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FAQ - Internal Medicine at MedStar Washington Hospital Center

One of the challenges of interview season is getting to know a program in a short amount of time. This list of questions and answers was compiled by the residents to provide you with an insider's perspective of our residency program. Please contact us if you need any other information.

What are the work hours and call schedule like?

The program recognizes that working grueling hours is not the best means to educate residents; therefore, the program is strict about the 80 hour rule and patient caps. The program demands residents work hard, but not to the point where they are too exhausted and defeated during the learning process. Neither we nor patients gain when we, as residents, are over-fatigued.

Details on call/shift schedules for different (e.g. wards, MICU, CCU, night float) can be seen in the “Rotations” section of the “Curriculum” tab.

Do you have a dedicated teaching attending with whom you round on a daily basis?

Yes. The wards team has a teaching attending with whom you round daily. The teaching attending is either an internist or a sub-specialist, who will be with you for the entire rotation.

On your service, you will also carry the patients of private attendings with whom you will discuss the plan of care for their patients daily. You will be the primary decision-maker for your patients, with supervision and guidance from your attending. Attendings are not allowed to write orders, except in case of emergencies, so house staff have complete ownership of their patients. This setup allows residents to develop autonomy in patient care, while getting training from the teaching attending who often sees both their and private patients with interesting clinical features.

A key distinction in our hospital is that we have a substantial non-teaching service. Cases deemed appropriate for educational purposes are assigned to the teaching service or "A medicine." These patients are taken care of by the resident teams, whereas patients assigned to B medicine, the non-teaching service, are taken care of by hospitalists and nurse practitioners.

During my intern year, what is my schedule going to look like?

The schedule for the categorical and preliminary internship year differs.

Categorical Interns: You will have 5 blocks of wards, 1 ICU, 1 CCU, 2 ambulatory, 2 electives (with vacations taken during elective/ambulatory months). For the year, there are 4 call-free months and 4 weeks of vacation.

Preliminary Interns: You will have approximately 5 blocks of wards, 2-3 units, and 4 elective months (with vacation taken during electives). For the year, there are 4 call-free months and 4 weeks of vacation.

How much vacation time will I have?

The American Board of Internal Medicine (ABIM) allows a maximum of 4 paid weeks of vacation in any one year. Since time off is crucial for residents to recharge and rest, the program offers additional time off during the holidays. Every resident gets an additional six days at either the New Year's or the Christmas holidays (i.e., one-half of the team gets the days leading up to and including Christmas off and the other half get the days leading up to and including New Year’s day off).

Categorical interns will have three weeks off distributed throughout the academic year, and at the end of the academic year, they will have ten consecutive days off before returning as a resident (these ten days are part of your "fourth" week of vacation). To sum it up, the six-day period during the holidays and the additional three days at the end of the academic year are nine days above the normal four-week entitlement suggested by the ABIM. 

Preliminary interns will have four weeks throughout the year in addition to the six days off during the holidays.

When are the educational conferences scheduled?

There are daily noon conferences that focus on the most pertinent topics that you will encounter on the wards. Each week, noon conferences concentrate on a different subspecialty.

Grand Rounds are scheduled on Wednesdays. A visiting or local expert from varying specialties leads the discussion.

Every morning (except Wednesdays and Fridays), we attend resident morning report. Intern morning reports take place on Wednesday mornings. On Friday mornings, we attend Chairman’s conference.

There are also several conferences held by the subspecialty medicine programs that you can attend (cardiology grand rounds, rheumatology, neurology, etc.).

Categorical residents have pre-clinic conference and reading once a week, where the most common diseases encountered in outpatient settings are discussed.

On MICU or CCU rotations, residents attend lectures focusing specifically on critical care issues. During the ICU & ED rotations, residents rotate through the simulation lab, learning procedural skills, ventilator associated issues, and ACLS skills.

Do you have enough time outside of hospital to study and to have a personal life?

