The overall goal of the training program is to develop healers and leaders in medicine. House staff education on the inpatient wards, in the ambulatory clinic, and in didactic teaching sessions is done by both primary care and subspecialty faculty who are full-time members of the SOM. Two assistant chiefs of service (our equivalent of chief residents), outstanding clinicians and teachers with SOM appointments, work closely with the directors of the department of medicine to mentor and educate house staff. Exposure to primary care physicians and subspecialists provides an opportunity for house staff to acquire knowledge, clinical skills, professional attitudes, and experience from different perspectives, creating a rich and enjoyable learning environment.
The training program offers both a "traditional" (i.e. categorical) and a primary care / general internal medicine (GIM) track. The PGY-1 experience for each track is identical and house staff from both tracks work "side by side" on inpatient rotations and in the resident's continuity clinic, the Medical House Staff Practice (MHSP). Beginning in the PGY-2 year, house staff who choose the GIM track have an expanded general medicine ambulatory experience and curriculum while those in the traditional program may tailor elective time to focus on one or more medical subspecialties, perform research activities, or participate in the ambulatory components of the GIM program. There is flexibility in the program, and it is not uncommon for residents to change tracks during training as their learning objectives and career goals evolve.
In the PGY-2 and PGY-3 years, all house staff participate in the Bayview Ambulatory Subspecialty Interdisciplinary Curriculum (BASIC). Residents rotate through clinics in cardiology, pulmonary medicine, hematology / oncology, endocrinology, nephrology, gastroenterology, rheumatology and geriatrics. The goal is to allow residents to learn aspects of the subspecialties that are no longer prominently featured in the inpatient setting, but are critical to the practicing internist. Residents in the traditional track participate in the BASIC for three month-long rotations; those in the primary care/GIM track have this experience integrated into their every third month ambulatory rotations.
The Traditional / Categorical Track
The Johns Hopkins Bayview traditional / categorical program is designed to train leaders in internal medicine and the medical subspecialties. Residents are taught and mentored by outstanding clinicians and researchers who help prepare house staff to become excellent physicians. Traditional / categorical residents are exposed to excellent training in diverse settings ranging from state-of-the-art medical and cardiac intensive care units to general internal medicine and subspecialty clinics. The high faculty to resident ratio facilitates the formation of close relationships between house staff and attending physicians, which are extraordinarily important to residents both during and after training. While GIM residents spend much of their PGY-2 and PGY-3 years in ambulatory practice, traditional/categorical residents have considerable elective time that can be tailored to meet their evolving educational goals and career objectives. Each resident in the traditional / categorical track is assigned an advisor who meets regularly with the resident to help shape the second and third years of training and to provide individual mentoring. In addition, each resident meets regularly with the program director who provides career advice and can serve as a strong advocate for the resident either for fellowship application or for another career path. Based on the resident's needs, the program director often facilitates meetings with local internal medicine or subspecialty faculty or practitioners to allow the resident to get a "bird's eye view" of life as an internist or subspecialist in various settings. We pride ourselves on being a program of academic excellence whose size and environment allow the resident to get the "personal touch." As a result of this focused mentoring and individual attention, combined with the academic excellence and reputation of our house staff and the Hopkins Bayview program, our residents have an unsurpassed record of obtaining subspecialty fellowship programs at leading academic institutions of their choice.
General Internal Medicine Track
The Johns Hopkins University GIM residency program at Hopkins Bayview started in 1979 and is one of the nation's most highly regarded residency training programs in primary care internal medicine. Each year, based on feedback from the GIM residents, the program has continued to evolve to meet the needs of young doctors who face a rapidly changing health care system.
The major distinction of the GIM track is the amount of time devoted exclusively to ambulatory practice and theory. During the PGY-1 year, both GIM and traditional track residents participate in two non-hospital-based GIM rotations: the Foundations of Clinical Excellence rotation and the evidence-based medicine rotation, described later.
During the PGY-2 and PGY-3 years, GIM residents spend much of their time in ambulatory practice. Three residents are teamed with a community-based preceptor (a full-time member of the Johns Hopkins faculty) to make up a small group practice or "firm." Each resident spends every third month dedicated to the group's practice, with no duties inside the hospital. Three sessions per week are committed to the group's community-based practice, one session to the resident's medical house staff practice (MHSP) and one session to home visits that are part of the Geriatric Division's Elder House Call Program. Residents maintain patient continuity in all three of these practice activities. In addition, four sessions per week are dedicated to the primary care approach in areas not included in the traditional track: ophthalmology, otolaryngology, gynecology and women's health, orthopaedics, and dermatology, or to ambulatory training in the medical subspecialties (BASIC). Weekly didactic seminars during ambulatory sessions cover topics such as community-oriented primary care, practice management, and important clinical topics in primary care such as Musculoskeletal Medicine.
The GIM division also offers electives in substance abuse, care of terminally ill patients, and care of medically underserved populations in Baltimore and elsewhere. Dinner meetings are held quarterly to discuss trends in U.S. health care, career planning, management and issues surrounding the multicultural nature of medical practices in the Hopkins Bayview area. The division also invites a nationally recognized leader in ambulatory medicine to spend a day with residents.
Finally, each GIM resident is assigned to an advisor; the two meet at least quarterly to make plans both for the residency and beyond and to discuss ways of meeting each resident's professional and personal needs.
Click here to learn more about the Division of General Internal Medicine.