Internal Medicine Residency

About the Program

Our Internal Medicine residency program is a three-year training program that consists of 45 house officers and two chief residents. Our program is ACGME- and ABIM-certified as a categorical residency program.

 

Our residents have a significant role in shaping the curriculum. Monthly resident feedback sessions (“Town Halls”) with the program director ensure we are meeting the educational and professional needs of our house staff. Our residents are also invited to completely review our core curriculum. This core curriculum, combined with conferences and Board Review lectures, ensures that our residents obtain a thorough knowledge of internal medicine principles. Our residents also review the program’s annual policies and procedures manual.

 

Two hospitals serve as the principal education centers for both inpatient and outpatient clinical experiences – the Nashville General Hospital at Meharry (NGH, an urban charity facility) and the Department of Veteran Administration Tennessee Valley Healthcare System, Alvin C. York Campus (VA). The residents spend approximately 50% of their time at each facility. Both facilities offer training by Board certified internists and specialists. General medical floor and intensive care unit (medical and cardiac) experiences are available at both hospitals. There are also training opportunities in the medical subspecialties as well as orthopedics, rehabilitation medicine, otolaryngology, gynecology, neurology, ophthalmology and outpatient psychiatry.

 

The Internal Medicine residency program is closely associated with the Meharry Medical College School of Medicine. Our residents are expected to supervise and teach third- and fourth-year medical students during their Internal Medicine rotations. The school’s resources, such as an extensive digital medical library and computer system, are available to all of our residents 24 hours a day.

 

The Department of Internal Medicine has strengthened its commitment to performing high-quality research with an emphasis on improving the care of minority patients. Our goal is to encourage all our residents and students to participate in scholarly activities related to ongoing clinical trials. This renewed focus on research should allow us to cultivate among our residents an interest in careers in academia and life-long learning.

 

Meharry Medical College’s Internal Medicine program offers a nurturing setting for our residents to be exposed to a broad range of patients at all stages of their illness (acute to chronic, ambulatory to nursing home) while participating in a stimulating academic environment.

 

The internal medicine residency training program is designed to help develop a fully rounded internist. Our objectives include, but are not limited to, development of the following:

  • Ability to generate a complete and accurate differential diagnosis list;
  • Ability to write proper histories, progress notes and discharge summaries;
  • Skills in the management of complex disease;
  • Familiarity with all phases of a patient’s care from continuity clinic to the ED to ward teams to the MICU/CCU;
  • Ability to perform—and teach—a wide variety of procedures without assistance;
  • Ability to work as a leader of the health care team;
  • Ability to manage patients in both the inpatient and outpatient settings; and
  • Ability to pass the ABIM Boards through an integrated series of review sessions and core lectures

 

Note: Passage of USMLE Step 3 is a requirement for promotion to PGY-3 level.

Eligibility & Requirements

Interviews are required and are by invitation only from the Residency Selection Committee. Interviews will not be offered until receipt of all of the above documents. Interviews are in the mornings and include attendance at either noon conference or Grand Rounds and a tour where you can freely and privately discuss the residency with a current house officer.

Requirements:

  • Applicants must be a graduate of an LCME approved medical school in the United States or an international school recognized by the State of California.
  • Graduation date is preferred to have been within the last five years of the beginning date of the PGY year (July 1st), but we will consider up to 10 years.
  • Applicants must have successfully passed USMLE Step 1, Step 2 CK and Step 2 CS exams.
  • Applicants must be either a United States citizen or permanent resident (“Green Card”). We do not sponsor visas or authorization to work permits (“EAD”).
  • Applicants must have no prior United States residency experience in any field of medicine.

To apply, submit:

  • ERAS application
  • Dean’s letter (MSPE) and three additional letters of recommendation
  • Medical school transcripts
  • USMLE Step 1 and Step 2 scores, dates and number of attempts at each exam
  • International medical graduates must also submit a valid ECFMG certificate and proof of permanent residency status (i.e. a copy of Green Card)

Contact Internal Medicine

Internal Medicine Residency Program
Meharry Medical College
1005 Dr. D. B. Todd, Jr. Boulevard
Nashville, Tennessee 37208-3599
Telephone: 615.327.6277

Rotation Curriculum

Inpatient Rotations
The Department of Internal Medicine operates on the thesis that the best patient care is rendered when major responsibility rests with the intern and assistant resident under the purview of the chief resident, all having ready access to attending faculty and consultants.

