Curriculum

Inpatient education is based primarily at Waterbury Hospital and provides trainees with a broad exposure to the breadth and depth of internal medicine. Residents also receive their education at Yale New Haven Hospital and the VA Connecticut Healthcare System in West Haven.

Yale New Haven Hospital (YNHH) is the flagship hospital of Yale New Haven Health and has 1,541 total beds across two campuses in New Haven. Our residents take part in inpatient and elective rotations at both campuses throughout their training. For additional information visit the Yale New Haven Hospital website.

The VA Connecticut Healthcare System in West Haven is located approximately five miles from Yale New Haven Hospital and provides an additional opportunity for our residents to enhance their clinical training in a unique setting.

The teaching service is a geographically localized 30 bed unit on two floors consisting of four day teams and two night teams divided into two Firms. These Firms are named after Drs. David Podell and Joseph Renda, master clinicians who embody the very best of medicine from clinical excellence to the highest standards of professionalism and devotion to patients. Areas of particular emphasis of the general medicine Firms include bedside rounding, the role of the physical examination in clinical care, and transitions of care. Each day team consists of an attending physician, resident, intern, and students. Ample teaching and charting space is available. Patients admitted to the medical service encompass the full range of age, socioeconomic status, and disease spectrum of internal medicine.

The Medical Intensive Care Unit team is comprised of Pulmonary/Critical Care attendings, interns, PGY II and PGY III residents, and advanced practice registered nurses. Clinical care is complimented with daily case discussions and a core intensive care unit curriculum. The goal of medical training in the intensive care units is to educate residents in the diagnosis, evaluation and management of patients with a wide range of critical illnesses. The resident is expected to become knowledgeable about the indications, contraindications, risks and benefits of common ICU level procedures. Residents have the opportunity to be trained in a variety of procedures such as arterial puncture and arterial blood gas interpretation, arterial line and central venous line placement, paracentesis, lumbar puncture, and naso-gastric tube placement. Inherent in the care of critically ill patients is the management of psychiatric, social and family concerns which are heightened in these intensive care settings and are addressed by residents as part of a multidisciplinary team. Patients are transferred to the medical ward teams when discharged from the intensive care units.

Our program has a wide range of educational conferences. Each morning residents have the opportunity to participate in chief resident-led reports. Each week we host noon conferences and Grand Rounds with Yale faculty in the Bizzozero Conference Room. Every month we have recurring core faculty-led conferences including journal club, tumor board, high-value care discussions, medical jeopardy, emergency medicine and ethics, research and quality improvement, peer teaching, intern support group, board review, Chairman’s Rounds, M&M conferences, and multi-disciplinary firm conferences.

The residents’ continuity clinic during dedicated ambulatory block rotations represents the cornerstone of their ambulatory experience. In addition, the residents have an opportunity to work with experienced physicians in subspecialty clinics, such as dermatology, psychiatry, diabetes management clinic, and joint injection clinic.

Residents provide ongoing continuity care for their own panel of patients at the Henry S. Chase Outpatient Center under the supervision of experienced faculty. Before each clinic session, residents participate in a pre-clinic conference, led by both a peer teacher and a core faculty member, which utilizes Yale’s internationally renowned Yale Office-Based Medicine Curriculum.

During the residents' continuity session, the faculty devotes their time exclusively to precepting. Typically, each resident will see 3-5 patients as PGY 1s, 4-6 as PGY 2's, and 5-6 as PGY 3's.

The Henry S. Chase Outpatient Center is located across the street from Waterbury Hospital. An electronic medical record allows for seamless documentation and sharing of patient information among providers. Physical plant resources include built-in audio-video equipment in two examination rooms, proxy server connections to the Yale Medical Library, and facilities for minor procedures. The practice sees greater than 20,000 visits per year, providing care for a large portion of numerous medically underserved communities. The payer mix is 62% Medicaid, 14% Medicare, 12% uninsured (self-pay), and 12% commercial insurers.

Residents will:

• Evaluate and manage patients with the range of problems encountered by primary care physicians;
• Address health care maintenance issues for adult patients
• Cultivate the robust set of physical examination skills essential to the practice of outpatient internal medicine;
• Perform primary care procedures, such as joint injection, cerumen impaction removal, etc.;
• Demonstrate communication skills necessary for effective medical interviewing and patient counseling;
• Orchestrate the longitudinal care of primary care patients, including follow-up, telephone medicine, and collaboration with consultants and various community services;
• Develop systems to convert their emerging information needs into well-formed clinical questions and to efficiently acquire, appraise, and apply medical information;
• Exemplify the highest standards of ethics in patient, professional, and interpersonal interactions;
• Efficiently provide patient-centered care as part of an interprofessional team within a practice microsystem;
• Accurately document and code for care provided in an electronic medical record.

• Understand the presentation, evaluation, and management strategies of chronic diseases and acute illnesses encountered by primary care physicians
• Understand the basic principles for interpreting diagnostic tests, including probability revision and cost-effectiveness
• Understand the health care system in the United States and Connecticut (and proposed reforms) and its impact on the provision of primary care

Residents will:

• Appreciate the rewards and responsibilities of assuming the primary care of a group of patients, including the importance of patient advocacy
• Consider their role as primary care physicians in the larger contexts of medicine in general, society, and their family and social networks

Residents will:

• Evaluate and manage patients with the range of problems encountered by primary care physicians;
• Address health care maintenance issues for adult patients
• Cultivate the robust set of physical examination skills essential to the practice of outpatient internal medicine;
• Perform primary care procedures, such as joint injection, cerumen impaction removal, etc.;
• Demonstrate communication skills necessary for effective medical interviewing and patient counseling;
• Orchestrate the longitudinal care of primary care patients, including follow-up, telephone medicine, and collaboration with consultants and various community services;
• Develop systems to convert their emerging information needs into well-formed clinical questions and to efficiently acquire, appraise, and apply medical information;
• Exemplify the highest standards of ethics in patient, professional, and interpersonal interactions;
• Efficiently provide patient-centered care as part of an interprofessional team within a practice microsystem;
• Accurately document and code for care provided in an electronic medical record.

Residents will:

• Understand the presentation, evaluation, and management strategies of chronic diseases and acute illnesses encountered by primary care physicians
• Understand the basic principles for interpreting diagnostic tests, including probability revision and cost-effectiveness
• Understand the health care system in the United States and Connecticut (and proposed reforms) and its impact on the provision of primary care

Residents will:

• Appreciate the rewards and responsibilities of assuming the primary care of a group of patients, including the importance of patient advocacy
• Consider their role as primary care physicians in the larger contexts of medicine in general, society, and their family and social networks

PGY-II

PGY-III

The Yale Department of Internal Medicine’s Research-in-Residency Program was created and is directed by Vincent Quagliarello, MD, vice chair for Education and Academic Affairs and professor of medicine (infectious diseases). Oversight for implementation of this program is provided by core faculty members Suleyman Felek, MD, and Medhat Ghaly, MD, FACP.

Learn more about the Research in Residency program.