While the major emphasis of our program is bedside learning alongside a teaching attending, we also have an extensive written curriculum that is competency-based and is supplemented by an interactive, on-line educational program consisting of case-based topics that reflect common inpatient and outpatient experiences. Through our on-line curriculum, our residents can address a wide range of topics with time for reflection and self-study. Inpatient and ambulatory topics are assigned to all residents weekly and reviewed by specialists in each field.
Clinical Skills Assessment Program
All interns are required to participate in the Clinical Skills Assessment Program, which is divided into three separate sessions:
- Part A is done during the beginning of internship. Interns are observed while performing a complete patient assessment in their continuity clinic, with emphasis on the importance of history-taking, physical exam skills, clinical reasoning, and formal presentation. Immediate feedback is provided to each intern by the preceptor.
- Part B focuses on teaching interns communication skills, specifically: delivering bad news to patients, the use of facilitative behavior, educating patients about their illnesses, and being attentive to cues and body language. Interns are videotaped during six clinical scenarios with patient instructors and are provided with feedback at the completion of the exercise. Additionally, as part of Clinical Skills Part B, the program places special emphasis on teaching sensitive examination skills and techniques.
- Part C occurs during the mid to late PGY2 year and involves a series of patient encounters focusing on common ambulatory presentations. Feedback regarding the resident’s ability to take a thorough yet concise focused history, perform a focused physical exam, develop a management plan, and counsel their patient effectively is provided by both the patient instructor and faculty
Personal and Professional Development Program
Residents must learn to balance the demands of their professional careers and their personal lives. Our educational philosophy emphasizes both personal and professional growth and is supportive of our residents’ personal time and interests. Under the guidance of trained faculty, all interns participate in a series of retreats designed to facilitate discussion on the stresses of internship, their perceptions of the program, and their personal feelings and concerns. Other highly valued retreat topics include preparing for the fellowship application process and getting involved in research, recognizing and managing stress, legal and ethical issues, end-of-life discussions, and transitioning to residency. These retreats are scheduled during the PGY1 year and are considered by the residents to be a very important part of their education. Similar morning retreats continue through the PGY2 and PGY3 years and deal with other aspects of medical education including medical errors, professionalism, residents as teacher's and debt management and financial planning.
Scholarly activity begins in the PGY1 year of all the Medicine Programs and grows exponentially. The PGY1 residents are required to present a case in intern morning report at least once a month during inpatient rotations. Evidence-based Medicine is the standard and literature review is expected during case presentations. Interns are encouraged to present case reports, vignettes, and abstracts at local and/or national American College of Physicians (ACP) or Society of General Internal Medicine (SGIM) meetings. Journal Club presentations are also required of our interns, who are mentored by faculty on how to critically analyze, interpret, and formally present current literature. In the PGY3 year, residents are expected to prepare a noon conference with the assistance of a faculty mentor and present this to their peers at the three major affiliate hospitals during the Summer Survival noon conference series, as well as to prepare for a Grand Rounds presentation.
A unique curriculum offering during the internship year is our “Scholarship in Medicine” rotation. This rotation is designed to introduce the intern to the concepts of Evidence-Based Medicine, quality improvement, and elements of research design and statistical analysis. Throughout this one-month rotation, interns learn skills that enhance their ability to use medical informatics, critically appraise the literature, engage in Quality Improvement projects, and develop and design sound research projects; all skills they will continue to use throughout their residency and in their future careers.
While it is easy for residents to meet the minimum requirement of scholarly activity throughout the residency, most residents go above and beyond what is expected. Development of residents’ leadership and teaching skills is encouraged throughout their training. At the completion of three years of residency, our residents are well-trained in formal presentations, comfortable with critical analysis of the literature, know how to access the most current medical information and, most importantly, are effective at teaching others these skills.
Research and publication are desirable components of the educational process. Abundant opportunities for elective rotations are available at UConn Health and its affiliated hospitals for residents interested in research. Many of our residents publish in peer-reviewed journals or present their work at national or regional professional meetings. Because we are a springboard for subspecialty training, our Internal Medicine Program residents who intend to pursue fellowship training are encouraged to explore research experiences in their specific subspecialty interest. A maximum of two months in research is available during elective time.
Subspecialty Fellowship Opportunities
The subspecialties in Medicine at UConn offer a full range of fellowship opportunities. Positions are available in Cardiology (including Interventional Cardiology and Heart Failure), Endocrinology, Gastroenterology, Geriatrics, Hematology/Oncology, Infectious Diseases, Nephrology, Pulmonary and Critical Care Medicine, and Rheumatology. Each fellowship combines intensive clinical experiences with clinical and/or basic science research opportunities. Each of the fellowships is integrated to involve our affiliate hospitals, thereby insuring a broad spectrum of clinical experiences. To gain additional subspecialty experiences, our program offers the unique opportunity to participate in longitudinal clinics in a given specialty. These ‘second continuity clinics’ allow our second and third year residents to spend a half day each week during their non-call rotations working alongside a specialist in their office practice gaining valuable clinical experience and building strong relationships with our subspecialty faculty.
