What Sets Us Apart
One of the country's premier residency training programs, the Weill Cornell Medical College Internal Medicine Residency Program is distinguished by a unique combination of activities and opportunities that set us apart. One of our core principles is that housestaff learn best through authentic responsibility. House Staff serve as the primary provider across all aspects of patient care. Please click on the headings below to learn more about Academic Time, Ambulatory Education, Global and Rural Health Offerings, Core Conferences, Quality Improvement and Patient Safety, as well as a special feature on Resident as Leader/Resident as Teacher.
- Academic Time
- Research Curriculum
- Ambulatory Education
- Global and Rural Health Offerings
- Simulation Program
- Quality Improvement and Patient Safety Experience
- Education and Learning at the Center
The innovative core curriculum for the residency program is done through weekly Academic Time. Each year of training has a dedicated 90-minute session every week to actively learn about key topics. All sessions run from 12 to 1:30 PM.PGY1s meet on Wednesdays, PGY2s meet on Tuesdays, and PGY3s meet on Thursdays. Residents are expected to prepare for each session through short reviews on the topics. They hand off their pagers before they arrive so they can concentrate on learning. The sessions vary but generally include a short mini lecture on the topic followed by team work to complete the uniquely developed workbook of patient cases to highlight the most important teaching points. Each curriculum is led by two high-energy medical educators and invited faculty experts on each topic. Sessions might also include board-like knowledge questions using an audience response system, interactive debates about best practice, timed races to find the relevant literature, and cost analysis of different diagnostic or management strategies. A new initiative to include iPad learning and multi-touch books is being launched in 2014-2015.
The curriculum provides almost 150 different topics over three years and is developmentally targeted to the year of training. For example, the intern curriculum includes fundamental topics like hyponatremia, acute chest pain, rapid atrial fibrillation, and delirium. The PGY2 residents wrestle more complicated topics like infective endocarditis, lupus nephritis, multiple myeloma, and autoimmune hepatitis. PGY3 topics expand to include fungal infections, leukemia, sarcoidosis, and transplant medicine.
Academic Time are enhanced by the weekly conference schedule of morning report, Radiology and Pathology Clinical Conference (autopsy based), Value in Practice (high value care journal club), Grand Rounds, Patient Safety Conference, Journal Club, Chairman's Conference, and Senior Seminar Series.
Residents are active learners in all of these conferences with strong faculty participation. A different faculty member serves as the guest attending each week for morning report with many of the hospitalists also attending and joining in the discussion. Morning report includes a Medical Librarian, Josh Richardson, who finds and distributes relevant medical literature after each conference.
Research Core Curriculum
Upper level residents can select as an elective the Research Core Curriculum. This elective includes a two-week block of intensive didactics and hands on sessions to learn the basics of doing hypothesis-driven research. Intensive mentoring is provided to each resident not only in the field of medicine, whether clinical research, basic science, or translational work but additionally around the research methods, including IRB submission, basic statistical concepts, data management, and manuscript preparation. Dr. Stephen Wilson, an infectious disease specialist and epidemiologist, directs the course with the assistance of Dr. Marshall Glesby and Dr. Mary Choi. Residents may choose to work on a project of their own design or to collaborate with one of many mentors across the specialties within the Department.
In an effort to improve the continuity of learning and sense of immersion into the outpatient setting, ambulatory education has been designed into 2-week blocks alternating with 6-week non-ambulatory assignments for the PGY1 and PGY3 residents. Trainees can anticipate their outpatient practice time for the entire year and cover 3-4 colleagues, their "pod partners," during their assigned block time. With a total of 12 weeks of ambulatory block time as an intern and then again as a senior, residents become fully engaged in their outpatient practices with an emphasis on continuity and ownership for their panel of patients.
Housestaff serve as the primary provider across all aspects of a patient's care, following their patients throughout their residency, maximizing continuity and the longitudinal relationship. Each of our three different outpatient practice sites is a fully integrated resident/faculty practice where patients of all payer types are seen (30% Medicare, 35% Medicaid and 35% private practice).
Housestaff become proficient in managing the spectrum of outpatient medicine and decision-making, including triage, telephone communication, and the transitions between inpatient and outpatient care. The Housestaff’s role is that of the practicing clinician.
Residents can choose between three available clinical practices:
- Weill Cornell Internal Medicine Associate (WCIMA), in the Helmsley Medical Tower (located across the street from NewYork-Presbyterian Hospital), is a large hospital-based academic general internal medicine practice.
