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Program aims

  • Train internal medicine-pediatric residents to be well-rounded physicians and physician leaders
  • Expose residents to aspects of the Quadruple Aim to improve care for all patients and for themselves
  • Focus on training residents in aspects of transitions of care and complex care
  • Utilize EHR to improve quality of care and drive clinical outcomes research
  • Develop the next generation of physician educators

Curriculum

The med-peds curriculum is designed to give you equal exposure to both internal medicine and pediatrics and combined training. To accomplish this, you’ll rotate between departments in a series of three- to four-month blocks throughout the four years. You’ll complete core and subspecialty rotations with increased responsibility.

The 14-block internship exposes you to core rotations, so you can focus on a fundamental skill set and subspecialty knowledge. During PGY2, PGY3 and PGY4, residents complete an additional 38 blocks of internal medicine and pediatrics. PGY1 focuses on general knowledge and skills. PGY2, PGY3 and PGY4 promote flexibility and greater exposure to the subspecialties. These inpatient experiences are structured to give you increased responsibility, autonomy and supervision. See a sample rotation.

Selectives are subspecialty experiences from internal medicine and pediatrics. Choose from:

  • Internal medicine:
    • Cardiology
    • Endocrinology
    • Gastroenterology
    • Hematology/oncology
    • Infectious diseases
    • Nephrology
    • Pulmonary
    • Rheumatology
  • Pediatrics:
    • Allergy/immunology
    • Cardiology
    • Child abuse
    • Dermatology
    • Endocrinology
    • Gastroenterology
    • Genetics
    • Hematology/oncology
    • Infectious diseases
    • Nephrology
    • Neurology
    • Pulmonary

Electives are educational experiences outside internal medicine and pediatrics. Geisinger residents use this time for things like:

  • Research
  • International health
  • Dermatology
  • Surgical subspecialties
    • Anesthesia
    • ENT
    • Orthopaedics
  • Away rotations

Med-peds condenses six years of training into four. This means you may not get to rotate through all the subspecialty areas during your residency. You have the option to merge some of your selectives into a one-month rotation.

One unique feature of our curriculum is the med-peds ambulatory rotation. It’s designed as a longitudinal educational experience, with one block every academic year. The first two blocks focus on increasing ambulatory internal medicine and pediatrics knowledge and skills. You’ll also gain experience with our advanced medical home and patient-centered quality initiatives. These lay the foundation for learning primary care and population health. The third and fourth ambulatory blocks incorporate practice management principles that prepare you to practice medicine independently.


Didactics

These sessions offer a comprehensive and in-depth look at a variety of topics in clinical medicine. Cases are presented in a variety of formats tailored to your individual learning style.

Med-Peds Mondays

The goal of Med-Peds Mondays is to educate you on what it means to be a med-peds physician in today’s changing healthcare system, all while exposing you to a wide range of topics.

Every week, residents get together (in-person or virtually) for med-peds lecture series, journal clubs, board review, retreats and wellness activities. This lecture series focuses on your unique learning needs. Lectures fulfill two purposes:

  • Present med-peds specific topics
  • Provide education on:
    • Healthcare delivery
    • Innovations
    • Hands-on procedural topics

Yearly professional development

The med-peds residency hosts fall and spring professional development sessions. Past topics have included:

  • Leadership development
  • Conflict management
  • Emotional intelligence
  • Physician burnout and wellness
  • Psychological safety
  • Career development

Monthly simulation session

All residents participate in these specialized training exercises held in our simulation center.


Unique educational opportunities

In addition to the daily lectures and conferences, residents can develop individualized educational opportunities based on their needs, such as continuity clinics in a selected field of interest. With the ability for third- and fourth-year residents to customize their education, current and past residents have gained experience in COAR (Comprehensive Outpatient Ambulatory Rotation), pediatric ambulatory, complex care through the age continuum, sports medicine, obesity, free clinic, culinary medicine and advocacy.

Quality improvement (QI) fundamentals

Course designed to advance knowledge and skills related to patient safety and quality improvement. Residents completing this course can participate on an active quality improvement team within the hospital. All residents will participate in an integrated QI project directed by Rose Barham, MD.

Global health

Med-peds residents can participate in international health electives. Previous residents have had the opportunity to travel to China, India, and Peru. This experience occurs as part of a structured educational rotation with a board-certified Geisinger faculty member. Financial support is available.

Health systems and leadership

As an educational program located within an integrated health system, residents have ample opportunity to expand their knowledge of modern health systems. All residents will experience our innovative health system from a clinical perspective. Residents with future interests in healthcare administration and leadership can take advantage of numerous opportunities to learn how our programs develop, starting at the highest levels. This educational offering can occur either as a longitudinal or block experience.

Simulation and procedure training

All med-peds residents will receive procedural and team training during their residency through Geisinger's Education and Medical Simulation Centers. The residents participate in monthly high-fidelity simulation sessions with R. Blake Lowe, DO. Adult and pediatric task trainers are available for procedural training in lumbar punctures, central lines and joint injections. Interprofessional team training occurs during regularly held pediatric and adult mock codes. Our residents are exposed to standardized patient experiences.

