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Curriculum

Internal Medicine Residency Curriculum

Our curriculum is designed to equip residents with the skills to be competent and confident physicians prepared to sit for the American Board of Internal Medicine (ABIM) examination. We also offer Osteopathic training through the Osteopathic Recognition Track, which prepares you to sit for the American Osteopathic Board of Internal Medicine (AOBIM) in addition to the ABIM.

The curriculum emphasizes focused learning in inpatient and outpatient settings. In 2020, we moved to a “3+1” block scheduling system, where residents are split up into four “firms” and are scheduled for 3 week blocks of an inpatient service (including ED or ICU) or elective, followed by a 1 week ambulatory block rotation that occurs 13 times a year.

This model allows for focus on scheduled rotations with limited cross-coverage, opportunities for wellness and self-care and improved continuity with patients in clinic

Residents rotate with a core of teaching attendings on the wards and in continuity clinic. Teaching attendings take residents to the bedside and engage patients, family and nursing staff to provide patient-centered care. In the continuity clinic, residents participate in team-based care with medical assistants, nurses and IM faculty.

Osteopathic Recognition

The Osteopathic Recognition track is an ACGME accredited track offered to any resident (DO or MD) interested in furthering their skill in Osteopathic Manipulative Therapy (OMT) or Osteopathic Principles and Practice (OPP). Residents in the track have multiple longitudinal opportunities to grow as osteopathic practitioners through our OMT clinic, our inpatient OMT consult service, quarterly seminars and monthly didactics and practical teaching sessions.

With our osteopathic affiliate, Philadelphia College of Osteopathic Medicine – Georgia Campus right around the corner, residents also benefit from the teaching and mentorship of osteopathic physicians who are board certified in OMM/Neuromuscular Medicine, and in turn, get to mentor medical students interested in Internal Medicine.  Participation in the track will prepare you to sit for the AOBIM board examination (alongside the ABIM exam) and allows you to be board certified prior to graduating residency.

OMM Silly
OMM Silly

Career Development Pathways

Unique to our training program, we offer individualized learning plans and pathways to help prepare residents for their future career goals. Information for our specific pathways can be found below. Residents may receive focused mentorship in various pathways including global health and social medicine, academic medicine, primary care, hospital medicine, advocacy and subspecialty fellowships.

Highlights

Ambulatory Medicine Block

The ambulatory experience occurs in 1-week blocks every 4 weeks (13 blocks a year) throughout the year. Here, residents spend time in continuity clinic as well as other educational settings to enhance practice and understanding of primary care (see below). This allows residents to experience all aspects of ambulatory care, including acute illness care, routine continuity and chronic disease management, post-hospital discharge and health care transitions and subspecialty care in nephrology and infectious disease. Some unique features of our ambulatory curriculum include:

Academic Internal Medicine Partners Continuity Clinic

Residents see their personal panel of patients at Academic Internal Medicine Partners (AIMP), our primary care clinic created specifically for the residency program. Residents learn ambulatory medicine through our comprehensive ambulatory curriculum and build a patient panel at the practice which they will follow throughout their residency program. Many of the patients are recruited during a resident’s inpatient ward experience and continuity in transition into the outpatient setting is maintained.

Foundations in General Internal Medicine Curriculum

Residents on ambulatory and quality improvement rotations participate in an ambulatory morning report discussing core topics in ambulatory general internal medicine and evidence based medicine. Residents complete online pre-work and readings and discuss landmark articles and guidelines in a case based format.

Osteopathic Manipulative Therapy (OMT/Musculoskeletal Clinic)

Residents (both DO and MD) interested in musculoskeletal medicine can participate in weekly OMT/MSK clinic as well. The focus is on practical, hand-on experience in dealing with common musculoskeletal complaints that are abundant in all primary care practices.

Residents learn common modalities of manual therapy, exercise therapy and supplemental medical therapy to optimize patients’ functional and quality of life.