- WCIMA Wright Center is a smaller satellite practice of Helmsley Tower. Located on First Avenue and 77th Street, this practice is nearly identical to the Helmsley Tower practice with the exception of its size and its ability to draw patients more locally from the Upper East Side.
- Long Island City Health Center (LICHC) is a federally qualified health center located in the northwest section of Queens. This multidisciplinary practice offers adult medicine, pediatrics, and obstetric/gynecology services to an ethnically diverse and medically underserved patient population. LICHC is committed to improving the health of its surrounding community and is located approximately 15 minutes from the main hospital campus. Residents are provided transportation.
Global and Rural Health Offerings
The Center for Global Health within the Weill Department of Medicine is part of the NIH Global Health Network and supports major international programs in Haiti, Brazil, and Tanzania. These long-standing international partnerships provide a wide-range of research and clinical activities for the internal medicine residents. Residents return feeling transformed by the experience of working in these resource-poor systems.
Third-year residents have the opportunity to participate in any of the three structured international health rotations under the supervision and direction of Weill Cornell faculty members.
- Bugando Medical Center and Weill-Bugando University College of Health Sciences (WBUCHS) in Mwanza, Tanzania , a large regional teaching hospital in East Africa
- Le Group Hatien D'Etude du Sarcoma de Kaposi et des Infections Opportunistes (GHESKIO), in Port-au-Prince, Haiti, an HIV research and clinical care site
- Federal University of Bahia's School of Medicine in Bahia Brazil, a medical research laboratory working on tropical diseases and public health efforts
The program supports other international medical rotations if residents wish to pursue experiences in other locations and has a Global Health Interest Group with focused topic discussions and two social events annually.
In addition to the global health opportunities, the Weill Department of Medicine has partnered with the medical community near Cornell University's main campus in Ithaca, New York, to provide residents with an opportunity to learn rural medicine and true community practice. The Cayuga Medical Center in upstate New York is a high-quality medical center with strong ties to the community, including the migrant farm workers in the surrounding area. Gannett Health Service, the student health practice on Cornell's main campus, offers electives in adolescent medicine, women's health, and behavioral medicine. The clinician-educators based at Cayuga are wonderful teachers and role models, all with Weill Cornell clinical faculty appointments. Residents rave about their experiences there.
Under the direction for Dr. Kirana Gudi, aided by Dr. Kapil Rajwani and Dr. Lindsay Lief, a comprehensive simulation program is offered with three primary components: bedside procedures, ultrasonography, and code team training. Bedside procedures, like thoracentesis, paracentesis, lumbar punctures, and central lines, are the domain of the well-trained internist. These skills are taught through hands on workshops using simulation models. Each intern is directly observed doing a central venous catheter insertion to ensure competence before performing this on patients.
Over the course of the intern year, each trainee will become adept at using bedside ultrasonography as an extension of the physical exam. In addition to visualizing the heart, lungs, and other organs, ultrasonography as an aid to bedside procedures is best practice to ensure safe care with these invasive tools. Residents also learn to recognize the hallmark signs of pericardial tamponade or RV collapse from pulmonary embolism, among others, to inform their clinical decisions and initiate treatment early.
Code Team Training
Finally, the internal medicine residents serve as the primary leaders for in-hospital codes. As part of the inter-professional team training and the patient safety curriculum, residents participate in once monthly mock codes in the hospital to hone their code leadership skills and managing a team in a crisis. Led by Dr. Oren Friedman, the mock codes consist of having the overnight code team called to an empty bed where a simulation mannequin sits in lieu of a real patient. The nurses, pharmacists, respiratory therapists, and others on the code team respond as if it were a real code with the entire event video taped for a short debrief after the exercise. The training helps reinforce closed loop communication and smooth execution of high-pressure life or death events. The residents are proactively taught these skills in a simulation-based retreat at the end of the PGY1 year so they are comfortable with ACLS protocols and the communication required to manage a coding patient.
