Program overview

Curriculum

Learn the skills you need to make you exactly the kind of well-rounded, skilled, compassionate physician who makes a difference in patients’ lives.

*All residents have a 6+2 schedule. 

During the academic year, you’ll have:

• Two weeks of ambulatory clinic every 6 weeks
• Thirteen 4-week blocks* 

We are committed to giving a comprehensive experience that enhances clinical skills and proficiency and focuses on preparing you for a fulfilling career as a compassionate primary care physician and leader of tomorrow’s healthcare. You’ll achieve these goals through dedicated rotations in Humanities in Medicine and in Population Health and Leadership. Curriculum is supplemented by required rotations in:

• Radiology
• Geriatrics
• Neurology
• Addiction medicine
• Palliative medicine
• Emergency medicine

In addition to your core rotations in internal medicine sub-specialties, you can choose elective rotations from a variety of specialties, including:

• Anesthesia
• Sports medicine
• Sleep medicine
• Psychiatry
• Rehabilitative medicine
• Dermatology
• Pathology
• Urgent care
  
  

IM block rotations by post graduate year

PGY1

PGY2

PGY3

Didactics

The Internal Medicine Residency Program provides a wide range of academic programs to supplement your diverse clinical training experiences. Didactic schedule largely revolves around the Academic Half Day (AHD). Content gets repeated yearly, giving you the opportunity to revisit the lessons

Weekly Academic Half-Day (AHD)

The weekly half-day didactic block is held Thursdays from 1 to 5 p.m at our Northeast Geisinger Education and Medical Simulation (GEMS) Center. Your direct feedback helps drive this highly interactive experience aimed at continuous improvement. AHD includes:

• Medical Knowledge Self-Assessment Program^® (MKSAP) based board review
• Faculty-driven lectures
• Institutional requirements
• Wellness and group-based activities
• Simulation sessions
• Journal clubs

The curriculum for this didactic series includes:

• General and subspecialty medicine topics
• Wellness and leadership activities
• Non-clinical topics like:
  • Coding and billing
  • Pharmacy services
  • Clinical documentation
  • Ethics updates
  • Communication

Attending faculty, residents and guest speakers typically present during each session. In addition, the program director can designate additional lectures for house staff each month.

AHD didactic topic list

• Intern Survival (for interns). First 3 AHDs in July
• Board Prep Boot Camp (PGY2 and 3). First 3 AHDs in July
• Mystery Case group discussions – Selected and presented by residents – 1st AHD of each block – Chiefs/Resident Driven Content
• Subspecialty (TOB) case presentation/lectures
• Board prep – MKSAP modules covering Topic of the Block (TOB) – 1 hour weekly
• Resident RAP Session – 1st AHD of the block – To discuss concerns, ideas and provide feedback related to previous block
• Monthly Meeting (RAP Recap) – The week following Rap Session to go over issues discussed during RAP and provide solutions
• Humanities Reflections (30 min) presented by the PGY-1 resident completing the Humanities rotation
• Quarterly Wellness Sessions and Team Building Retreats (for residents and faculty)
• Quarterly Sim Sessions at NE GEMS (Geisinger Education and Medical Simulation) Center. Additional Simulation sessions at Wilkes Barre VA Medical Center during Ambulatory rotations.
• Reflections (General) before each Quarterly Sim session and more frequent shorter sessions during didactics. 
• Leadership Module/leadership lectures by Geisinger Healthcare Leaders
• Sleep/Fatigue Mitigation sessions twice a year
• Poverty Simulation (Yearly) – Subject to resource availability
• Implicit Bias sessions (Yearly)
• Safe Hand off Exercises – Orientation and as part of Residents as Teachers sessions
• Communication Workshop (Yearly) 
• Introduction to C.I.CARE (During Intern Survival)
• Professional and Ethical Dilemmas – Resident driven (Quarterly) – Chiefs/Resident driven content
• Safe opiate prescribing (yearly)
• Evidence Based/high value Medicine
• YouTube Surprise (Resident driven video/Video Podcast selections from online resources on relevant topics) – Chiefs/Resident driven content
• Clinical Documentation Improvement (CDI) (Yearly) 
  
   

Yearly workshops:

• Sleep/fatigue mitigation
• Poverty simulation (when available)
• Implicit bias workshop
• Prescribing opiates safely
• Clinical documentation improvement (CDI)

Twice-yearly workshops

• Safe hand off exercises
• H&P exercise
• Communication workshop

Board Review (AHD)

Throughout your training, you’ll review chapters from the most current edition of MKSAP in weekly 60-minute sessions. Each year, all topics are reviewed and discussed, empowering you to cover the information multiple times over the length of the training program. Dedicated faculty lead an interactive Q&A discussion session. Topics discussed are scheduled at the beginning of the academic year as Topic of the Block. You’ll be expected to read the material and be prepared for the discussion.

Journal Club (AHD)

Journal Club meets once a month during the AHD. This monthly format developed was designed to meet the research recommendations of the American College of Physicians (ACP). This format includes methods for analyzing, interpreting and presenting original data published in medical journals.

