The primary goal of the residency program is to develop well-rounded physicians. In addition, the program is designed to train the physician to see the patient as a whole person affected by family, society, environmental and economic factors, rather than as a disease entity.

Residents gain experience in a collegial, multi-disciplinary environment in the care of ambulatory and inpatients.

The emphasis in the outpatient experience is the long-term primary care management of patients. Residents will generally have two outpatient sessions each week, as well as continuity block time throughout  three years, in a variety of settings, clinic, physician's offices or community based projects. This element is designed to simulate office practice. Outpatient training includes rotations through both medical and non-medical subspecialties. There is a strong experience in both geriatrics and adolescent medicine. Approximately 400-420 beds are occupied daily by patients who are available to the Department of Medicine's teaching program. The Hospital Center serves a large and diverse population, providing a broad clinical base of varied disease entities. Each resident at the first-year level is responsible for eight to 12 patients. Inpatient teams on the medical floors are assigned geographically and are composed of one PGY-2 or PGY-3, two PGY-1s, and medical students. The teaching program includes a variety of well-organized learning experiences based on written curricula. These include formal rounds with attending physicians on the floors and acute care units, director's rounds, grand rounds, daily conferences, seminars, journal club, guest lectures, a board review course and a molecular medicine course.

Faculty
Salaried full-time physicians and select members of the voluntary staff comprise the nucleus of the residency program's faculty. 

Accreditation
The general internal medicine training program conforms to requirements on resident hours, supervision and credentialing mandated by the American Board of Internal Medicine and the State of New York . Upon successful completion of the three-year program, graduates qualify for the Board's certifying examination. The program is accredited by the Accreditation Council for Graduate Medical Education (ACGME(), American Board of Internal Medicine (ABIM) and the New York State Department of Health 

Students
Students from Weill Medical College of Cornell University participate in departmental activities and assist the residents as team members on the floor. They participate in departmental activities, as well as having weekly group teaching sessions with a preceptor, often the Chairman of the Department. 

The Program - Primary Care Training

Residency training in Internal Medicine at The Brooklyn Hospital Center emphasizes primary care in the context of an urban teaching hospital. Residents in the training program receive exposure to an unmatched variety of cases and diversity of patients.

The training program uses the "firm" model for ambulatory education, whereby residents are grouped into teams of eight to 10 physicians. By actively working together and sharing information, the firm is responsible for providing and/or tracking all aspects of care for a defined group of patients. The firm model enables residents to train with close faculty supervision and to participate in an on-call rotation for patients cared for by the firm.

Additionally, the firm enhances continuity between the inpatient units and the outpatient setting, as the physician caring for the patient in the office ­ or a colleague from the same firm ­ acts as a liaison to the inpatient team.

Continuity of care throughout the three years is a major focus, with residents having one or two half-day sessions in continuity clinic per week throughout the program. Fully one-quarter of the residents' time is spent caring for cadres of patients that they follow in outpatient settings throughout the three years. The continuity experience is carried out in one of the Hospital Center's many on- and off-site clinics, to fully-operational off-site primary care centers, to "private" faculty practice offices.

Residents have one month of ambulatory block time in the first year and a total of four months during the next two years. They have excellent exposure to ambulatory practice in fields important to the primary care practitioner, such as dermatology and gynecology.

Internal Medicine primary care faculty bring a wide range of experience to the program. Each is committed to primary care education, and actively provides primary care to the community.

Categorical First Year (PGY-1)
As the primary physician for assigned medical patients, the categorical first year resident works closely with attending physicians. Inpatient responsibilities in the first year of training include performing complete histories and physical examinations on patients; preparing a problem list; writing daily progress notes and orders using a modified problem-oriented approach; active involvement in decision making, choosing diagnostic and therapeutic interventions and providing care in a culturally sensitive manner.

One half-day each week is devoted to the continuity clinic caring for ambulatory patients assigned to the resident or to the resident's firm. There is also an exposure to outpatient experiences in non-medical specialty clinics. The first-year resident attends daily work rounds with the senior resident and teaching rounds with the attending each weekday. The resident works closely with medical students and provides the students with a significant part of their educational experience. On call duty averages every fourth night. There are also elective and ambulatory block rotations during the first year. 

Preliminary Year (PGY-1)
A preliminary year is available to those who require a clinical year prior to beginning residencies such as ophthalmology, radiology, anesthesiology, dermatology, rehabilitation medicine, or neurology. Candidates who are undecided about future career goals may also choose this program. Categorical and preliminary residents are considered co-equals except preliminary PGY-I do not work in clinics. If the resident decides to continue in medicine, the full year is credited toward board certification. Priority is given to current residents should a vacancy arise in the program for the second year. 

Second & Third Years
There is a graduated increase in responsibility and instruction throughout the program. No pyramid exists between the second and third years. Advancement, however, is determined by performance. 

Second Year (PGY-2)
The second year resident supervises, assists and teaches assigned first-year residents in their duties on the general floors and acute care units, and makes daily rotations with them and their medical students. The resident writes admission notes on each patient in conjunction with the attending and manages the ongoing care of hospitalized patients.  Ambulatory experience occurs both in general medicine continuity clinic and continuity sessions with experienced faculty in a practice setting, as well as block rotations in ambulatory medicine.

Second Year On-Call
On-call duties are every fourth day; a night float system admits and manages patient at night.

Third Year (PGY-3)
The third-year resident supervises ward rotations and spends several months in elective subspecialty rotations in a consultative and teaching capacity. The remainder of the year includes rotations through emergency service and admitting/consultation service. Ambulatory experience occurs both in general medicine continuity clinic and in continuity sessions with experienced faculty in a practice setting, as well as block rotations in ambulatory medicine. Supervision is provided to PGY-2 and PGY-3 residents and medical students by the attending staff and faculty. 

Third Year On-Call
On-call duties are every sixth or seventh day; a night float team manages new admissions during the nighttime hours. At the end of the year, the resident is eligible to sit for the certifying examination of the American Board of Internal Medicine. 

Chief Resident (PGY-4)
The year is designed to improve further upon general medical and subspecialty skills, to work on clinical research projects and to enhance teaching and administrative aspects of the residency program. It is a year to expand one's knowledge and clinical base in preparation for the examination or to prepare for fellowship training. 

Evaluations
Evaluations are completed by inpatient and outpatient teaching attendings, other residents, and select members of the staff. A bedside examination is conducted annually for all residents. A composite evaluation is written by the Program Director at the end of each year. Residents are also evaluated by periodic written Departmental In-service examinations structured to prepare the candidate for the ABIM certifying examination. Though not part of the process, residents are encouraged to take the ACP In-service examination. The residents, in turn, submit periodic evaluations of the teaching attendings and of the program. They are involved in contemplated changes in the curriculum. Biennial sessions are held with each resident to review performance. There is an open-door policy and residents have access to the Program Director. Counseling and support services are immediately available to anyone who requests them. 

Fellowships
There are approved fellowship programs in Gastroenterology, Hematology/Oncology and Pulmonary Medicine. Preference is given to medical residents who have demonstrated the highest degree of ability requisite to enter advanced training. For further information about fellowships, please call 718-250-6925. 

Research Projects
A clinical research project or in-depth case report is a mandatory requirement in residency. It may begin in the first or second year, with the added goal of either submission for presentation at a local or national scientific meeting or for publication. 

How to apply
Applications are accepted through ERAS.  For further information call or write to Lydia Phang, Residency Coordinator of the Department of Medicine, 121 DeKalb Avenue , Brooklyn , NY 11201 (718) 250-6946.