Internal Medicine Residency Program
L. D. Saravolatz, MD
Chairman, Department of Medicine
R. Hilu, MD
Internal Medicine Program Overview
The objectives of the St. John Internal Medicine Residency Program are to provide high quality education, supervision and an academic atmosphere that prepares the resident physician to practice comprehensive, scientific and cost-effective primary care Internal Medicine. The St. John Internal Medicine program accomplishes these objectives and more.
Our program is under the direction of the Chief of Medicine and the Program Director, with a sizeable General Medicine and subspecialty faculty. There are 51 Medicine Resident positions, 15 categorical residents in each academic year, 6 preliminary 1 year R1 residents, and 2 Chief Residents. All faculty are involved with the organization and implementation of the I.M. teaching program. All subspecialties of Internal Medicine are taught by qualified specialists including those in Adolescent Medicine, Allergy-Immunology, Cardiology, Critical Care, Endocrinology, Gastroenterology, Geriatrics, Hematology/Oncology, Infectious Diseases, Nephrology, Neurology, Pulmonary Medicine and Rheumatology. The medical staff is committed to sharing patient care responsibilities and contributing to the teaching program.
Students from several nearby medical schools rotate through I.M. and it's subspecialties and a formal affiliation exists with the Wayne State University School of Medicine.
The curriculum in Internal Medicine supplements patient care experiences with conferences, which are planned to cover all subspecialties as well as primary care areas. A staff of well-trained internists provides one-on-one teaching and learning opportunities. Emphasis is placed on thorough history-taking and careful physical examination. The "problem-oriented record" is emphasized as a problem-solving and teaching device. The curriculum focuses on achieving the core competencies as defined by the ACGME, outcomes project, patient care, medical knowledge, interpersonal and communication skills, professionalism, practice-based learning and improvement, and system-base practice.
The Internal Medicine Specialty Center is specially designed as a resident outpatient practice. It provides an opportunity for the resident in Internal Medicine to examine and treat his/her own ambulatory patients and to personally follow the natural course of disease in and out of the hospital. Each resident is assigned weekly half-day sessions (two half-day sessions during selected elective months) and is supervised by members of the faculty. Residents maintain responsibility for their patients throughout the three years of training. They are responsible for the total care of these patients and will see them in emergencies and admit them to the hospital when needed.
Following is a summary of the St. John Internal Medicine resident schedules. More detailed schedule information can be found in the Schedule Section of this brochure. The educational goal of the R I year is to learn broad aspects of Internal Medicine and to develop clinical knowledge and skills. The R I rotates through 4-5 months of general medicine wards and subspecialties of Nephrology and Cardiology; one month each of M.I.C.U., C.I.C.U., Emergency Medicine and Anesthesia; one month of outpatient I.M. and a very unique one-month experience of combined electives, and practice-based improvement rotation.
The goals for the R II year involve increased patient care responsibility, supervisory, teaching and leadership roles. The R II rotates on General Medicine, Neurology, Nephrology, Geriatrics, three to four months of elective rotations and two-months of Ambulatory Care, during which the resident is exposed to specialty areas related to internal medicine (i.e. Outpatient, Gynecology, ENT, Orthopedics, PM & R, STD clinic. They also have night rotation for MICU and CCU.
The main thrust of the R III year is additional responsibility in patient care and increased supervisory and teaching roles. The R III academic year is characterized by senior resident responsibility in the critical care units, subspecialty rotations and the staff patient service. A one-month rotation in Medical Consultation, and four to five subspecialty elective months round out this year.
This listing outlines the conferences within the Department of Medicine. A monthly conference schedule delineating dates, topics and locations is provided to all Medicine residents and students at the start of each month.
This is a mandatory conference presented by faculty running from 8:00 - 9:00 a.m. on Monday, Wednesday, Thursday and Friday. It combines case presentations with planned topics (which are posted to allow the residents to prepare for the discussion). Coffee and pastries are provided.
These are formal bedside rounds conducted by faculty members 5-6 hours/week. In-depth case discussions and emphasis on physical exam skills occur during teaching rounds.