OMM 1
OMM_2

Lifestyle Medicine/Weight Management Clinic

Our clinic offers patients the opportunity to treat disease and optimize health through therapeutic lifestyle changes, including focus on nutrition, physical activity, sleep and mental health. Interested residents work with our two faculty who are board certified in Obesity Medicine to work with patients to optimize their health, quality of life and longevity.

Veterans Affairs Ambulatory Clinic

Through collaboration with the Atlanta VA Medical Center some residents participate in continuity clinic the Lawrenceville VA Community Based Outpatient Clinic during the ambulatory block to gain experience in the health care of veterans. This exposes residents to a unique patient population as well as a unique health care system.

Public Health/Tuberculosis Clinic

Perhaps one of the most unique experiences residents at Northside receive is working at the Gwinnett-Rockdale-Newton Public Health Preventative Health Clinic in Lawrenceville. Here, residents get the opportunity to treat patients with tuberculosis as well as other common chronic conditions, which are often diagnosed at presentation. Residents see cases of extra-pulmonary TB from head to toe, including TB meningitis, peritonitis, Pott’s disease, genitourinary TB and TB arthritis. Additionally, residents get to learn the fundamentals and practice of social medicine, as many of the patients in the clinic do not have insurance or any history of prior healthcare. Residents get to practice continuity of care as our patients from this clinic continue to follow us at AIMP after their tuberculosis is treated.

During this experience, residents also learn to place and read PPDs, read common x-rays and CT findings suggestive of TB, do home visits and directly observed therapy (DOT) and see opportunities for working with the Department of Public Health (DPH).

Subspecialty Continuity Clinic

As available, PGY 2 and 3 residents are placed in subspecialty continuity clinics for 1-2 half days a block in the subspecialty to which they plan to apply.  This allows for a longitudinal experience and mentorship from an expert in their chosen field.

Community Health Clinic

Residents in the Global Health/Social Medicine Pathway and Osteopathic Recognition Track spend time at the Cosmo Health Community Health Center, a local Federally Qualified Health Center that exposes residents to a unique and diverse group of patients from all over the world, while working in a resource-limited setting.

Didactics

Academic Half Day

Residents have a dedicated educational block ("academic half day"), during their ambulatory week. This highly interactive small group session focuses on health promotion and disease prevention, women’s health, advocacy and health equity, practice of evidence-based medicine, high value care, and point of care US (POCUS).

Hospital Noon Conference

Hospital noon conference occurs 3-4 times a week and focuses on inpatient medicine. Early in the year is focused on foundations of inpatient medicine primarily for PGY-1’s, while later in the year focuses on higher level diagnosis/management and board review.

Grand Rounds

Internal Medicine residents participate in a weekly Grand Rounds series that brings guest presenters, both locally and nationally, to talk about various topics in Internal Medicine.

Morning Report and Intern Report

During the week, residents participate in morning report, where cases from the night prior are discussed in depth. The focus of learning is on clinical reasoning and evidenced based diagnosis and management. Once weekly, there is a conference dedicated to interesting radiology or EKG findings seen in the past week.

Intern report is a once weekly interactive session, which focuses on clinical reasoning and the diagnostic process.

Grand Rounds

Patient Safety Conference

Once monthly, we have a patient safety conference where cases that highlight issues of patient safety are discussed. Residents learn the process of root cause analysis and the multifactorial nature of patient safety.

Conferences end with discussion of institutional changes that can happen to prevent similar patient safety issues in the future, as well as discussion of implementation of prior changes from previous conferences.

Skills Development

As one of our most innovative rotations, the skills development block is a dedicated educational session in block 7 of intern year that aims to enhance physical exam skills, medical knowledge and clinical decision-making. The rotation takes interns through a variety of learning methods, including simulation, didactic lecture, game-based review and resident-led teaching.

Residents teach and learn physical exam techniques, presentation skills, self-assessment and feedback skills and other tools to help them transition to the second half of the intern year. Topics covered during the block are based on a needs assessment determined by rotation feedback, in-training exams, and directly observed needs by faculty. 

