One-Year Preliminary Program
At Norwalk Hospital, we feel that the preliminary resident is an essential and valued part of the overall residency program. Therefore, our Preliminary Internal Medicine and Categorical Year schedules are identical with the addition of special mentoring so individual goals are met. For many Preliminary residents, this year is the only opportunity to learn inpatient and ambulatory medicine and to be prepared for caring for the complicated patient during the rest of your career. All first-year residents have Ambulatory Medicine and elective time. The integration of the Preliminary and Categorical residents is facilitated by the fact that most of our residents choose to live in subsidized apartments across the street from the hospital.
Inpatient care at Norwalk includes exposure to Team Care (general medicine and neurology patients) and critical care units (including intensive and cardiac care). Team Care, our inpatient medical service, provides broad clinical exposure with a special blend of autonomy and personalized supervision. The critical care experience emphasizes the importance of an organized thought process when caring for complicated patients.
During the first year, all residents have two Ambulatory months, placed throughout the year, with special educational programs. There are physical diagnosis skills and quality improvement courses as well as ambulatory conferences. All residents receive a personal business card upon entry to the program and are expected to develop a thriving continuity medicine practice at the Norwalk Community Health Center. Continuity patients include patients discharged from the hospital and patients who have never been inpatients. Translation services are available at the Health Center to facilitate communication with all patients and families.
The goal of the Categorical Internal Medicine Residency is to train superior internists able to care for inpatients and outpatients across a wide disease spectrum. By graduation, all of our residents have participated in leadership and scholarly activities. Our program is the right size to provide breadth and depth of experience with personalized mentoring and feedback. The three major areas of clinical exposure are Team Care, Critical Care and Ambulatory Medicine at the Norwalk Community Health Center. These areas are also further described within the Learning Environment page. We have a high Internal Medicine Board passage rate, with our residents pursuing excellent fellowship and practice opportunities upon graduation from our program.
- Team Care
Team Care (general medical floors) is vital to our residents’ education program and the delivery of quality healthcare at Norwalk Hospital. There are seven teams participating in Team Care as well as a night float system.
The Team Care Service has ten full-time hospitalist clinician-educator faculty members and one Chief Resident responsible for much of the ongoing teaching, in addition to that provided by other members of the Department of Medicine. Our hospitalists are stellar teachers and clinicians who have published their unique approach to inpatient care and teaching in prominent medical journals. On Team Care, you are responsible for all patients admitted under your care under attending supervision and enter all orders. Team Care is an invaluable close-to-the-patient learning experience and includes daily resident reports, walk rounds, daily teaching conferences and journal club.
- Critical Care Facility
The Norwalk Hospital Critical Care Facility is nationally recognized for its work developing new technologies, including the use of computers in patient care. While on this rotation, our residents are closely involved with the care of patients in the Coronary Care Unit, Medical Intensive and Respiratory Care Units as well as the Telemetry Unit. The house staff team has one PGY-3, two PGY-2s and four PGY-1s, as well as a critical care fellow and a full-time teaching attending.
- Ambulatory Medicine
Ambulatory training in a variety of sites is critical to the development of outstanding clinicians. Our Ambulatory Medicine Program is composed of two major parts: continuity care and the ambulatory rotations offered in each of the three years.
- Continuity Care
Participating in a unique academic practice model, residents follow their own group of patients in conjunction with a faculty member, at a state-of-the-art ambulatory care center located in Norwalk. Special emphasis is placed on the development of the patient-physician relationship, as well as establishing preventive medicine approaches to patient care. Teleconferencing equipment allows the residents to participate directly in conferences held at the hospital. Five faculty members and the Ambulatory Chief Resident work closely with the house staff in this setting, allowing for close one-on-one supervision and mentoring.
- Ambulatory Rotations
There are Ambulatory block rotations in each of the three years of residency. The time is divided between a variety of patient opportunities and a significant number of educational conferences. An extensive Ambulatory Curriculum includes exposure for medicine residents to nursing home care and multiple practice sites.
The patient care opportunities include continuity and acute medical visits (with particular emphasis on the approach to patients with undiagnosed symptom complexes), a general internal medicine private practice office experience, subspecialty office experiences, geriatrics (including a four-week rotation at a teaching nursing home) and hospice care. The educational conferences include an ambulatory resident report, ambulatory care curriculum, evidence-based medicine, clinical skills curriculum and a quality improvement.
Residents are provided a personal business card upon joining the program with the Norwalk Community Health Center phone number. Senior residents and faculty provide phone coverage 24 hours a day, seven days a week, so our patients have ready access to physician advice and residents have experience with telephone medicine.
The Department of Medicine believes strongly in the humanistic approach to patient care and has worked closely with the Department of Psychiatry in the development of this concept. Members of the Psychiatry Liaison Staff work closely with the residents in the care of their patients in both the inpatient and outpatient areas.
- Subspecialty Rotations
While at Norwalk Hospital, each resident is able to choose from many subspecialties electives including Hospitalist Medicine, Cardiology, Endocrinology, Gastroenterology and Nutrition, Hematology-Oncology, Neurology, Pulmonary Medicine, Nephrology, Wound Care, Allergy and Immunology, Rheumatology and Pathology. Residents also take electives at Yale where they draw upon the knowledge and skills of physicians doing pioneering work in the practice of medicine and in research.
- International Medicine/Global Health
In addition to exposure to general medicine as practiced in another setting, this elective offers a chance to experience another culture and broaden one’s perspective in a structured way through a partnership with the University Of Vermont School Of Medicine.
The Medical Student Program
The Department of Medicine offers clerkships for third- and fourth- year students. The clerkships include General Internal Medicine inpatient clerkship, sub-internships in inpatient General Internal Medicine and Critical Care, and elective rotations in Hospitalist Medicine, Cardiology, Endocrinology, Gastroenterology, Neurology, and Pulmonary Medicine. The Department of Medicine has affiliations with the Yale University School of Medicine, The University of Vermont and Ross University. Occasionally, students come from other schools as well.