PROGRAM STRUCTURE

Internal Medicine

Program Structure

Our program is designed to prepare our trainees for the full scope of practice in Internal Medicine. Our graduates leave the program comfortable with acute and critical care, outpatient medicine, and procedures.

The academic year (July 1-June 30) is divided into 26 two-week blocks. All residents will rotate through the medical wards, intensive care unit, night float, ICU night float, various inpatient and outpatient electives, and the ambulatory clinics.

PGY1
  • Inpatient Floors – 7-8 blocks
  • ICU – 4 blocks
  • Night float – 3-4 blocks
  • Ambulatory Medicine – 6 blocks
  • Elective (Neuro and Geriatrics) – 3 blocks
  • Vacation – 2 blocks
  • Emergency Medicine - 2 blocks
PGY2
  • Inpatient Floors – 6-7 blocks
  • ICU/ICU Night float – 4/3 (total 7 blocks)
  • Night float- 1-2 blocks
  • Ambulatory Medicine – 6 blocks
  • Elective – 3 blocks
  • Resident Admitting Officer – 1 block
  • Vacation – 2 blocks
PGY3
  • Inpatient Floors – 3-4 blocks
  • ICU/ICU Night float 2-3/1 (total 3-4 blocks)
  • Night float – 1-2 blocks
  • Ambulatory Medicine – 6-7 blocks
  • Elective – 6-7 blocks
  • Resident Admitting Officer – 2-3 blocks
  • Vacation – 2 blocks

Note: Above schedule is subject to minor modifications.

Inpatient Floors

PGY1s spend about 1 out of every 3 blocks on floors. Together with a supervising senior resident, they are responsible for one of three patient teams (A, B, or C). PGY1s carry a maximum of 10 patients, and the remaining patients on the team (if any) are solely the responsibility of the senior resident. Teams are capped at 14.

A typical day is as follows: Interns come in at 6:30 to prepare for the day and at 7:00, receive sign out from the night float team. From 7:15-8:30, residents preround on patients and implement follow ups with their senior residents. From 9:00-11:00, they round with the teaching attending. Between 11:45 - 1:30, the residents have protected time for lunch and conferences (only responding to emergent issues). They then resume work and followups after 1:30. 1 of the 3 inpatient teams is on long call from 16:00-19:00. This team is also responsible for attending rapid responses/codes and managing new admissions during the day. At 16:00, the on-call team will receive sign out from the other floors teams.

Inpatient Floors Inpatient Floors

Medical Intensive Care Unit (MICU)

Mountainside Medical center has a mixed ICU, where residents learn the care and management of critically ill medical, surgical, and neuro patients

At any given time, patient care is shared between two ICU resident teams, each consisting of an intern and supervising senior resident. ICU teams alternate call days. A board-certified ICU attending conducts rounds and is available on site 24h a day.

The Ambulatory Block

Throughout residency, 1 out of every 4 blocks will be ambulatory, where residents will practice outpatient clinic medicine. Some half days during this block are reserved for tasks like refilling meds, updating patients, and other administrative responsibilities. We emphasize continuity in patient care and re-schedule the same patients with residents as much as is practical.

One half day per week is protected time for ambulatory didactics. Residents have time to work on personal QI projects.

Of the two weekends on Ambulatory block, one is “golden” (free) and the other requires an overnight shift to relieve the night float team.

Ambulatory Block Ambulatory Block

Elective Rotations

All Residents will have around 15 blocks throughout their training dedicated to subspeciality services. Essential rotations are assigned and usually completed within the first two years of residency, leaving the third year available for personalization and focus on future careers. Mountainside prides itself on the heavy involvement of the subspeciality attendings and their dedication to resident education.

Elective options include:

  • Cardiology
  • Pulmonology
  • Infectious Diseases
  • Gastroenterology
  • Hematology and Oncology
  • Endocrinology
  • Nephrology
  • Radiology
  • Anesthesiology
  • Neurology
  • Emergency Medicine
  • Geriatrics
  • Rheumatology
  • Research
  • Dermatology
  • Ophthalmology
  • Surgery
  • Hospitalist Medicine
  • Outpatient Private Practice
Elective Photo

Generally, elective hours are from 8:00 AM to 4:00 PM from Monday to Friday; however, schedules may vary depending on the individual service and attending to which you are assigned.

Away Electives

As a member of the Hackensack Meridian Health System, Mountainside is part of a robust hospital system that offers electives at different sites. We also work with other institutions outside our network. The goal of these away electives (which are offered in the second and third years) is to expand the resident's exposure to different specialties and health systems.

Night Float

The night float teams consist of 1 PGY1 and 1 senior resident who provide cross coverage to the Med-surg and stepdown patients on teams A, B, and C. Night float residents attend rapid responses and codes and address any issues that arise during the night in addition to admitting new patients, an average of 2-5 per night. Night float residents are on call from 19:00 to 7:00 AM.

Resident Admitting Officer (RAO)

PGY2 and PGY3 residents spend time functioning as the RAO, the major gatekeeper to the teaching service of the department of Medicine. All admissions coming to the teaching service are presented to the RAO, who performs a quick review and triage of the patient and assigns the patient to the appropriate team. In addition, the RAO responds to rapids and provides consultation services to other departments in the hospital such as Psychiatry, Ob/Gyn and Surgery.