Quality Improvement and Patient Safety Experience
Chief Resident of Quality and Patient Safety
In today's era of an ever-changing healthcare environment, it is critically important that physicians understand society's expectation for them to be advocates and leaders of an improved system of care. The residency program puts an emphasis and quality improvement and patient safety with the goal of having every graduate well versed in the concepts of improvement sciences, process mapping, and how to lead important changes to improve the delivery of healthcare to our patients. As part of this commitment, we have a dedicated Chief Resident of Quality and Patient Safety (CRQPS). This Chief Resident serves as in important leader for Department and Hospital level improvement efforts. In addition, the CRQPS is integrally involved in providing the residents with a dedicated curriculum on quality improvement and patient safety.
QI and Patient Safety Curriculum
In the outpatient arena, residents work in teams to develop relevant projects for improving the patient care systems in the outpatient practice. Using the Plan-Do-Study-Act model, they are encouraged to do rapid cycle improvements toward sustainable change. Throughout the training, resident revisit these concepts and apply them to inpatient projects and key priority improvement efforts for the hospital and inpatient wards.
Patient safety practices are promoted throughout the program From the daily Handoff Rounds where residents are observed and coached in the handoff process to the close monitoring of best practice documentation in the electronic medical record, residents learn to observe health care delivery through a lens of safety and improvement. The Patient Safety Elective provides an in-depth look at how a hospital works. Resident have the opportunity to become a patient safety expert, collecting reports from colleagues about patient care incidents and attending a variety of high-level meetings on how system improvements take shape. The safety resident performs safety “consults” on the events brought up, working to identify the various contributors to these events and the works to develop and implement system-level fixes to the problems that led to the near miss or medical error.
Education and Learning at the Center
The weekly core conference schedule includes morning report with residents Monday through Thursday and with intern report on Friday mornings. In addition, the weekly offerings include Medical Grand Rounds, Chairman's Conference, the Senior Seminar Series, Journal Clubs, Patient Safety Conference, an autopsy-based Radiology and Pathology Conference and the newly added Value in Practice conference to discuss high value care principles. The Program Director offers weekly office hours for residents to drop in and discuss what’s on their minds. Cookie Rounds on Tuesday afternoon are another opportunity for residents to meet with the Chief Residents and program leadership to chat. The schedule provides multiple opportunities to learn medicine and debate clinical controversies within the program’s strong community of learning and community of practice.
Residents as Leader: Residents as Teacher
The Weill Cornell Internal Medicine Program additionally emphasizes its academic mission in training the next generation of physician teachers and physician leaders. The program's graduates have a long tradition of becoming leaders in academic medicine.
As part of the PGY1 retreat every spring, residents learn the fundamental skills of clinical teaching including creating a good learning environment, communicating goals, evaluating learners, and providing effective feedback. The PGY2 retreat every spring teaches residents important lessons in leadership, active listening, facilitating, and managing change. These activities explicitly demonstrate the power of teamwork and collective thinking, skills that are essential for physicians in the 21st century.
Resident as Clinician Education Rotation
Third year residents are additionally invited to choose the Resident as Clinician Educator rotation, an inpatient general medicine rotation where one senior resident acts as the "junior attending" to a team of one intern and one subintern. The resident is coached by the team's attending on teaching skills and bedside learning. This rotation is among the highest rated; residents are given a tremendous amount of independence in clinical decisions and managing the learning environment.
Cathy Jalali, a cognitive scientist with expertise in medical education, serves as a resource to the department to ensure best practice teaching by the faculty with the focus of promoting critical thinking and active learning. She observes rounds to provide important tips to both residents and faculty aimed to enhance learning. She assists residents in their scholarly pursuits as well by shepherding IRB submissions and helping design targeted, deliverable research projects. For those interested in medical education research, ample opportunity exist within the Division of Education to participate in scholarly projects.
The Housestaff Committee is another leadership opportunity for residents. This self-organized group of residents serves as an advisory council for the program. With 5-6 elected representatives from each PGY class, this committee is instrumental in all key changes for the residency program. A president and vice-president manage the work of the group. We additionally have resident representatives on hospital and departmental committees including the Housestaff Quality Council, the Code Committee, and the Quality Improvement and Patient Safety (QIPS) Committee.
General Contact Information
Weill Cornell Medical College
Weill Department of Medicine
525 East 68th Street, Box 130
New York, NY 10065
530 East 70th Street, M-528
New York, NY 10021
Tel: (212) 746-4749
Fax: (212) 746-6692
Steve Wilson, MD, PhD
Director of Research Core Curriculum
Marshall Glesby, MD, PhD
Liaison for Clinical Research
Mary Choi, MD
Liaison for Basic Science Research