INTERNAL MEDICINE RESIDENCY PROGRAM PHILOSOPHY New York Medical College (Richmond) Residency is an ACGME fully accredited and approved three year training program designed to train people who are interested in primary care or entering any of the variety of internal medicine subspecialty fellowships. The primary site for the internal medicine training program is Richmond University Medical Center in Staten Island New York. The goal of the training is to prepare our residents to be physicians for adults from all walks of life, and/or to enter training in one of the internal medicine subspecialties. We want our graduates to be skilled at clinical assessment, evaluation, and therapeutics, and to function and communicate empathetically. All requirements of the Residency Review Committee for training in Internal Medicine are fulfilled, and all graduates are eligible to sit the American Board of Internal Medicine certifying examination. During the three years of training, Richmon University Medical Center’s internal medicine residents have the opportunity to learn all aspects of medical care delivery necessary to function well as an internist. Throughout the three years of residency, residents learn ambulatory care by participating as primary care physicians to patients in the continuity clinic located at the RUMC site. At the beginning of every continuity clinic session, a general medicine topic is reviewed and presented to the residents who are participating in that clinic session that day. In addition, residents do several block rotations in which they learn those aspects of non-internal medicine specialties, such as gynecology, orthopedics, ophthalmology, dermatology etc. that are essential for primary care internists to understand. All residents attend the daily core curriculum conference, which is organized according to subspecialty blocks. In addition there are conferences that emphasize and teach how to improve interview skills and how to deal with emotionally-difficult aspects of patient care; sessions that teach cultural competency, and a monthly death and dying conference held in conjunction with the risk management, nursing, pastoral care, patient relations, and social work. Full-time internal medicine faculty supervise the residents on the wards. Each clinic session has two regular general internal medicine faculty supervisors. SIZE AND SCOPE
The NYMC (Richmond) Internal Medicine Residency is sponsored by New York Medical College and takes place at Richmond University Medical Center, a hospital with approximately 200 beds in the Department of Medicine, including 10 Intensive Care Unit beds, 10 Coronary Care Unit beds, a cardiac catheterization laboratory, a pulmonary function laboratory, a sleep center, an endoscopy suite, and fully equipped laboratory and radiology departments. All levels of training and all rotations involve both outpatient and inpatient management. Approximately 33% of total training time is in ambulatory settings and 66% involves inpatients. The hospital load includes sufficient housestaff-managed patients to provide an adequate experience of patients with all varieties of internal medicine problems, but does not produce an overwhelming service need. The number of AIDS patients has been constant at a low of approximately 5% of the in-patient complement. Outpatient experiences include two continuity clinics a week for each resident. Every resident goes to his/her continuity clinics no matter what rotation he or she is doing. Each resident follows a panel of patients which is assigned to him or her throughout the three years of residency. In the 2nd and 3rd years, residents go to outside preceptors, who are doctors in practice in Staten Island, for their 2nd continuity clinic. After hours, one of the residents on call holds the “clinic beeper” and is available at all times to any clinic patient who is having a problem. That resident will speak to the patient, take care of any acute problem, and then notify the primary care resident that his or her patient had a problem when he/she returns to the hospital. If a clinic patient is admitted to the hospital, that patient’s primary care resident is notified, and he/she is required to follow the patient and be aware of what happens during the patient’s hospital admission. DAILY ROUTINE The day begins with Morning Report, from 7:30-8:30 a.m., followed by Work Rounds and then Teaching rounds daily from 10:00 a.m.-11:30 a.m. Every day at 11:30 a.m.-12:30 p.m. there is a conference in the Bloomfield Conference Room. The entire Internal Medicine curriculum is reviewed in block didactic sessions over the course of the academic year. There is a monthly Radiology/Medicine conference, a two month Emergency Medicine course held in July and August, a monthly Journal Club, a Research Course, and several case presentations. Endorsement rounds are held at 4 p.m. as each floor turns over their cases to the team on call that night for that floor. ON CALL SCHEDULE The schedule meets all New York State requirement for housestaff work hours. PGY1s are usually on call until 9pm when the night float takes over, unless they are rotating in the ICU or CCU when they are on call over night every 4th night. Each PGY1 resident has at least four weeks of elective, and more during the PGY2 year. PGY3
