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General Internal Medicine and Traditional Tracks Compared
What are the similarities between the GIM and Traditional Track residencies?
- All residents receive intensive training in Ward Medicine, ICU, CCU and Emergency Medicine. All residents have scheduled rotations in Neurology, Hematology-Oncology, HIV Care, and Chemical Dependency.
- Two ambulatory rotations in the PGY-1 year for all medicine residents, include Foundations of Clinical Excellence , a month for focusing on interviewing skills, psychosocial medicine and physical diagnosis, and Evidence-Based Medicine/Systems-Based Practice, a month for focusing on the retrieval, assessment, and presentation of evidence for effective medical practice, and on the principles of quality improvement in medical practice. In both months, emphasis is on the diagnosis and management of common ambulatory problems.
- Ambulatory training in traditional medical subspecialties, including cardiology, endocrinology, gastroenterology, geriatrics, hematology-oncology, pulmonary medicine, nephrology, and rheumatology, is an essential feature of the PGY-2 and PGY-3 curricula for both GIM residents and categorical track residents. Categorical residents spend 3 months training in these outpatient clinics at Johns Hopkins Bayview Medical Center; this is part of the every third-month Ambulatory Rotations for GIM Residents.
- All residents spend one half day each week in a hospital-based primary care practice precepted by GIM faculty (Medical House Staff Practice). Residents care for their own panel of patients and follow them over three years of residency. In the third year, all residents spend one month in the Medical House Staff Practice full time, providing acute care and intercurrent care for patients in the practice, and precepting PGY-1 residents in a “New Patient” clinic.
- All residents participate in the General Medicine Consultation (GMC) Service and Curriculum. Every resident spends two weeks in each of the PGY-2 and PGY-3 years providing general medical and preoperative consultations on non-medicine services, under the supervision of faculty general internists. Weekly GMC teaching rounds include presentation of interesting and challenging cases. There is also a monthly didactic GMC Conference, and a syllabus of reference materials which complement clinical experiences during GMC Rotations.
What are the differences between the GIM and Traditional Track residencies?
In addition to the above curricula, GIM residents receive more intensive ambulatory training designed to prepare them to practice in primary care settings and in managed care networks.
- Every 3 months during the PGY-2 and PGY-3 years, GIM residents spend a month in an ambulatory practice rotation. During each week of the rotation, 3 half-day sessions are spent in a community-based practice (CBP). Three residents, who form a “firm” or small group practice with core GIM faculty preceptor(s), follow a shared panel of patients in the CBP. One half-day per week is spent in a unique continuity clinic called Johns Hopkins Home-Based Care (JHOME), making scheduled visits to homebound patients under the supervision of faculty in the Geriatric Division. The other half-day sessions are divided between ambulatory training in the medical subspecialties (listed above), as well as training in non-internal medicine specialties relevant to primary care (dermatology, gynecology, ENT, ophthalmology, and orthopedics).
- Each GIM resident is assigned a GIM faculty advisor, while categorical residents are assigned faculty advisors based on their subspecialty interests. Residents and advisors meet quarterly to discuss the resident’s experience in the program, formulate individualized learning plans, identify additional potential advisors and mentors, and to plan for post-residency careers.
- Traditional track residents have more elective time to pursue subspecialty interests than do GIM residents, who gain broader exposure in outpatient subspecialty medicine during their 8 ambulatory months in the PGY-2 and PGY-3 years. GIM residents get, on average, 3 to 3 ½ months of elective time over the three years of residency.
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