Simulation sessions (AHD)

Attend simulation sessions several times throughout the year at Wilkes-Barre VA Medical Center. After an initial reflection session, you’ll have training on simulation equipment and modules in their state-of-the-art simulation lab. You’ll have access to a full suite of equipment including:

• SimMan 3G
• Vein illuminating technology
• EGD/bronchoscopy trainer
• Arterial and venous puncture training arm
• Central line mannequin
• Central line training package with articulating head
• Ultrasound machine

Wellness activities (AHD)

We hold wellness-related activities, reflection sessions and retreats throughout the year to:

• Encourage social interaction
• Develop relationships with faculty
• Provide opportunities for feedback to improve the learning environment.

You’ll have protected time to attend quarterly wellness retreats.

Topic of the Block
An internal medicine sub-specialty will be assigned to each block of rotation. The goal will be to cover all key areas of internal medicine over the course of the academic year. In addition to the regular clinic discussions, faculty will review related topics. At the end of each block, you’ll take a quiz.

Morning Report
During this case-based discussion, our upper-level residents discuss interesting or complex clinical cases from the previous night’s admissions.

Interdisciplinary team rounds
Daily rounds take place at GWV and GCMC. This activity brings interdisciplinary teams (IDTs) together to facilitate treatment, including discharges and transitions of care. 

Patient rounds
Patient rounds are divided into 3 categories to give real-time patient team updates throughout the day:

• Morning rounds begin with pre-rounding at 7 a.m. and continue following morning report. 
• Attending rounds start immediately after IDT meetings. Faculty attendings lead the discussion to verify history and physical findings and review treatment plans.
• Afternoon wrap-up rounds begin at 2 p.m. to review:
  • New admissions
  • Transfers
  • New labs
  • Investigations
  • Consultant recommendations
  • Discharges

Transition-of-care issues and concerns are also discussed.

• Sign-out rounds are held at 4:30 p.m. They follow I-Pass format for TOC (transitions of care) and hand-out to on-call team members.

Morbidity & mortality review
Each month, a morbidity and mortality review conference is held at Geisinger Wyoming Valley Medical Center. Internal medicine residents are assigned to present the case and discuss aspects for improvement as part of the practice-based learning core competency. Cases are chosen by residents or attending faculty.

Tumor Conference
These monthly conferences, scheduled by the oncology department, are held at each campus. While you attend, you’ll rotate on in-house medicine oncology services.

Behavioral & psychosocial curriculum
Your training includes many aspects beyond knowledge and clinical skills, like:

• Integrity
• Respect
• Ethical behavior
• Compassion
• Empathy

Besides specific group activities and presentations, you’ll attend a weekly 30-minute resident-led presentation. This scheduled time is an opportunity for you to reflect on your experiences and to comment on reading assignments.

Standardized patient session
The residents will participate in standardized patient session focused on patient communications and diversity. This program is sponsored by the GEMS Standardized Patient program and has over 50 cases to select from. Cases relevant to current curriculum and training goals are preselected for residents and scheduled across the year and include principles of effective physician-patient relationships, patient-centered approach, talk-back techniques and difficult topics such as giving bad news and how to deal with a difficult patient.

Annual education day
You’ll have the opportunity to develop your teaching skills through an annual education day. There, you’ll learn about leadership, communication and educating junior residents and other learners. Sessions also address:

• Principles of effective physician-patient relationships
• Patient-centered approach
• Talk-back techniques
• Difficult topics, such as giving bad news and how to deal with a difficult patient.

Annual scholarship days
Traditionally held in the first week of May each year at the Henry Hood Center for Health Research in Danville. Geisinger Scholarship Days allow for the presentation of outstanding research that reflects the considerable efforts that were put forth by the residents, fellows, faculty, mentors and research teams. It showcases this scholarship to demonstrate the innovation and inquisitiveness that furthers our commitment to the patient experience.

Research and scholarship requirement
You’ll have the opportunity to give Journal Club presentations and morbidity and mortality case conferences throughout your residency program. All residents must complete at least two scholarly activity projects during residency — one during first year of residency and one between second and third year of residency. Scholarly activities include:

• Case reports
• Quality improvement projects
• Clinical research projects 

All PGY-1s are required to complete a scholarly project and present it as a poster presentation for Geisinger’s Annual Resident and Fellow Scholarship Days. As per ACGME requirement, residents will be required to work on a CQI (Clinical Quality Improvement) project during their three years of training. You’ll have time for CQI and clinical research projects during your population management and research rotation under the guidance of a faculty research mentor. Residents are expected to plan and start a CQI project during PGY 2 and may continue it through PGY 3. We encourage you to submit your scholarly work to local and national conferences.

Senior presentation
Throughout the year, a senior presentation will be held in lieu of grand rounds. Each PGY3 resident is required to present a grand rounds caliber presentation related to a chosen medical or healthcare topic, original research or QA/QI project.