Internal Medicine Residency Program

The program application is available here.

I. General Hospital Information
Cabrini Medical Center (CMC) is a modern 493-bed major university-affiliated teaching hospital located in the scenic Gramercy Park community and serving the areas of mid-Manhattan and the Lower East Side. A hospital of the Missionary Sisters of the Sacred Heart, this institution offers a broad array of clinical services from primary to tertiary care. There are adult medical and surgical services, as well as specialized services in such areas as geriatrics, laser and advanced surgery, oncology and diabetes treatment, bone marrow transplantation, wound care, hyperbaric medicine, breast diseases, and is a state-designated AIDS center. In addition to its acute care services, Cabrini operates a nationally recognized hospice program, home health agency, and is affiliated with two nursing homes, Cabrini Nursing Home and St. Cabrini Nursing Home. Cabrini provides outpatient services at several community locations: Cabrini-Haven Plaza Family Medical Practice (HP), Cabrini-East Village Family Medical Practice (CEV), The Eye Care Center, The Wound Care Center and is involved in multiple community outreach efforts. As an academic institution, the medical center is committed to teaching and is the site of residencies in medicine, surgery, psychiatry, orthopedics, and podiatry. The residency-training program in Internal Medicine is a fully accredited program sponsored by The Mount Sinai School of Medicine as part of its consortium of teaching hospitals. A clinical alliance between CMC and the Mount Sinai Hospital provides a direct connection between Cabrini's primary and acute care programs and the internationally recognized tertiary care, teaching and research at Mount Sinai Hospital.

II. Residency in Internal Medicine
Approximately 70 residents and 14 fellows are trained under the close guidance of dedicated full time faculty, and equally qualified voluntary attending physicians. Between 20 to 30% of our residents and several of our faculty members come from under-represented minority groups. Our residency appeals to those seeking a career in internal medicine (categorical program), as well as those pursuing a subsequent career in radiology, anesthesiology, rehabilitation medicine, dermatology, psychiatry, and ophthalmology (preliminary program). The training program provides excellent clinical training with emphasis on Primary Care in Internal Medicine. Fellowship training in five medical subspecialties and research opportunities are also available to the resident. Our program combines a warm, friendly community hospital atmosphere with the academic benefits of a large teaching institution. Patients admitted to the 320-bed medical service comprise a cross-section of people reflecting the cultural and socio-economic diversity of the hospital's vicinity. There are approximately 8,300 admissions to the medical service each year. The Department of Medicine encompasses various medical units including an inpatient AIDS unit, as well as special units such as an 15-bed MICU, 8-bed CCU, 6-bed cardiac telemetry unit, 30-bed oncology unit, 9-bed geriatric unit, 3-bed bone marrow, and a 3-bed acute hemodialysis unit. All admitted patients, whether private or non-private, are considered to be teaching" cases with responsibility shared by both the attending physician and the residents. The level of resident's responsibility is commensurate with his/her abilities and level of training.

Cabrini staff physicians Approximately 70 residents and 14 fellows are trained under the close guidance of dedicated full time faculty, and equally qualified voluntary attending physicians. Between 20 to 30% of our residents and several of our faculty members come from under-represented minority groups. Our residency appeals to those seeking a career in internal medicine (categorical program), as well as those pursuing a subsequent career in radiology, anesthesiology, rehabilitation medicine, dermatology, psychiatry, and ophthalmology (preliminary program). The training program provides excellent clinical training with emphasis on Primary Care in Internal Medicine. Fellowship training in five medical subspecialties and research opportunities are also available to the resident. Our program combines a warm, friendly community hospital atmosphere with the academic benefits of a large teaching institution. Patients admitted to the 320-bed medical service comprise a cross-section of people reflecting the cultural and socio-economic diversity of the hospital's vicinity. There are approximately 8,300 admissions to the medical service each year. The Department of Medicine encompasses various medical units including an inpatient AIDS unit, as well as special units such as an 15-bed MICU, 8-bed CCU, 6-bed cardiac telemetry unit, 30-bed oncology unit, 9-bed geriatric unit, 3-bed bone marrow, and a 3-bed acute hemodialysis unit. All admitted patients, whether private or non-private, are considered to be teaching" cases with responsibility shared by both the attending physician and the residents. The level of resident's responsibility is commensurate with his/her abilities and level of training.