Absolutely! With our wards call schedule, you are not on overnight call. We have a very well-organized night-float system, which allows our team greater flexibility and free time to recharge for the next day. When you are done with your work, you may sign out to the cross-cover at 4 p.m. on weekdays and as early as 11 a.m. on the weekends. This system allows you to have most of your evenings free and most of your daytime during weekends to spend time with your family and friends, read, explore, run errands and enjoy the many activities available in D.C.

The program strongly believes your hard work should be appreciated. A variety of events are organized throughout the year, including happy hours, bowling nights, departmental retreats to Chesapeake Bay, an end-of-year banquet and holiday parties. Camaraderie allows us to work stronger together as a team, and one of the best ways to build this camaraderie is through such social gatherings.

What is the interaction like between residents and interns?
    
This program emphasizes teamwork rather than encouraging the traditional hierarchy seen at many programs. We welcome and encourage interaction between all levels of the teams on the wards and in the intensive care units. We believe an open dialogue enriches the education process, and we do not stifle interns, nor expect them to learn alone: we work and grow as a team.

How are the ancillary services at Washington Hospital Center?

The hospital has a host of ancillary services that perform many functions, including phlebotomy, IV therapy, respiratory therapists, PICC line nurses, EKG technicians, patient transport, etc.  The American Board of Internal Medicine requires that you demonstrate competency in arterial and venous blood draws as well as IV placement; however, you will NOT need to provide these services routinely. 

Where do the residents live and how do they commute to work?

Washington, D.C., provides you with many choices. You may live as far away as the leafy suburbs of Columbia, Maryland (45-60 minute drive) or as close as trendy Dupont Circle, Adams Morgan, Woodley Park, Columbia Heights (Metro, bus and bike accessible). It all depends on your budget and lifestyle. In the District of Columbia, most of us pay $1400-$1800/month for a one-bedroom apartment. There are many options all around D.C., if you wish to seek roommates, furnished housing, etc.

Most of the residents commute by car, though some of us prefer to commute via public transport (bus, Metro and shuttle).

What kind of food is there to eat at the hospital? Do I get a food stipend?

There are three places to get food:

  • The main cafeteria: a large public dining hall with options like sushi, Mexican cuisine, a daily buffet, salads, a burger bar, a sandwich bar, an ice cream bar and a coffee bar. It serves breakfast, lunch and dinner.
  • Physicians' dining room: private area accessed only by doctors
  • Blimpie’s and Noble Roman’s Pizza: 24/7 fast-food dining

The house staff is allotted about $115 per month for food by the Graduate Medical Education office, which usually covers monthly in-house dining expenses.

What role does resident feedback play in the program?

A great program evolves only with creative and honest feedback from the residents and faculty. Informal comments can always be directed to the chief residents, program director or your mentor. You can also provide anonymous feedback through our online program site. There are formal events where you can share your concerns with the group, including annual intern and resident breakfasts, where we meet as a class with the program leadership. There is an annual retreat held each spring, where the program leadership collects feedback from residents in anticipation of the new academic year. This event allows each of us to voice our concerns and suggest changes from what we have learned and witnessed during the academic year. There is also a house staff committee meeting, chaired by the rising chief residents, in which all residents may participate.

How long is the program's accreditation?

In 2006, our program received a continued five-year full accreditation with no citations noted, and seven program commendations from the Residency Review Committee in Internal Medicine. The prior review in 2001 also resulted in a full five-year accreditation. The program was given an additional year of accreditation from the ACGME, and now is scheduled for a self-study in October 2015.

If I come here, what help is offered to help me pass the boards?

Passing the board is a commitment that both you and the program have to make. Our program recruits bright residents who are eager to learn, and brilliant faculty who love to teach.  In addition to discussing several board-review questions each day at morning report, all of the third-year residents are provided free board review materials. We also run a faculty-led formal board review series the second half of each academic year. Yearly in-training exams also provide a barometer about resident preparedness of the boards. Our residents have found this multi-faceted support crucial to passing their boards.

Does this program give me a good chance of getting a fellowship afterwards?

