Internal Medicine Residency Didactics | Palisades Medical Center

The Internal Medicine Residency at Hackensack Meridian Health Palisades Medical Center is of 36 months duration. The program is hospital based and follows the Internal Medicine Track as identified by the Accreditation Council for Graduate Medical Education (ACGME) which includes the following:

• Residents are required to spend a minimum of 130 distinct half-day sessions in outpatient Continuity Clinic over the course of at least a 30-month period. Our program will achieve 180 distinct half-days with the current PGY-1 to PGY-3 rotation schedule. In these sessions, the residents function as the primary caregiver for patients, some of which they will have seen as inpatients, on an ongoing outpatient basis. This is achieved in the Internal Medicine faculty physicians’ ambulatory clinics, where the attending physician will: supervise, discuss management, review all charts, and enhance the residents’ education including diagnosis, treatment, billing, coding, and health prevention efforts common in the outpatient setting. Ambulatory clinic logs must be kept by all residents (recorded in New-Innovations).
• PGY-1 year: Internal Medicine Floors (20 weeks), Cardiology (4), Neurology (4), ICU (5), Internal Medicine Night Float (6), Women‘s Health (2), and Ambulatory medicine (7).
• PGY-2 year: Internal Medicine Floors (16 weeks), Internal Medicine Night Float (6), ICU (5), Endocrinology (4), Gastroenterology (4), Infectious Disease (4), Nephrology (4), Geriatrics (4), and Ambulatory medicine (5).
• PGY-3 year: Internal Medicine Floors (15 weeks), ICU Nights (5), Hematology/Oncology (4), Pulmonology (4), Rheumatology (4), Emergency Medicine (4), and Ambulatory medicine (4). Opportunity for 1 month outside elective (4).
• All residents will participate in the annual resident In-Service exam (IM-ITE) sponsored by the American College of Physicians. (Administered late August to early September)
• All residents are required to complete a scholarly project to be reviewed and approved by PD/APD and presented at a scientific meeting (Example: NJACP Chapter Residency Abstract poster competition) or publish an original research/review article in a peer-reviewed medical journal.

Morning Report

Our residency program’s main educational activity that occurs Monday through Friday from 7-8 AM via a hybrid in-person and virtual model. The format generally begins with a presentation of a recently admitted patient with interactive discussion, addressing important aspects of the history and physical examination, formulation of a complete differential diagnosis, and management of the disease process in the individual patient.

Morning report also integrates a didactic program presented via lectures. The didactic session is based on the ABIM curriculum, MKSAP 19, and augmented with sources such as Harrison’s Principles of Internal Medicine. Faculty members and chief residents facilitate this activity with all levels of trainees (PGY1s, PGY2s, and PGY3s, Family Medicine as well as Transitional Year residents)

Education Conferences

Monday: PGY-3 Board Review (9-10 AM)

Held weekly, catered to PGY-3s, and held by one of our senior hospitalists, prepares the PGY-3s for the upcoming ABIM Board examination via discussion of the UW questions

Monday: EKG lecture series (8-8:30 AM)

Catered to PGY-1s, a senior resident reviews the Basics of an EKG, the interpretation of normal and abnormal EKGs in a systematic way to strengthen their clinical acumen in regards to EKG interpretation

Tuesday: Medical Jeopardy (7-8 AM)

Held on the first or Second Tuesday of every Block, a fun in person activity for all the residents to participate in. Hosted by the Academic Chief Resident in a Game Show Based Format. Needless to say, the team that wins gets a prize!

Tuesday: Subspecialty Lecture (12:30-1:30 PM)

Weekly Attending lectures are generally held on Tuesday (usually) or Thursdays. These are catered to Internal Medicine Subspecialties - in-patient and outpatient medicine. Lecturers are faculty members who present topics from a planned 36-month curriculum designed to provide each resident with a broad knowledge base of Internal Medicine. The conferences are directed at providing information pertinent to the ACP-ITE in-service exam, ABIM examination, and future clinical practice.

Wednesday: Grand Rounds or M&M (8-9 AM)

Grand Rounds are held every Wednesday morning. Speakers may be either from Hackensack Meridian Health Network or out of network distinguished guest speakers.

Morbidity & Mortality conference is held monthly on the last Wednesday of each month. PGY-3s present cases with unexpected or unusual outcomes with the intent to avoid future adverse outcomes and improve the quality of patient care.

Thursday (Once a Month): Journal Debate (7-8 AM)

Journal Debate is held on the third Thursday of every didactic Block. A healthy debate about a prompt announced at the beginning of every Block with 2 teams discussing 1 article each, with an aim to answer the clinical question announced in the prompt. Needless to say, the team that wins gets a prize from the judges (A Panel of 2 attendings and the chief)!

Thursday (Once a Month): Quiz (7-8 AM)

Quiz is held on the last Thursday of every didactic Block using Socrative, an interactive web based software. The curriculum encompasses the topics discussed during the entire Block. The Academic Chief Resident monitors the scores.

Thursday: POCUS Lecture (8-9 AM)

Held by one of our senior intensivists Dr. Perry, this lecture caters to the basic POCUS principles in regards to cardiac, lung, and abdomen examinations. Residents also learn how to insert Central Venous Catheters on a mannequin. How to rule in or rule out DVT is also taught and mastered by the residents. This is catered to residents posted on electives/ambulatory rotations.

Friday: Board Review (7-8 AM)

Board Review: Faculty Members hold a weekly board review session. Board-review sessions concentrate on the ability to appropriately decipher and answer board style questions, using the latest version of MKSAP 19.

PEAC modules

These are modules designed by the John Hopkins catered to Outpatient Medicine. They are made available to the residents posted in the ambulatory rotation for free to further their knowledge on the commonly encountered chronic diseases.