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Residency Program
Applicant Information
House Staff Resources
(password required)
Educational
Resources
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| Core Experience |
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The Department of Medicine of Columbia University has developed several career track programs for residents in Internal Medicine. Professional guidance and counseling, as well as specific training opportunities, are provided to residents contemplating various career paths in medicine. There are three tracks: Categorical Internal Medicine, General Internal Medicine/Primary Care, and Research. Each track offers a similar core experience of rigorous general internal medicine training, yet is flexible enough to ensure a specialized experience. A Preliminary intern year is also offered to those destined for careers in other specialties.
Applicants may match into the Categorical Track (40 intern positions), or General Internal Medicine/Primary Care Track (4 intern positions). The core experience for all of these groups is largely the same. In addition, each track consists of track-specific seminars, assigned mentors, Divisional and Departmental conferences, and biannual meetings with core faculty. Residents may change tracks as their interests evolve or change.
The overall goal of the Career Track approach is to ensure that the individual resident has the opportunity to develop his/her interests in a supportive and nurturing environment. Flexibility and personal attention are two key elements of this process, as is exposure to the wealth of resources available at the Columbia University Medical Center (CUMC).
The following sections describe the training program’s core experience in more detail.
The Medical House Staff Training Program at New York-Presbyterian Hospital, Columbia University Medical Center is a renowned 3 year program combining an extensive inpatient and outpatient training experience, research opportunities, peer teaching and career development. We train knowledgeable, skilled, empathic and dedicated physicians in a challenging, exciting and cutting-edge environment. Straddling the challenges of primary and tertiary health care, we serve both a disadvantaged patient population and a national and international referral community. Our graduates become superior clinicians, socially active individuals, esteemed academicians and published researchers. We take great pride in our residents’ great success in each of these fields.
Residents in all Tracks engage in a similar core experience. Residents in the Primary Care Track receive equally rigorous and similarly structured training as those in the Categorical Program. Unique aspects of the General Internal Medicine/Primary Care Track can be found below.
We care for patients at two hospital sites: The Milstein Hospital and the Allen Pavilion. The Milstein Hospital is the main hospital at the Columbia University Medical Center in Washington Heights. The Allen Pavilion is a small community hospital located in Inwood, at the northern tip of Manhattan. Residents spend 2 to 3 months at the Allen their first year, rotating through a general medicine service, an intern-run ICU and a multidisciplinary geriatrics rotation. They return in the third year for another month on the general medicine wards and to supervise interns in the ICU. The remainder of time is spent at the Milstein campus.
Below is a brief overview of the 3 years. More detailed information can be found in the Rotations section.
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PGY-1 Year
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The Intern Year has an inpatient focus, with about 5-6 months spent on ward services and 2-3 months in the various ICUs. Interns learn to identify acuity of illness, to manage sick and critically ill patients, to perform invasive procedures and to function as the primary care providers for their patients in an outpatient clinic. They also refine their presentation and synthetic skills, teach medical students and their fellow residents, and critically appraise the scientific literature. Throughout the year, interns serve as the primary point of contact for each of their patients, from admission through discharge to follow-up. It is a time of tremendous personal and professional growth.
A typical ward team consists of 2 attending physicians, 2 residents, 2 primary interns, and a ”team intern”. Additionally, there are usually 1 to 2 medical students assigned to the team. Primary interns admit overnight on a Q4 schedule with around-the-clock supervision and teaching. Our house officers rotate on general medicine ward services and subspecialty inpatient services, including rotations on Oncology, Cardiology, and Infectious Diseases services. Attending rounds occur on a daily basis and encompass discussion of individual patient management, literature review and, of course, presentation of new admissions. Interns also spend about one month functioning as the “team intern.”
Weekly continuity clinic and 1 month of dedicated outpatient care form the core ambulatory experience in the Intern Year. A unique outpatient educational curriculum includes practical epidemiology and essential outpatient topics ranging from smoking cessation to depression to low back pain.
Additional rotations include one month each spent on vacation (divided into two), an elective of your choosing, and working within a multidisciplinary geriatric service at the Allen Pavilion. Some interns also rotate in the Emergency Department for 2 weeks.
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PGY-2 Year
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Residents make an important transition this year, as they become the leaders of an inpatient service. The goals of the second year include developing time management and supervisory skills, making primary management decisions with less immediate supervision, honing procedural skills and accepting more responsibility for the education of the students and interns on their services. On the wards, Resident call is not overnight, enabling you to further focus your efforts on teaching and leading your team. Second year residents also run the intensive care units, with the assistance of the critical care and cardiology fellows and the attending physicians, and serve as the “Arrest Resident”. More time is dedicated to the outpatient clinics and to elective time. A unique rotation that occurs during this year is the Irving Center for Clinical Research experience, an introduction to the practice of clinical research in an academic health center. Residents identify research mentors and create IRB proposals with the assistance of statisticians; many residents use this experience as a point of entry into basic, translational or clinical research that they go on to continue throughout their residencies. |
PGY-3 Year
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The last year of residency is spent refining and synthesizing the many skills acquired over the past 2 years, teaching students, interns and fellow residents, and preparing for entry into further training or the work force. PGY-3 (also known as Senior) residents lead the inpatient cardiology and general medicine services, function as the medical consults for other services within the Medical Center, and return to daily direct patient care with a Hospitalist-style rotation. Two blocks are spent on outpatient rotations, during which time senior residents engage in a curriculum focused on teaching residents how to teach. In a unique 1-week course focusing on health systems and public health residents attend an intensive group of workshops moderated by national leaders on subjects such as general health care policy, negotiating contracts, creating resumes and practicing medicine in the managed care environment.
If you have further questions about the Core Experience, please contact us by email at intap@columbia.edu |
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