Community Outreach Leadership Track

This track was created to engage residents in the Danville and surrounding communities while providing valuable leadership skill training. This track is completed over 18 months, starting in January of the first year of residency. After receiving eight months of formal flipped-classroom interactive education, participants work together in small groups to develop and implement a community service project. Each resident completing the track will receive a certificate of distinction in community leadership.

The purpose includes:

  • To help participants understand the value of community leadership.
  • The class gets exposure to new elements of the community, participates in/completes a community project and hopefully becomes inspired to become more involved in serving the community by volunteering time and talent.
  • Develop organizational leadership competencies regarding engagement through trust, listening and emotional intelligence, coaching and leading change.
  • Support the development and retention of residents.

Community development topics include:

  • Leading through Engagement: Trust and Listening
  • Poverty and Human Services
  • Leading through Engagement: Emotional Intelligence and Crucial Conversations
  • Education and Early Childhood Learning
  • Coaching for Performance and Development
  • Philanthropy, Volunteerism and Boardsmanship
  • Leading Change
  • Economic and Workforce Development

Clinician-Educator Track

In coordination with Geisinger's Internal Medicine Residency colleagues, our med-peds residents have the opportunity to apply for and participate in our two-year Clinician-Educator Track. The purpose of this track is to provide resident physicians with a foundation in medical education in preparation for future careers as clinician educators. As the rigors of intern and second year preclude involvement in this track, it is completed over the third and fourth years of residency. Upon successful completion of the clinician-educator track, each resident will receive a certificate of distinction in medical education.

Timeline

Year 1 (third-years)

  • Participate in clinician-educator track education 
    • Read assigned material
    • Utilize video/simulation
    • Emphasize application of principles of medical education 
      • Content focused on topics including:             
      • Adult learning theory
      • Metacognition and cognitive bias
      • Best clinical teaching practices
      • Teaching clinical reasoning
      • Learner assessment
      • Curricular development
      • Large group presentations/lecturing
      • Small group discussion/teaching
      • Hidden curriculum
      • Teaching procedural skills
      • Conflict resolution
      • Flipped classroom
      • Mentorship
      • Advanced feedback skills (the "problematic learner")
      • Creating a teaching portfolio
  • Create and work on an educational scholarly project, with faculty guidance
  • Facilitate morning reports with observation and feedback by faculty

Year 2 (as fourth-years)

  • Continued participation in clinician-educator track didactics
  • Facilitate morning report and complex case conference with observation and feedback by faculty
  • Lead student didactic sessions
  • Observation and feedback by faculty of bedside teaching during rounds
  • Implement and complete an educational scholarly project 
  • Submit academic research for publication and/or national conference presentation

Continuity clinics

Continuity clinic is the cornerstone of your internal medicine-pediatrics training. Residents participate in innovative primary care practices providing high-quality, comprehensive care for patients of all ages. Our medical home model, Proven Health Navigator® is a partnership between patients and Geisinger Health Plan. It allows us to deliver patient-focused care, helping us better manage chronic health conditions, so patients can lead healthier lives. Our goal is to coordinate care by maintaining wellness and managing illness. We’ve been nationally recognized for innovative practices in quality, delivery models such as ProvenCare® and the use of an award-winning electronic medical record, Epic®

During your four years of continuity clinic, you’ll build and manage a panel of patients. With the help of our electronic medical record (EMR), you’ll seamlessly transition from inpatient to outpatient venues. You also have access to quality data. This helps you provide real-time feedback on clinical effectiveness and management of chronic disease conditions. With these tools, you’ll help patients be up to date with preventive health measures, including immunizations.

Under the guidance of med-peds trained physicians, you’ll build your own panels of adult and pediatric patients at multi-disciplinary clinics. Each one has a lab, pharmacy services and healthcare managers. Choose from locations in Lewisburg, Milton or Selinsgrove.

During PGY3 and PGY4, you may choose to schedule an additional half-day experience during elective rotations. Choose an experience in underserved free clinics, subspecialty clinics or within your own continuity clinics.


The Comprehensive Care Clinic at Geisinger

Geisinger’s Comprehensive Care Clinic (CCC) is designed for adolescents and young adults with pediatric acquired chronic medical conditions expected to remain through adulthood. These may include:

  • Cystic fibrosis
  • Adult congenital heart conditions
  • Developmental delay/autism
  • Cerebral palsy
  • Chromosome abnormalities
  • Epilepsy
  • Technology dependence
    • Tracheostomies
    • Feeding tubes
    • Vagal nerve stimulators
    • Chronic vents
    • Baclofen pumps

Established in 2012 to aid in transition, the clinic has evolved into a unique healthcare delivery model. It provides transitional services and serves as a medical home to the most medically complex.

We evaluate all patients and their families for transition readiness.

We offer consultations for patients 15 and up. During this consultation we:

  • Guide the patient and their family through the transition process
  • Help them with co-management of complex medical conditions

Patients over 18 can be transitioned to the CCC as their primary care provider and get their care all in one location.

Our interprofessional team is here to:

  • Assess the patient’s medical condition
  • Develop patient-centered transition and management plans
  • Educate about community resources and waiver programs

Resident experience

All residents are involved in the CCC as part of their med-peds ambulatory curriculum. A rotation is available in caring for medically complex patients.