Simulation

Simulation is one of the most important innovations in medical education in recent times. Northside Hospital Gwinnett has embraced simulation-based training in its residency programs and throughout the hospital. Newly opened in 2021, our Diane Clark Center for Patient Simulation, Education, and Safety has cutting-edge technology, including multiple hi-fidelity simulators, a cardiopulmonary physical exam simulator, and procedural task trainers for central line placement, thoracentesis, paracentesis, lumbar puncture and knee/shoulder injections.

Internal Medicine residents also receive individual licenses for online instructional modules for point of care diagnostic ultrasound with the ability to practice on both real ultrasound and an ultrasound that simulates common pathologies.

Simulation sessions are held weekly on the ambulatory rotation, in academic half day, and at various times in the year including intern orientation and Skills Development. Internal medicine faculty, led by a faculty physician certified in simulation education, individualize simulation experiences to the needs of each resident to ensure they receive the most out of simulation training.

Skills development
Simulation 1

Resident As Teacher/Personal-Professional Development Series

Residents have multiple opportunities to grow as educators throughout their training. During inpatient general medicine wards and cardiology service, residents will supervise 3rd and 4th year medical students. Senior residents also serve as team leaders and managers of the inpatient team, supervising interns in Internal Medicine and Transitional Year programs.

PGY1 Retreat

Retreats are held on a semi-annual basis that focus on team building, leadership, and teaching methods to improve skills as a team managers and educators.

Structure of the ward teams include PGY 3 senior residents who serve as the team educators, leading teaching sessions with residents and students and teaching core inpatient medicine topics. Senior residents may also take a senior teaching elective in either their PGY2 or PGY 3 year, where they spend 2-4 weeks working on an educational project. Past projects have included night float and ultrasound curricula and a resident needs assessment.

Towards the second half of the year, rising PGY 2 and PGY 3 class split up in interactive sessions which focus on personal and professional development, and being a team leader and educator. These have been well received and our series has been presented nationally at educational conferences.

Procedure Training

Residents in the inpatient setting participate in performing bedside procedures including central line placement, paracentesis, thoracentesis, lumbar puncture, midline placement, and ultrasound guided IV placement. Residents undergo skill acquisition by completion of both pre-work and simulation followed by real hands on procedures.

Point of Care Ultrasound Curriculum

Residents receive lectures on image interpretation during noon conference and twice annually undergo hands on training with designated standardized patients. In addition, residents interested in point of care ultrasound participate in an ultrasound curriculum for a full week during which they spend more time on image interpretation through both daily didactics and simulation in addition to real life patient experiences.

Point of Care Practice

Geriatrics

Residents have ample exposure to geriatrics during their residency training. Each resident will complete a geriatrics rotation, where they rotate at Northside Gwinnett Extended Care Center, located on the Northside Hospital Gwinnett campus, caring for sub-acute rehabilitation and skilled nursing patients on the nursing home teaching service.

 

Online Curriculum 

Medical knowledge is constantly evolving and to assist residents in keeping up with reading and self-assessment, the program provides several web-accessible curricula and question banks specifically for Internal Medicine residents. Residents have paid access to Challenger, a large online question bank and reference material for topics in internal medicine and Rosh Review, an interactive board review platform. Online access to the Physician Education and Assessment Center’s Internal Medicine Ambulatory Care Curriculum provides focused ambulatory education for residents to complete during their outpatient rotations. In addition, all categorical residents receive the American College of Physicians MKSAP program at the start of PGY-1 year. All residents have access to UpToDate, Virtual Dx, Access Medicine and Dynamed, as well as the full online medical library at Northside Hospital. 

Community Service 

Advocacy and community involvement are some of the cornerstones of being a well-balanced physician. In this spirit, residents participate in a community service project yearly that gives back to the Gwinnett County community in which we serve.

Former resident projects have included volunteering at community health fairs, providing medical care at free clinics, and participating in Breathe Better Gwinnett, a system wide community health fair funded by a CHEST Foundation grant focusing on respiratory disease identification and prevention. Residents in the OR track and Global Health/Social Medicine Track also volunteer at a Grace Village Clinic in Clarkston, GA, a hub many new immigrants and refugees from all over the world.

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