Internal Medicine Residency
Curriculum
Educational Conferences and Scholarly Work
Noon Report
Noon Report is led by a Chief Resident everyday Monday through Thursday. The Program Director is in attendance each day and the Department Chair and general and subspecialty attendings are in frequent attendance. The 50-minute session is case-based and devoted to in depth clinical reasoning with a focus on problem representation and the development of focused differentials. Sessions are highly interactive and make use of buzz groups, small group activities with report out, and cold call. Short didactic components are utilized to highlight important concepts and to fill in knowledge gaps. The material presented is high yield for the Boards and many teaching pearls come directly from MKSAP. Focused clinical questions are also posed and answered. Teaching pearls are uploaded to the resident blog at the end of the week, and residents have used this blog during their Boards prep. The educational philosophy of morning report is in line with adult learning theory: problem based, learner focused and highly interactive.
Practicing bedside echocardiography with Dr. Smith at morning report
Academic afternoons
Starting with the 2019 academic year we have done away with didactic lectures that are less effective for retention and are in the process of replacing them with learner-centered, interactive sessions. Our academic afternoons serve to complement our Noon Report by offering 2 separate curriculums for interns and residents. Intern sessions focus on knowledge and skills acquisition for commonly encountered care situations. Knowledge topics include stroke, hypotension, bleeding, fever, etc. and skills sessions focus on ECG analysis, CXR reading, ACLS drills and systems training. The resident curriculum’s focus is on deepening and broadening your fund of knowledge and pushing you to understand and be able to employ evidence-based medicine. Sessions include time to recap the previous week’s learning points, time for residents to teach each other, a block of time for residents to work through a nested case in small groups and then facilitated debriefing with a subspecialist to review areas of confusion and to address questions that arose.
Chief Resident, Dr. Hakim, teaching at the board
Ambulatory care curriculum
Focused didactic/experiential learning is built into the 2-week ambulatory blocks in protected half days. Many of these sessions utilize the Internal Medicine curriculum from Johns Hopkins. These modules include pre and post-tests to enhance learning. Other faculty-led sessions include procedure workshops, women’s health, implicit bias training, humanities in medicine and experiences targeted to increase understanding of health disparities and the social determinants of health. Like our other curricular activities, we are currently in the midst of writing interactive cases to enhance engagement and retention. These cases promote the concept of a ‘flipped classroom’ where learners teach themselves through engagement with the material and the teacher serves more in the role of facilitator. Residents also spend time reviewing their own practice patterns through chart audit.
social medicine lecture series
In addition to our conferences focused on clinical reasoning, medical knowledge and evidence-based medicine, we have a complementary series that builds other skills needed to be an outstanding physician. We have a Residents as Teachers series that includes various topics including feedback on performance and on oral presentations, teaching without time, clinical reasoning 101, micro-skills of teaching, bedside teaching and more. We have a Residency Wellness series that incorporates resident facilitated, small group “healer’s art” sessions, as well as large group sessions on mindfulness, patient story and more. And lastly, we have a social medicine lecture series that includes topics in social determinants of health, care of the homeless patient, care of African American, Vietnamese and Latinx patients, custody medicine, LGBTQ care and more.
Research and scholarly activity
All residents are involved in quality improvement projects beginning with chart audits. Although other scholarly activity and research is not mandated, it is strongly encouraged. SCVMC’s robust academic culture allows our faculty to serve as mentors guiding residents through various projects including patient case-series and retrospective reviews, meaningful QI work, presentations at national conferences and societal meetings, and competition at regional meetings where many of our residents have received awards and recognition. The residency works to facilitate this mentorship with faculty either here at SCVMC, at Stanford, or in the community. Please follow the link Resident Research to see a list of the scholarly activities produced by our residents.
South Bay weather – BBQs year round!
Evidence-Based Medicine
Evidence-based medicine is woven into noon report, teaching on the wards and our academic afternoons. The backbone of much of this teaching is Professor EBM, a compact and high-yield resource for learning and teaching evidence-based medicine. This resource, developed and continually updated by our faculty, is used by other institutions as well and is a tremendous resource for residents and faculty alike. Click here to view the Professor EBM website.
Morbidity and Mortality Conference (M&M)
The Morbidity and Mortality conference is held monthly by the Department of Medicine. Cases from the general medical wards and critical care units are discussed based on interest, teaching value, postmortem findings and hospital complications. Residents present the cases, review of radiographic findings are discussed by our radiology colleagues, Medicine faculty discuss pathophysiology, disease management or treatment options relevant to the case, and members of the pathology attending staff discuss the postmortem findings. Pertinent articles from the medical literature are provided as well. Each case lends itself to different structures and teaching points. The focus may be on knowledge gaps, cognitive biases, and communication problems or systems errors. The sessions are non-punitive in nature and are focused on creating systems change.
Board Preparation
We approach boards prep as a 36-month process, rather than a last-minute dash. Early in the year we have a 1-hour session that teaches residents the best way to work through question modules like MKSAP to ensure understanding, retention and mastery. Our lecture series are mapped out to the ABIM blueprint to ensure we cover as much material as possible. Many teaching points are taken directly from MKSAP and we weave relevant questions into our Noon Reports. We also offer residents individualized sessions that help identify learning and testing strategies through structured reflection. Does it work? Yes! Our 3-year rolling pass rate is 96%.
2016 Northern California ACP clinical vignette competition