residents have elective without night or weekend call at least eight months out of twelve. Every resident has four weeks vacation each year. OTHER BENEFITS Permanent inexpensive living quarters for housestaff are located on the grounds of the Hospital only a minute away. Every resident has full medical and dental coverage, and receives a tax-free meal allowance, a book allowance, and money and time for conferences during the second and third years of residency. FACULTY Full time board certified staff are employed in the areas of greatest intensity of service (e.g. General Internal Medicine, Intensive Care Medicine, Cardiology, Hematology/Oncology, Gastroenterology, Infectious Disease). All medical subspecialties, including General Internal Medicine and Ambulatory Medicine, are headed by division chiefs salaried for the purpose. In addition, the program is supported by a large number of mature, well trained, Board certified, actively involved attending teachers holding faculty appointments at New York Medical College. TESTING The teaching program is intensive and extensive. The conference schedule (as described above) includes monthly quizzes on each subject, with regular feedback to the housestaff regarding test performance. Those residents who are having test-taking difficulty are identified early and referred for evaluation and education to a group of educational psychologists at the Robert Wood Johnson Cognitive Skills Department. Each year the housestaff sits the national In-training examination and the results are reviewed with each resident. Problem areas are identified and each resident is required to prepare a study plan in conjunction with the Program Director based upon personal performance on departmental and national tests. EVALUATION The performance of housestaff on the general rotation, specialty rotations, and outpatient clinics are evaluated monthly by the Teaching Attending supervising those programs, full time Faculty, Chief medical Residents, other residents, and the nursing. Physical examination skills are evaluated during the first year. Each PGY1 is required to do 4 mini-clinical competency examinations in order to be promoted to PGY2. Written histories and physicals, consultations and progress notes are evaluated and reviewed with residents quarterly. Interview skills are evaluated in small group sessions using role play techniques. MEDICAL STUDENTS Medical students from New York Medical College and SUNY/Health Science Center of Brooklyn (Downstate Medical Center) do rotations and a variety of electives at
the Hospital. Residents are responsible for working with no more than one medical student at a time. RESEARCH The Department of Medicine has a Research Division and a formal course in conducting clinical research is provided to all residents. Every resident who completes the three year program is required to participate in a research project. Special instruction is provided by a unique method of conducting Journal Club with analysis of not only the medical content of the work, but with critical instruction in medical literature review following evidence-based medicine principles. All housestaff are instructed in computer literacy, and there is computer access available to housestaff 24 hours a day. All internal medicine residents have electronic access to the New York Medical College electronic library, which includes many online journals. FUTURE PRACTICE Housestaff members remaining in Staten Island who wish to enter Primary Care practice are assured Attending privileges at Richmond University Medical Center. Many residents develop close relationships with primary care attendings during their three years of residency and then go into practice with an attending after graduation. Staten Island is also the home of the Staten Island Medical Group, a large health maintenance organization, which is included in our teaching program, and is available for graduates who wish to work as primary care physicians in a managed care setting. STATEN ISLAND AS A COMMUNITY Richmond University Medical Center is located in a residential area along the North Shore of Staten Island. The community itself maintains a unique flavor, close to the activity of Manhattan, yet with a country-like atmosphere of parks, wooded areas and small town living. Unlike many other sections of New York City, Staten Island has an abundance of good neighborhood private and public schools where stable, high quality teaching skills provide for a strong and diversified educational system. Opportunities for relaxed family life and individual recreation are in great supply with the availability of boating, horseback riding, the Staten Island Zoo, nature trails, historical tours, golf courses, tennis courts, and a variety of playing fields. The excitement and flavor of Manhattan are only a brief ferryboat ride across the Hudson River channel, or a short drive over the Verrazano-Narrows Bridge, while the Jersey Shore is just a few hours away via Staten Island’s three New Jersey crossings: the Goethals Bridge, the Bayonne Bridge and the Outerbridge Crossing. You’ll enjoy living in Staten Island and working at Richmond University Medical Center.
Call (718) 818-2419 for further information about applying for residency