Philosophy and Approach
Sinai Hospital's internal medicine residency program emphasizes compassionate care for patients in an environment of disciplined learning. Our graduates complete their training with a strong sense of confidence and a commitment to the principles and practice of internal medicine.
Our Philosophy
We believe that the physician leaders of tomorrow will need a connection not only to their individual patients, but also to the communities they serve, along with a firm grasp on health care policy and practice within the larger global community. In today's challenging healthcare environment, physicians are required to practice in a cost-conscious manner and be heavily invested in the quality improvement process, areas that we emphasize throughout our residency training.
Diversity of Experience
Sinai Hospital is the largest community teaching hospital in Maryland, providing state-of-the-art medical care for an active heterogeneous patient population in Northwest Baltimore. While committed to improving the health of individuals in the local community, Sinai Hospital is also a destination for referred patients from areas outside the immediate region, including western Maryland and southern Pennsylvania. The Department of Medicine at Sinai has a tradition of excellence in patient care, teaching and research that goes back more than 140 years.
Our large, multidisciplinary full- and part-time faculty provide close supervision for acute-care patient units, critical care units, the emergency room, long-term care and outpatient practices. Chief-resident led morning reports, faculty-led teaching rounds and noon conferences, as well as a wide variety of research, ambulatory and elective opportunities, complete the residency experience. Our core curriculum covers all areas of medicine and includes special topics of quality improvement, cost-conscious care, professional development and medical ethics.
Strong Partnerships
Sinai's Graduate Medical Education Committee sponsors six residency programs across various specialties, of which the internal medicine program is the largest. Our program has enjoyed a longstanding academic affiliation with the Johns Hopkins University School of Medicine, which allows residents to do both required and elective rotations at the Johns Hopkins Hospital and has resulted in our being one of the core teaching sites for Johns Hopkins University students completing core clerkships in medicine. Core faculty members at Sinai have teaching appointments at Johns Hopkins' School of Medicine.
Accredited Best Practices
Our program is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME) and adheres to all ACGME guidelines for internal medicine residency programs. There is no overnight call on any rotations completed at Sinai, with a full night float team working with hospitalists on the general medical floors overnight and a night medicine team in the ICU supervised by a medical intensivist. All orders are written by house staff, who also teach students from Johns Hopkins and several other medical schools on clerkship and sub-internship rotations.
Real-World Learning
All residents are required to complete one-third of their residency training in an ambulatory setting. Nurses and technicians provide support for the house staff by taking responsibility for IVs, phlebotomy and patient transport, allowing Sinai residents to function as physician-managers of the patient care team.
Sinai Hospital has a fully implemented electronic medical record system for all clinical areas, both inpatient and outpatient, including the residents’ continuity clinic. The hospital also has liberal computer access throughout the campus, permitting rapid access to medical records, test results, information databases and imaging studies
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Research
Our Eisenberg Medical Library is electronically accessible from all areas of the campus as well as remotely. It includes a robust number of journals, textbooks and other clinical decision support tools, such as UpToDate. The library is staffed during daytime hours with librarians who are trained to assist in optimizing literature searches and obtaining hard-to-find journal articles. Additionally, residents have 24/7 access to the physical library facilities as well as the adjoining simulation lab where procedural training and mock clinical situations take place regularly.
Sinai’s medicine residents have gained national recognition for their scholarly activity. Many residents have been published in high-impact journals and have presented at national conferences. We have always been extremely competitive in the Maryland Doctor's Dilemma competition, a statewide academic competition among residencies sponsored by the American College of Physicians. Our team has been named state champions and represented Maryland at national competitions on multiple occasions.
Our internal medicine residency program emphasizes compassionate care for patients in an environment of disciplined learning. Our graduates complete their training with a strong sense of confidence and a commitment to the principles and practice of general internal medicine, gaining direct experience in medical research.
Program Highlights
Sinai Hospital of Baltimore’s internal medicine residency program has a strong academic affiliation with The Johns Hopkins University School of Medicine. Residents in our program gain extensive clinical experience by working with patients in inpatient and ambulatory settings at Sinai as well as through core and elective rotations at The Johns Hopkins Hospital.