Attendance at Grand Rounds is also a "must". This is done in a classic Medical Grand Rounds format, with lectures given by an expert in his/her respective field. Grand Rounds occur on Tuesdays from 8:00 - 9:00 a.m.
“Noon Conference” is an umbrella term denoting a variety of conferences and seminars offered during the noon hour. A buffet lunch is provided daily for residents and medical students. The following conferences occur during the noon time slot:
July Medical Emergency Series
This series is devoted to a practical review for incoming first year medical residents. Topics such as “Emergency Evaluation of Chest Pain”, “Management of DKA”, “Treatment of Anapylaxis” etc. are covered.
Subspecialty conferences occur during the noon hour throughout the year. These are dedicated to each of the sub-specialty areas of Internal Medicine, with a specific number of slots assigned to each area. These conferences review key problems and discuss recent advances in knowledge or therapy within the respective sub-specialties and other relevant medical specialties.
Journal Club is a twice-monthly conference occurring at noon. Two articles are presented by assigned residents and group discussion then occurs. Faculty members mentor the residents who present and actively participate in the discussion. During this time, serious teaching on “Critical appraisal of the medical literature” is emphasized.
Business Seminar Series
This is a once monthly conference series. These conferences attempt to prepare residents for their futures as physician managers. Some topics presented are: business planning, personnel and medical-legal issues, management topics, managed care, investment, etc.
The ethics conferences occur bimonthly and are dedicated to discussion of the principles of medical ethics. A case review format is used to generate discussion of moral options and ethical behaviors within a given set of circumstances.
Resident Counseling Series
This is a multi-purpose series that includes topics from a variety of areas which concern residents. Included are discussions on law and medicine, continuous quality improvement and utilization practices.
M & M Conferences
This is a monthly session held to discuss mortality and morbidity occurring on the Medicine Service. A review of the facts of the case is followed by discussion of what occurred — including diagnosis, treatment, behavioral and ethical issues.
Research Assistance Program
Conferences dedicated to research project design, data collection and statistical analysis are provided. The department and the Office of Graduate Medical Education both support research activities clinical and bench research.
A monthly written examination is given to residents in the Department of Medicine. The exams help prepare the residents for their I.M. certifying exam (the Boards). The exam questions are based upon monthly conference material. These exams are not used for evaluation/promotion of residents, but rather as a tool for self-evaluation.
Monthly Resident Meetings
These luncheon meetings take place every month for each resident class. They are designed as a forum for the residents to identify problems and seek solutions to them.
There are a number of social events organized for the residents every year. They are designed for fun and to allow the residents to get to know one another. Monthly social lunches, an annual welcoming reception, holiday parties, and sporting events occur, just to name a few.
All first year residents are scheduled for a two day retreat at the end of their R I year. The focus of the retreat is preparation for a supervisory role and teaching skills based on the Stanford Faculty Development Course.
The Internal Medicine training received at St. John is designed to train well-rounded internists. Due to the location of the hospital (at the intersection of the cities of Detroit and Grosse Pointe, Michigan) the patient population is perfect for training — a good cross-section of staff and private patients. The hospital facilities are state-of-the-art with a well-groomed campus, convenient hospital-owned housing and nearby shopping and recreation resources. Regular teaching rounds with program faculty and daily conferences support the teaching program. The Internal Medicine Specialty Center, the office in which the residents have their outpatient training, is a beautiful facility and is run as a private practice for the residents. Graduates from Internal Medicine at St. John have a choice of practicing General I.M. or going on for sub-specialty training. Our graduates have been very successful in obtaining desirable practice opportunities and fellowships across the United States. In addition, St. John offers fellowship training in Cardiology, Interventional Cardiology, Non-Invasive Cardiology, Infectious Diseases and Nephrology.
Feel free to continue reading more about the Internal Medicine training at St. John Hospital and Medical Center in the remainder of this packet. If you have questions, please call 313-343-3875.
For more information or an application you can write to the following address or call (313) 343-3875.
Medical Education Department
St. John Hospital and Medical Center
19251 Mack Avenue, Suite 340
Grosse Pointe Woods, Michigan 48236