Float. Second-year residents rotate on subspecialty and general medicine consult services, gaining expertise in consultative medicine. Junior residents work one module in either the Coronary or Medical Intensive Care Unit, under the supervision of a senior resident, subspecialty fellows, and a full-time intensivist. Second-year Hospital Medicine Track residents will add Palliative Medicine ward service and General Internal Medicine consult service if not performed during their PGY-1 year. Second-year Hospital Medicine Track residents will also have a dedicated block of 2 consecutive modules during which includes introduction to the system-based concepts of Hospital Medicine as well as perioperative medicine clinic.
Typical PGY-2 Schedule (combination of 13 modules)
- Consult Services: 3 – 4 modules
- General Internal Medicine
- Coronary Intensive Care Unit: 0 – 1 module
- Hospital Medicine Block: 2 modules
- Longitudinal Continuity Clinic (1/2 day per week)
- Medical Intensive Care Unit: 0 – 1 module
- Neurology (or as a GL-1): 0 – 1 module
- Night Float: 0 – 1 module
- Outpatient Clinic or Research Elective: 0 – 1 modules
- Palliative Medicine: 0 – 1 module
- Supervisor Subspecialty and/or General Medicine Services: 3 modules
- Vacation: 1 module, includes a float week
Third Year
Third-year residents act as supervising residents for five modules, including two to three modules on General Medicine Services and one module as a Night Float. Senior residents act as supervisors for one module in the Medical Intensive Care Unit. Third-year residents work one module in the Emergency Department. Third-year Hospital Medicine Track residents will spend 2 modules working one-on-one with academic hospitalists on the General Internal Medicine private service.
Typical PGY-3 Schedule (combination of 13 modules)
- Attendance at CCF IM Board Review Course in June (1 week)
- Clinics, Consults, Electives or Research: 4 – 5 modules
- General Internal Medicine
- Emergency Department: 1 module
- Hospital Medicine Block: 2 modules
- Longitudinal Continuity Clinic (1/2 day per week)
- Night Float: 0 – 1 module
- Supervisor General Medicine Services: 2 – 3 modules
- Supervisor GI/Hepatology (Green) Team: 0 – 1 module
- Supervisor Medical Intensive Care Unit: 1 – 2 modules
- Vacation: 1 module, includes a float week
Longitudinal Continuity Clinic
All residents in the Hospital Medicine Track are responsible for ambulatory outpatient clinic half a day per week throughout the three years of training. Residents have clinic either at the Cleveland Clinic main campus or at a Cleveland Clinic Family Health and Surgical Center. These Family Health and Surgical Centers are located throughout the greater Cleveland area and make up the Division of Regional Medical Practice. These Family Health and Surgical Centers provide an excellent setting in which to experience the delivery of primary care to the community.