Each of our interns is assigned a faculty advisor who schedules periodic meetings with him or her throughout the course of the internship year. The first meeting typically involves discussions about how the transition from medical student to intern has gone. The faculty advisor uses this opportunity to provide insight and support to the intern to help make this a smooth transition. Throughout the rest of the academic year, these meetings focus on the personal and professional development of the interns and their achievement of professional as well as personal milestones. The faculty advisor will also help the intern choose an appropriate subspecialty mentor. During the second and third years, the faculty advisor along with the subspecialty mentor will help the resident to achieve his or her specific subspecialty goals.
Evaluation and Feedback
The Residency Program uses a multi-source evaluation system that includes videotape sessions with clinical instructors, clinical evaluation exercises that are performed in the presence of faculty, peer review, and monthly performance evaluations. Also critical to residents' professional growth is their Biannual Evaluation. This evaluation includes a review of the resident’s progress on each rotation, the identification of strengths and weaknesses, the development of plans to improve performance, and a review and update of procedural competency. Each resident's career goals are discussed and strategies to realize these goals are identified. Our evaluations system is fully electronic. All of our residency programs utilize www.myevaluations.com software to enhance our ability to evaluate residents and our residents ability to evaluate the various programs, faculty, and affiliated hospitals. Our online evaluation system ensures effective, real-time evaluations that encourage self-improvement and program enhancement.
Board Pass Rate/Board Review
The program offers several forms of continuous Board review to insure that our graduates are well-prepared for the exams. In addition to our online, case-based curriculum, the program offers a weekly chapter review on major topics in Internal Medicine using ACP Medicine. MKSAP review questions are completed in morning report at all of our sites. A noon conference series presented by faculty has been organized to cover major topics in internal medicine. The program also subscribes to Yale Office Based Medicine Curriculum for our ambulatory lecture series. Additionally, our program has created a board review course for all senior residents participate in the spring eliminating the need to travel.
UConn Health provides multiple educational resources that enhance the educational experiences of our residents. Our main clinical sites, Hartford Hospital, Saint Francis Hospital, and UConn John Dempsey Hospital have state-of-the-art simulation centers that offer our residents experience in dealing with critical care scenarios in a simulated environment. The University’s library provides free online access to most of the major databases and thousands of on-line journals and textbooks. Residents may access these databases from home, through use of a proxy server. The program also provides a generous book allowance during each year of training which can be used to purchase educational items. Additionally, the program offers a stipend of up to $2,000 to be used by residents for travel to an educational meeting once in either the second or third year of the program. Finally, if our residents have their abstracts selected for presentation at local, regional, national or international meetings the program offers financial support for printing of posters and additional support for travel arrangements.
Through the use of www.myevaluations.com, our residents can maintain an on-line portfolio of their learning experiences and educational activities. Items in their electronic portfolio include not only their evaluations and patient and procedure logs but also individualized personal learning objectives and goals, self-assessment and reflection on strengths and weaknesses, as well as files containing publications and presentations of the individual resident. The portfolio is a learning tool that enables residents to track their experiences, self-reflect on those experiences, share their insights for further discussion with their mentors, and receive real-time, formal feedback on designated learning experiences. The portfolio serves as a repository for resident work products and professional documents, which ultimately may serve the needs of many groups including licensing bodies and certification boards. Use of the portfolio will prepare residents to manage their continued learning and professional development as they transition to practicing physicians.
Medical Student Education
Our Residency Programs value the role that residents have in shaping the choices of medical students and therefore emphasize one-on-one teaching in the ambulatory and inpatient rotations. There is a very strong link between the UConn School of Medicine and the Medicine Residency Programs. Medical students are specifically integrated into the residents training experience in all required rotations.
Because we are a multi-hospital program,it has been a long-standing tradition that the Program Director, Associate Program Directors, Site Directors, Ambulatory Directors, and Chief Medical Residents meet weekly to discuss our educational program, curriculum, evaluations, promotions, recruitment, hospital sites, and resident performance in an effort to continuously improve our educational product. Our program emphasizes evaluation, improvement, and striving to be the best as we achieve our ultimate goal of preparing residents to pursue their professional goals upon a strong foundation of General Internal Medicine. The educational bond that exists between our hospital facilities is our strength and the reason we succeed. We train our residents by providing an environment of support, collegiality, strong faculty-resident relationships, and educational enrichment.