• Preliminary Year
• Categorical Program
• Women's Health
• Hospitalist Track

The Department of Medicine accepts into the preliminary year program the candidate desiring a strong clinical year of internal medicine before pursuing training at the second-year level in other specialties such as dermatology, anesthesiology, or ophthalmology.  The rotations and responsibilities for the intern accepted into the preliminary program are similar to those of the intern in the categorical program. Successful completion of this year qualifies the trainee for one year toward board certification in internal medicine.  Compared to the categorical first year, the preliminary year includes one rotation in the NMH Emergency Room and one month of critical care (instead of two).

The three-year categorical program provides excellent preparation for a career in general internal medicine or one of its subspecialties. Our curriculum provides a well-balanced experience for all residents and prepares them for board-certification in internal medicine.

The first year of residency consists of 13 rotations, including general medicine inpatient wards (both NMH and VA); hematology/oncology ward medicine (NMH); intensive care and coronary care medicine (NMH); outpatient general medicine (VA-Chicago Lakeside Division); and two subspecialty consult rotations. Supervised by a resident and an attending faculty member, the PGY 1 resident provides primary care for his or her assigned patients, writes all orders, and coordinates consultations and other communications.

The 13-rotation system continues in the second and third years of the program. The resident receives extensive experience in both inpatient medicine and ambulatory care. Six rotations each year are spent in the inpatient setting, including general medicine wards, intensive care units, and subspecialty rotations such as hematology-oncology, hepatology or cardiology. Two outpatient months and five elective rotations each year are available, which may include subspecialty consultative rotations, an ambulatory block, or research.  During this time, the resident serves as a supervisor and teacher of junior residents and medical students.

Approximately one-third of the residency is devoted to ambulatory education. The ambulatory medicine experience for each resident consists of general medicine clinic, rotations in the emergency room of NMH and outpatient department of VA Lakeside, and ambulatory block rotations. The resident’s clinic starts during the first year with one half-day session per week and expands to two half-days per week during the second and third years. The typical resident will have one outpatient clinic at both the faculty group practice plan (Northwestern Medical Faculty Foundation) and VA Lakeside. Rotations in the emergency room of NMH and VA Chicago’s outpatient area augment the resident’s general medicine clinic experience.

An important feature of the outpatient experience for residents is the ambulatory block rotation. During this rotation, the resident focuses entirely on outpatient experiences in a variety of locations, including nonmedical disciplines such as dermatology, neurology, gynecology, and ophthalmology. Additionally, internal medicine subspecialties with a prominent ambulatory component, such as allergy,  endocrinology, and gastroenterology are offered. Other rotations within the ambulatory block include hospice home care, sports medicine, sexually transmitted diseases, HIV medicine, and clinical nutrition counseling. Residents intending to pursue a career in general internal medicine may select more than one ambulatory block rotation as part of their elective experience. In addition to the Department of Medicine’s noon lectures series, which incorporates primary care topics, a weekly morning report for residents on the ambulatory block rotation provides a forum for discussion of primary care management issues.

The Department of Medicine sponsors a noon lecture series on a wide range of topics. In addition to Grand Rounds, core curriculum conference, CPC, mortality and morbidity, and autopsy conference, the department conducts a boards review for senior residents and a diagnostics conference that helps fine-tune the interpretation of diagnostic tests.  Journal club is held monthly at VA-Chicago and NMH.

Each resident is encouraged to devote a portion of his or her elective time to a research project and present a poster at the annual spring resident research symposium. A committee of faculty members in the Department of Medicine selects the best presentations, and the department sponsors these awardees’ attendance at a research meeting of their choice. Residents planning a career in academic medicine are encouraged to apply to the clinical investigator track.

In July 2002, a new residency track began in the categorical program.  The Women's Health pathway has been developed to provide extensive clinical and research experience in the field of women's health and gender-based medicine.  Residents in this track receive this education in conjunction with the usual training in the categorical program.  Upon completion of the curriculum, graduates will be well prepared for clinical practice or academic careers, including further specialty training.