The majority of our residents pursue fellowships. In the past five years, about half of our residents have entered fellowship either immediately after their training or after a chief-resident year. Fellowships have been obtained at places like Massachusetts General Hospital, the National Institutes of Health, Yale-New Haven Hospital (Pulmonary/Critical Care), Columbia University (Rheumatology), Brown University (Pulmonary/Critical Care) and of course, Washington Hospital Center (Cardiology, GI, Endocrine, Hematology/Oncology, Rheumatology, Pulmonary/Critical Care, Infectious Disease and Nephrology).

Is there an education stipend and if so, how much is it?

Each year, you are provided an educational stipend of $833. Of this, $750 can be used to purchase computers or PDA device. Each year, unspent money carries over to the following year. So, as a categorical resident, you have a total education stipend of $2,499 during your residency.

Do preliminary interns have a continuity clinic?

No, only categorical residents attend continuity clinic.

What is continuity clinic for categorical residents like?

You will be assigned a clinic attending as your primary ambulatory supervisor and mentor for ambulatory clinic that you will be primarily working with for the duration of your training but in general, you get to work with all the clinic attendings at some point during your residency.

What is the relationship between Washington Hospital Center and Georgetown University Hospital?

We have two separate internal medicine training programs. Each has unique qualities. Since both hospitals are members of MedStar Health, we have a mutually beneficial relationship between the institutions, sharing services and educational opportunities. We offer residents rotations at Georgetown University Hospital to increase their exposure to a different patient population.

Some of our fellowship programs have been merged, including cardiology and endocrinology. Some members of the Georgetown house staff rotate to the Hospital Center on subspecialty services, including CCU and the heart failure service, since our hospital is a leading regional provider of cardiac education and services. We also have third- and fourth-year Georgetown medical students rotating at the Hospital Center on the medicine wards, MICU, CCU, ambulatory clinics and other subspecialty electives. You can choose to take electives at the Hospital Center or at Georgetown University Hospital based on our areas of interest.

Diplomas awarded upon completion of training will say "Georgetown University Hospital/Washington Hospital Center Internal Medicine Residency Program."

Does Washington Hospital Center Have Electronic Medical Record (EMR)?

Washington Hospital Center currently has full electronic medical records (GE Centricity) in the outpatient setting as well as electronic order entry through MedConnect for inpatients with plans to have a full inpatient EMR in place by 2014/2015.

Are there opportunities to perform procedures?

There are endless opportunities to perform a large variety of procedures (central venous catheters, arterial lines, thoracentesis, lumbar puncture, paracentesis, joint aspirations & injections, etc.).

Can I do a Research Elective?

A one month research elective during one of your three years of training is available to residents in good standing with the program and a plan for a concrete plan for a research project with IRB approval.

Can I do away electives outside of the DC area or abroad?

Typically there have to be extremely compelling reasons to allow/arrange for residents to do electives outside the District of Columbia especially as there are other excellent hospitals in the DC area where residents typically go for additional exposure in their fields of interest (e.g. Georgetown University Hospital, National Institutes of Health).

So, what do you really think of this place?

Washington Hospital Center is a high acuity tertiary care hospital where you can learn just about everything that falls under the scope of medicine. The variety of cases seen here are absolutely remarkable in terms of scope and complexities; you will see every stage, level and variety of pathology. This leads to broad exposure within the field of internal medicine.

The expertise and experience available here with the Washington Heart program, Washington Cancer Institute and others lead us to be ranked among the nation’s best hospitals, recognized annually by U.S. News and World Report. Washington Hospital Center is among AARP’s listing of its top 50 hospitals, as well as on top lists of numerous other organizations.

Our program continually evolves through feedback and an open-door policy that welcomes ideas. Our constant desire for excellence pushes the members of our program to challenge themselves to become respected leaders and physicians in their fields. Through the clinical and educational experiences are rigorous, we reach a balance of work and play. Our residents enjoy their years here; they learn and grow exponentially each and every day; and they leave with life-long friends and colleagues.


For more information about our program, please contact:

Ms. Gaitri Tiwari
Program Coordinator
Department of Medicine

MedStar Washington Hospital Center
110 Irving St, N.W.
Washington , DC 20010

Phone: (202) 877-8278
1-800-WHC-PGY1
E-mail: Gaitri.Tiwari@MedStar.net