Our program highlights include:
- A three-year categorical program focusing on primary care as well as excellent medicine subspecialty exposure
- Longstanding academic affiliation with The Johns Hopkins University through which our core full-time faculty members have academic appointments
- Direct supervision on all rotations by distinguished Sinai faculty members who are highly experienced in clinical teaching and managing complex, diverse medical conditions
- Around-the-clock, in-house attending physician coverage
- A comprehensive curriculum encompassing all internal medicine topics in a systematic manner
- A focus on evidence-based medicine in daily practice, didactics and journal clubs, covering both inpatient and outpatient topics
- Competitive fellowship placements in numerous fields and specialties
- Various basic and clinical research opportunities with nationally recognized authorities in their respective fields
- Core and elective subspecialty rotations at Sinai, Johns Hopkins Hospital
- A fully equipped simulation lab to prepare residents to manage rapid responses and practice procedures along with point of care ultrasound (POCUS)
- A primary teaching site (Sinai) for students from The Johns Hopkins University School of Medicine. Our inpatient medicine resident teams have year-round teaching responsibility for JHU MS-III's and MS-IV’s on their core medicine clerkships, and our teaching faculty annually precept MS-I and MS-II students in their clinical skills longitudinal clerkships
- Longitudinal board preparation program with both didactic and mentored components
- Inpatient resident supervision by dedicated academic hospitalists chosen and evaluated for their excellent teaching skills and superior clinical care on a monthly rotation
- Non-teaching services for the patients of our many community physicians
- No overnight calls during rotations at Sinai Hospital
- Formal resident and faculty mentorship program for all house staff
- Strong culture of support and camaraderie both in the residency program and in the hospital
Internal Medicine Residency Program facts and figures
- In 2020, we received 5,700 applications
- Our residents have a high success rate matching with fellowships programs across the nation (e.g. Johns Hopkins Hospital, University of Maryland, Stanford University, Albert Einstein Hospital, Robert Wood Johnson)
- We have a longstanding academic affiliation with Johns Hopkins University through which our core full-time faculty has academic appointments
LifeBridge Health system facts and figures
- LifeBridge Health is a diverse community of 26,000 faculty, staff, students, trainees and volunteers from around the world, with more than 13,000 employees
- LifeBridge Health has more than 2,700 credentialed physicians within its network
- LifeBridge Health operates five hospitals (Sinai Hospital, Northwest Hospital, Carroll Hospital, Grace Medical Center, and Levindale Hebrew Geriatric Center and Hospital) with 1,052 pediatric, adult and psychiatric beds
The Curriculum
Educational Mission
Sinai Hospital's internal medicine residency program provides residents with a three-year curriculum, emphasizing the skills required to practice general internal medicine and the proficiency needed for board certification.
Our curriculum covers all subspecialty areas of medicine as well as topics related to medicine, nutrition, ethics and research, among other areas. Our goal is to foster lifelong learning in a supportive and friendly environment. Our residents enjoy a close relationship with faculty members and have easy access to numerous basic and clinical research projects on site. Graduates going on to fellowships view this as a valuable springboard to a successful subspecialty career, while graduates planning to practice general internal medicine find that this pragmatic experience equips them well for clinical practice. All of our didactics embody the principles of evidence-based medicine and high-value care.
Curriculum Objectives
Ambulatory Medicine
This training experience is designed to teach residents the essential aspects of ambulatory medical practice and the principles of managed care. Residents see their own patients throughout the three-year program and work closely with ambulatory preceptors who ensure they acquire the necessary knowledge and skills to practice outpatient internal medicine. Many electives are available that reinforce or expand the scope of training in ambulatory practice. Training at a community-based practice site is an essential building block of the resident’s training experience, and opportunities within the Sinai program are plentiful. Ambulatory experiences are provided in a variety of specialty areas, including: dermatology, urology, otolaryngology (ENT), orthopedics, ophthalmology, rehabilitation and gynecology. A self-directed, computer-based ambulatory curriculum is used to augment the learning process.
Inpatient Medicine
The curriculum in inpatient internal medicine gives residents an opportunity for autonomy in diagnostic decision-making and care of acutely ill patients. The diversity of the patient population served by Sinai Hospital encourages residents to learn the delicate interplay between social circumstances and the management of complex illness. Residents will have the opportunity to provide ongoing care for these patients following discharge in their office practice. PGY-2 and PGY-3 residents will further their medical education by supervising the work of PGY-1 residents on the patient care units and teaching medical students from The Johns Hopkins University School of Medicine.
Critical Care Medicine
Residents learn to manage patients with cardiovascular disease and other complex, critical illnesses while in the intensive care and coronary care units. They are given significant autonomy in patient care decisions and medical procedures. Cardiology and critical care faculty provide teaching and case-based supervision in settings where a core understanding of pathophysiology is emphasized.