Faculty members in the Department of Medicine with expertise in the field serve as mentors for residents in this track.  The clinical experience begins in the PGY-1 continuity clinic with instruction in the prevention, treatment, and evaluation of ambulatory conditions of particular importance for women.  One elective month will be offered during PGY-1 for additional training.

At the beginning of the second year, a second continuity clinic will be added.  Each resident will have a 2-month research block under the supervision of their faculty mentor.  4-5 additional block rotations will further develop clinical experience and procedural skills in the areas of gynecologic care and treatment, osteoporosis prevention and management, the evaluation of breast disease and the nature and treatment of psychiatric disorders.

Faculty Mentors Sonja Boone, MD Nancy Dolan, MD Andrea Dunaif, MD Beatrice Edwards, MD Aparna Priyanath, MD MPH Diane B. Wayne, MD

Interested applicants should apply to the categorical program and contact the program director for any further information.

Sample Research Topics For Women's Health Track

• Breast cancer risk assessment
• Breast and cervical cancer screening
• Breast cancer prevention
• Breast cancer epidemiology
• Osteoporosis
• Polycystic Ovary Syndrome (PCOS)
• Early detection of ovarian cancer
• Gestational diabetes
• SLE
• Heart disease in women
• Peripheral artery disease and women
• Musculoskelatal disease in pregnancy

Sample topics from Women's Health Journal Club

• Effects of Raloxifene on Cardiovascular Events and Breast Cancer in Postmenopausal Women
• Gabapentin, estrogen, and placebo for treating hot flushes: a randomized controlled trial
• HRT and the Women's Health Initiative
• Risk-Reducing Salpingo-Oophorectomy in Women with a BRCA1 or BRCA2 mutation
• Randomized double-Blind Trial to Compare the Efficacy of Teriparatide with Alendronate in Postmenopausal Women with Osteoporosis
• Comparison of C-Reactive Protein and Low Density Lipoprotein Cholesterol Levels in the Prediction of First Cardiovascular Events
• Results of a randomized trial on the management of cytology interpretations of atypical squamous cells of undetermined significance. The ASCUS-LSIL Study Group.
• Randomized Trial of Letrozole in Postmenopausal Women after Five Years of Tamoxifen Therapy for Early-Stage Breast Cancer
• A Randomized Trial of a Low-Carbohydrate Diet for Obesity
• Effects of conjugated equine estrogen in postmenopausal women with a hysterectomy: The women's health initiative randomized control trial.
• Famciclovir suppression of asymptomatic and symptomatic recurrent anogenital herpes simplex virus shedding in women: a randomized, double-blind,  double-dummy, placebo-controlled, parallel-group, single-center trial.
• A Randomized trial of Low-Dose Aspirin in the Primary Prevention of Cardiovascular Disease in Women.

Hospitalist Track

Hospitalists are the fastest growing medical specialty in the United States.  The goal of the Hospitalist Track at Northwestern is to provide superb education in a broad range of clinical areas as well as training in key areas vital to careers in Hospitalist Medicine. Northwestern is well suited to a leadership role in educating the next generation of hospitalists.  Currently we have over twenty full-time faculty members who serve as hospitalists as their major clinical role.  These faculty mentors are actively engaged in patient care and quality improvement projects and research. Additionally they serve many important administrative and teaching roles in the Division of General Internal Medicine and the Department of Medicine. With the outstanding clinical facilities, dedicated faculty, and diverse clinical training provided, the Northwestern residency program is committed to a major role in the development of future academic hospitalists.

Highlights of the Program

• Individual Hospitalist faculty mentors
• Active participation on the Department of Medicine QualityManagement Committee
• Rotations on the Medicine Consultation, Palliative Care,Geriatrics, and Neurology Services
• Medical Informatics
• Teaching Masters Course
• Health Economics
• Physician Leadership Training

Residents will actively participate in Quality Improvement projects and are encouraged to pursue dedicated research blocks with faculty members from the Division of General Internal Medicine. Funds are available to help residents attend the annual Society of Hospital Medicine meeting as well as other appropriate conferences. Upon graduation from the program, trainees will be well equipped to provide and coordinate clinical care as well as participate in and direct hospital quality improvement and patient safety initiatives.