Regularly Scheduled Educational Activities
Left: Our inpatient teams round with COWS! (Computers On Wheels). The COWS allow residents to place orders, view radiology studies and access the internet right at the bedside.
Residents start the day by leading bedside teaching and work rounds with the team. Team members review the progress of each patient, incorporating patient management, teaching and discussion of clinical decision making.
Left: Teaching attending rounds occur in both didactic settings and also at the bedside.
Residents, interns and students from the Albert Einstein College of Medicine regularly present and discuss patients during rounds with the teaching faculty. A dedicated teaching attending is assigned to each resident team. Discussions range from the bench to the bedside, with a focus on clinical teaching and covering the curriculum for a particular rotation.
The Chairman of the Department of Medicine rounds with one of the ward teams each week. The house staff present a case, which is then discussed, often at the bedside.
Resident Morning Report
In a dynamic, interactive forum, house staff meet with the chief medical residents, the program directors and the teaching faculty to present and discuss interesting and instructive cases. The history, physical and all test results are reviewed, with faculty pointing out pertinet findings on labs, ECGs or radiologic studies. Rotating senior ward residents and residents rotating on night medicine (aka "nightfloat") present cases, often along with articles they have chosen from the medical literature, pictures they have taken of patients (with consent!), or other supporting educational materials.
Each day residents are provided a noon conference that can take many formats. Case presentations and lectures are delivered in an interactive format, with audience response technology used to enhance the learning experience. Lunch is provided. The noon conference curriculum covers the range of clinical Internal Medicine and subspecialty topics, as well as topics such as ethics, cost-effectiveness and health care systems.
Above: House staff enjoying a noon conference while refueling for the rest of the day.
Interns' Core Curriculum
Using the Socratic method, the chief medical residents meet with the interns weekly to discuss physiology, pathophysiology and treatment in a relaxed environment. Major areas of Internal Medicine are covered in this year-long curriculum.
Left: Simon Gringut, PGY-3, presenting at Journal Club
Resident Grand Rounds/Evidence Based Medicine
Each resident presents a clinical or research topic of their choosing to their house staff peers and selected facutly. The session is moderated by a faculty member who is an expert in the field. During the presentation, the resident presents a scholarly review of the topic, including basic science background, current trends, and future directions. In addition, residents critically appraise and present an article from the recent literature which is relevant to the topic being presented. Direct one-on-one mentoring and preparation is given to each resident by a Chief Resident. Residents are encouraged to be presenter-teachers and are taught evidence-based concepts that can be imparted to others, and incorporated into their own practice. Journal club/Evidence Based Medicine allows the presenting resident to become an expert on that particular topic, expose them to the faculty in that field, and practice public speaking.
Residents' Board Review
Each year residents are enrolled in a Board Review Course. The Residency Program covers the cost of the course for all PGY-3 residents.
Clinicopathologic Conference (CPC)
During a medicine grand rounds forum, house staff, medical students, and faculty present current cases of extraordinary interest, with outstanding CPC-style discussion by attendings from medicine, pathology and radiology.
Each week, Beth Israel faculty and distinguished invited local, national and international speakers discuss topics of major interest and current advances in medicine.
Research Summer Lecture Series
During July and August, each Division within the Department of Medicine presents their research activities. This immediately exposes incoming house staff to the scholarly work going on in the Department, and facilitates resident selection of mentors.
In addition to the above, each Division holds weekly subspecialty conferences, frequently including prestigious outside speakers. Residents on elective participate in these conferences. Senior residents rotating in the CCU are required to present formally to the faculty and fellows of the Division of Cardiovascular Disease.
The Alice and Richard Netter Simulation Center
With the days of "see one, do one, teach one" gone, simulation training has become an essential part of the residency experience. Our Pulmonary/Critical Care faculty has published research on simulation training, in addition to teaching simulation at both the regional and national level.
Beth Israel boasts a newly-renovated state-of-the-art simulation center. Our advanced simulation "dummy" (SIM Man) can be programmed to mimic a great variety of clinical scenarios, including neurologic emergencies, seizures, cardiac and respiratory emergencies, metabolic derangements, and cardiopulmonary arrest, among others.
Under the guidance of a Chief Resident and faculty, our house staff undergo high-fidelity traning for managing a wide variety of emergent clinical situations. From behind a one-way mirror, dedicated Sim Center staff and faculty throw out scenarios for teams in training to handle. Interns are taught proper airway management and chest compressions. Medical residents serve as Code Team and Rapid Response Team leaders for all such calls throughout Beth Israel, and recieve intensive clinical and leadership training in these areas. Communication and other tools adapted from the aviation industry and the military are taught and practiced. Multiple video cameras record all angles and aspects of a team's performance, down to the sureness of the seal of an ambu-bag on Sim Man's mouth (there's a camera directly overhead of the airway team member.) Post exercise team debriefing includes a video review, allowing residents to see themselves in action and reflect on their performance. This is widely viewed among the house staff as a superb learning experience.
Residents also learn central line insertion and other procedures in the Sim Center.
Left: Dr. Yuichi Shimada teaching Dr. Bier how to place a central venous catheter in The Alice and Richard Netter Simulation Center.
Above: Sim Man, our highly advanced simulation dummy.
Left: Richard Lee, PGY-3, using the ultrasound machine to insert an internal jugular central line in our simulation center.