Program Overview

Internal Medicine residents care for inpatients at Crozer-Chester Medical Center. Required inpatient rotations are a mix of general internal and subspecialty medicine. Two of our five floor services are general IM, one of which is a hospitalist experience. Our residents rotate on three multispecialty services that offer diverse pathology with teaching by subspecialists.

The resident will become proficient in the care of the critically ill over the course of three years. Neurology and psychiatry are also required inpatient rotations in our program.

Crozer Medical Associates (CMA) is an Internal Medicine combined faculty/resident practice. Each of the 24 CCMC Internal Medicine Residents have their continuity ambulatory practice in this office over their three year residency. #1 The residents attend one session/week (2 during their ambulatory/elective blocks). One faculty preceptor oversees 2-3 residents during each session. The residents generally see 4-6 patients/ session in 30 minute slots. The residents develop a panel of patients over the time at CMA. The practice sees patients from 18-100 (we also have a geriatric practice embedded in CMA). Most of the patients in the practice are medically complex with multiple comorbidities such as diabetes, hypertension, hyperlipidemia, renal disease, cardiac disease and arthritis. The residents are responsible for the patient’s ongoing care, their health prevention and screening, lab and test results, hospital follow-up, and referrals. There is also an OMT table to perform manipulations for our osteopathic physicians. In addition each of the residents has access to the network Physician Dashboard so they can monitor their quality measures and develop performance improvement plans for those unmet goals.

Crozer Medical Associates has been a Level 3 NCQA Medical Home since 2009. The office has been using the electronic medical record since 2007 (Centricity). As a large busy suburban/urban practice the residents see patients from all socioeconomic backgrounds. As a result the residents learn the challenges patients and physicians must address including unaffordable medications, poor diet, limited transportation, mental health issues, and sometimes limited access to specialty services. There is a case manager and social worker in the office to assist with the various challenges. The breadth of disease, severity of illness, and complexity of the healthcare system the residents encounter in this practice, along with the emphasis on quality and clinical outcomes, will prepare these physicians to be able to deliver excellent care in almost any setting they choose to practice. This continuity practice is one of the best continuity practices in the Philadelphia area.

Ambulatory care - which includes continuity care, primary-care blocks, geriatrics, home care, palliative care, gastroenterology, and emergency medicine, comprises a minimum of a third of the total residency experience. The percentage of time in the ambulatory setting can be increased to 50 percent with the addition of ambulatory electives for those residents interested in careers in primary care.

Crozer Medical Associates' (CMA) state-of-the-art facilities include procedure rooms, a clinical laboratory with spirometry, teaching microscope, and a networked system of electronic medical records.

Multiple four-week blocks round out the ambulatory experience. In each year, a four-week block is devoted to areas not traditionally considered to be IM such as back pain, dermatology, gynecology, allergy, ENT and orthopedics among others. Additionally, in the second year, a resident will spend a block in a busy practitioner's office during which time he/she will refine skills needed to manage acute office problems. During this block, time is also devoted to developing the resident's own teaching skills.

In addition to our various clinical opportunities, our residents have access to sophisticated information technology tools which both improve patient care and enhance education. Patients' records and test results are easily available using our Web-based reporting system. Medical databases such as Medline, Ovid, DocLink, LexiComp and UpToDate, as well other electronic aids are easily accessed from multiple sites within the hospital and in the office which facilitate learning. EMR is taught, which is a valuable and marketable skill you will take with you upon graduation.

Other highlights of our program include service and admission caps, and night floats throughout all three years of the program, ensuring adequate rest, access to full-time phlebotomy and EKG support. Residents have 24-hour access to our library, which has state-of-the-art search capability in addition to a comprehensive collection of journals. Overall, our program offers residents comprehensive training as well as a solid basis in all aspects of internal medicine care.

Scholarly Activity

The Scholarly Activity program is a highlight of our residency. A mandatory team-based program allows the residents to participate in two projects a year with their colleagues, culminating in a minimum of six completed projects by graduation day. In addition, many of our residents engage in other scholarly activities that range from book chapter publication to case report publications to new discovery research. A special Grand Rounds dedicated to the top three scholarly activities takes place in the Spring just before graduation. The activities continue further in invited poster and oral presentation in various regional and national meetings. The residents are supported to attend these prestigious conferences that further enhance their Curriculum Vitae. In turn, these demonstrations of dedication, independent thought and hard work lead many of our residents to achieve fellowships of their choice.

The Simulation Center  

Internal Medicine residents at Crozer have access to a large modern Simulation Center. The Simulation Center provides a safe but realistic environment for the residents to practice and perfect complex procedures such as ultrasound-guided Central Venous Catheter placement, Arterial Line placement, Peripheral Line Placement, and Intraosseous Line placement. Residents are also encouraged to rehearse their Advanced Cardiac Life Support (ACLS) skills to deliver the best possible care to our patients. Our Simulation Center provides valuable training space to all of our residents at various levels.