Representative Resident Rotation Schedule
Residents are assigned 13 four-week rotation blocks, with each rotation lasting either two weeks (0.5 block) or four weeks (1 block). A representative schedule for the three-year curriculum is shown below:
PGY-1 (Preliminary): Rotations
- Critical Care: 2
- Elective: 3-4.5
- Emergency Medicine (Anesthesiology only): 1
- Night Float: 1.5-2
- Vacation: 1
PGY-1(Categorical): Rotations
- Inpatient General Medicine: 4-4.5
- Critical Care: 2
- Elective: 2.5-3
- Inpatient Selective: 1
- Emergency Medicine: 1
- Ambulatory Medicine: 0.5
- Night Float: 1.5
- Vacation: 1
PGY-2 (Categorical): Rotations
- Inpatient General Medicine: 3.5-4.5
- Critical Care: 2
- Elective: 3
- Night Float: 1
- Cardiology Selective/CCU: 1
- Solid Tumor Oncology at Johns Hopkins Hospital: 1
- Geriatric Medicine: 0.5
- Vacation: 1
PGY-3 (Categorical): Rotations
- Inpatient General Medicine: 3-4
- Critical Care: 1-2
- Elective: 3
- Night Float: 1-1.5
- Ambulatory Medicine: 1
- Medical Consultation: 1
- Neurology: 1
- Renal Transplant Medicine at Johns Hopkins Hospital: 1
Vacation: 1
Please Note:
Residents are typically admitting until 7 p.m. every four days while on inpatient rotations and every three days while in the ICU. Electives must be approved by the program director and meet ambulatory requirements and individual needs. Only one four-week away elective is allowed per academic year. You must reach 4.5 rotations or electives over the three-year period in ambulatory areas. No more than one elective per year is allowed in emergency medicine. Critical care experience represents six months of the three-year categorical residency as allowed by RRC.
The program director reserves the right to alter this schedule.
Teaching Conferences
In light of the current COVID pandemic, all didactics have been moved to virtual platform, i.e. Zoom, but the essence and quality of the teaching conferences remain the same.
Morning Report
The morning reports are held on Monday and Wednesday mornings. Wednesday morning reports start with an EKG review. This is followed by a resident presenting a diagnostic dilemma and a clinical pearl related to the case. Friday mornings are spent discussing board review questions, answers and explanations are discussed afterwards. The chief medical residents lead these sessions, with faculty joining morning reports to provide expert opinions and teaching points.
Ambulatory Report
The ambulatory report is held on Tuesday mornings and presented by either an intern or a resident. A wide variety of commonly encountered topics that span all areas of outpatient medicine are discussed here.
Attending Rounds
Attending rounds on teaching hospitalist services are conducted daily by distinguished clinicians chosen for their teaching abilities. These include bedside instruction and demonstration of physical examination skills.
Critical Care and Coronary Care Rounds
Daily multidisciplinary bedside rounds provide in-depth reviews of pathophysiology and patient management. A full curriculum is provided during each rotation.
Noon Conference
Using innovative, state-of-the-art educational methodology, residents are exposed to a comprehensive core lecture series based on Harrison’s Textbook of Internal Medicine and American Board of Internal Medicine curriculum. There is ample opportunity to discuss topics with knowledgeable faculty. An urgent and emergent lecture series is given during the first few months to discuss critical and clinically relevant topics in order to provide a solid foundation early in the year. An "Issues in Medicine" series provides a full curriculum in the business of medicine, nutrition, risk management, performance improvement, research, ethics, and a variety of basic science topics.
Combined Report
A combined report is presented twice a month by an inpatient general medicine team, usually on Tuesdays during the noon conference. Team interns give a case presentation and team residents discuss a teaching topic related to the case.
Quality Improvement Conference
The Quality Improvement Conference (formerly known as Morbidity and Mortality Conference) is presented monthly at the noon conference by the PGY-3 Medical Consult resident. The resident will review and present a case (or a set of related cases), identify any system-related issues that were involved and offer potential solutions. The discussion is then open to all house staff to provide their input. The goal of this conference is to continue to improve our patient care and patient safety.
Journal Club
The Journal Club is held monthly at the noon conference by four PGY-2 and PGY-3 residents on either elective or selective rotations. An article selected from a leading medical journal is discussed, critiqued and analyzed to see how it would impact current medical practice.
Clinico-Pathological Conference
The Clinico-Pathological Conference is presented by an intern or resident and held monthly at the noon conference. They bring together the expertise of faculty of the Department of Medicine, Pathology and Radiology for case review as necessary.
Medicine Grand Rounds
Medicine grand rounds are held on Thursday mornings in the fall through spring, and consist of a weekly conference featuring nationally and internationally renowned speakers who address the most current controversies and discoveries in medicine.