 

PGY-1 (Internship)

 

PGY-1 residents, otherwise known as interns, have the following major responsibilities:

  • Initial evaluation of all patients, including assimilation of old records and outside information
  • Developing a plan for each patient to present to the resident
  • Communicating with the patient and family about treatment plans, consultations, risks and benefits of procedures and medications, and other aspects of care
  • Getting write-ups on the chart no later than 8:00 a.m. following a call day
  • Discussion of “Do-Not-Resuscitate (DNR)” orders and other end-of-life issues when appropriate
  • Asking surviving family members for permission to perform an autopsy
  • Working on discharge planning from day one
  • Writing daily progress notes

Interns are expected to attend all daily attending rounds (except when off duty), morning report, Grand Rounds, and all other teaching conferences. Interns work closely with medical students and assist with their education.

The PGY-1 year is organized to ensure a comprehensive clinical experience in a variety of settings. The intern “learns by doing,” and must be kept at the forefront of patient evaluation and therapeutic decision making if he or she is to develop the confidence and proficiency upon which sound clinical judgment is based. The teams provide the intern with individualized supervision and the resident with time for study, case management, and teaching.

 

PGY-2, PGY-3 (Assistant Residency)

 

The primary roles of the PGY-2 and 3 residents are supervision and education. This includes:

  • Seeing every patient on the day of admission and writing a note
  • Review and approve diagnostic and treatment plans with the interns
  • Review patients’ progress daily, giving feedback to the intern on progress notes, order writing, and discharge planning
  • Organizing and planning attending rounds, meetings with consultants, and other teaching opportunities
  • Setting time aside for teaching medical students, including reviewing write-ups and giving timely feedback
  • Creating an atmosphere such that the intern is encouraged to ask for help when appropriate
  • Supervising procedures
  • Dictating discharge summaries
  • Interacting with nurses and other personnel in a way that respects all members of the healthcare team and encourages their input
  • Being certain all members of the team are familiar with the current literature regarding their patients
  • Attending teaching conferences including Grand Rounds, Morning Report, Noon Conference, and Journal Club

The upper-level resident is responsible for all aspects of the patients’ care. As such, this resident is ultimately responsible for requesting consultations and interacting with them, for keeping the attending fully informed of changes in status, and for overall supervision of the intern(s) and student(s).

Curriculum

PGY-1 Residents:

  • General Medicine—32 weeks
  • Electives (including multispecialty block rotation)—9 weeks
  • Emergency Medicine—4 weeks
  • ICU—4 weeks
  • Vacation—3 weeks

PGY-2 Residents:

  • General Medicine—20 weeks
  • Electives—17 weeks
  • ICU—12 weeks
  • Vacation—3 weeks

PGY-3 Residents:

  • General Medicine—20 weeks
  • Electives—17 weeks
  • ICU—12 weeks
  • Vacation—3 weeks

Night Float

  • Interns have two, 2-week night float rotations.
  • PGY-2 & PGY-3 residents have one, 2-week period of night float.

Emergency Medicine Training
All interns are assigned a rotation in the Emergency Department under the supervision of full-time academic faculty in emergency medicine. This is a well-organized rotation with excellent teaching; on this rotation interns attend a morning didactic series that addresses topics in emergency medicine and ambulatory care. A second designated emergency medicine rotation is assigned during the PGY3 year.

Rounds and Conferences

Attending Rounds
Bedside teaching rounds are conducted on the inpatient clinical services seven days per week. The emphasis is on developing fundamental clinical skills, diagnostic reasoning, pathophysiology, and professionalism. Our department has a written policy that teaching rounds are to be conducted “at the bedside.” Emphasis is on evidence-based medicine and on creating an environment that optimizes learning and patient care. All residents have continuity clinic ½-day per week. The program strictly adheres to all ACGME mandates, including work hour restrictions. Our program operates with 4-week rotations, resulting in 13 rotations annually. Resident supervision is available at all times by attending physicians who are on-site twenty-four hours a day.