III. The Educational Program

Director of Medicine, Wilfredo Talavera, MD, reviewing charts with residents The educational program offers a dynamic outline of required knowledge that each resident will acquire during his/her year(s) of training. The curriculum activities are in step with the changes in scope of the medical education regulatory agencies and the realities of the profession. To impart this wealth of knowledge there is an intensive program, which includes daily morning report, bedside patient care and teaching attending rounds, and weekly Medical Director's rounds. Weekly grand rounds are presented by prestigious outside speakers. Following the emergency management seminars given over the summer months, noontime conferences remain the medium for study of major subjects, clinical management seminars, basic science review, subspecialty topics, psychosocial medicine, and primary care series. Ambulatory care seminars are also used to teach the principles of Primary Care Internal Medicine and the art of medical interviewing, and introduction to such disciplines as liaison-psychiatry, epidemiology and biostatistics, medical ethics, and community health issues. A Mortality and Morbidity conference is held monthly and subspecialties seminars emphasizing pathophysiology and pharmacology are held weekly. Journal Club is a biweekly conference attended by both the resident and attending staff. Research seminars, medical consultation conference, and an extensive board review course are additional educational opportunities available to the medical resident. Additionally intensive mini courses in: ACLS/BCLS, EKG, Radiology and Acid Base Disturbances are provided for the intern class.

IV. The Faculty
Teaching attending faculty are available in primary care, critical care, cardiology, endocrinology/metabolism, gastroenterology, nutrition, general internal medicine, geriatrics, hematology, infectious diseases, neurology, nephrology, oncology, hospice and palliative care, pulmonary diseases and rheumatology. Part-time or voluntary consultant physicians are available in allergy, dermatology and surgical subspecialties. Both voluntary and salaried physicians play important roles in the teaching program and are readily available for consultation, guidance and teaching.

V. Medical Students
Mount Sinai School of Medicine students as well as students from other medical schools are in integral part of the educational responsibilities of the Department of Medicine at Cabrini Medical Center. The current academic involvement with the students includes:

VI. Primary Care
The emphasis of this program is primary care internal medicine. During the course of the residency, the trainees will spend at least 33% of their time providing ambulatory care services to their own panel of patients, thereby providing continuity of care. The Primary Care Service and its faculty (12 full-time Board Certified Internist) are dedicated to provide teaching and supervision of the residents at every session. They are responsible for the ambulatory care seminar didactic sessions, and some serve as mentors to many of the residents.

The Primary Care Division, presently, provides every resident, in each of the three years of training, with abundant primary care experience. The first year resident, becomes familiar with common problems encountered in internal medicine and the principles of treatment as well as health promotion and disease prevention. There is an appreciation of the natural history of disease as well as the socioeconomic, preventive and psychiatric aspects of illness. The resident will attend two half-day continuity of care sessions every week at either outpatient site. The second year resident participates in a continuity of care session at the original site assigned twice a week and has an additional one-month primary care block rotation in their continuity clinic. There is a required one-month block ambulatory care sub-specialty rotation with exposure to disciplines such as urology, surgery, gynecology, dermatology, ophthalmology, and office orthopedics.
The third year residents will learn to master the art of the medical consultation and preoperative evaluations. They will broaden their base knowledge of therapeutic interventions and the impact of socioeconomic factors on the health care delivery system. Thus, the Ambulatory Care experience during the residency includes the following:

VII. Residency
First Year
The first year resident is given as much responsibility in management of patients as experience allows. More importantly, the resident is supervised at all times by a more senior and seasoned physician and learns the basics of treatment of acute medical illnesses as well as health promotion and disease prevention. The PGY-1 physician is responsible for and admits both private and non-private patients to the regular medical units for approximately 7 months. There is a rotation through several attending-supervised services such as Primary Care Medicine (one month), ICU (one month), CCU (one month), and the Emergency Department (one month). The Emergency Department experience allows for the PGY-1 to see acute problems in a variety of clinical settings. The PGY-1 also has attending-supervised outpatient sessions in the form of two half-days per week at one of our two community-based outpatient centers. Some residents will rotate through the inpatient surgical service allowing for incorporation of the principles of perioperative management as well as mastering basic surgical techniques for the practicing internist.

Second Year
The PGY-2 spends a significant portion of this year supervising the PGY-1 in the management of the acutely ill patient. While on the medical wards, special units or "night float" each PGY-2 is responsible for two PGY-1 physicians. Emphasis is placed on gradually increasing patient responsibility, the cultivation of leadership attributes and broadening the knowledge base. The PGY-2 physician is responsible for admissions to the medical units for approximately 6 months. There is a rotation through several attending-supervised services such as Ambulatory Medicine (one month), ICU (one month), CCU (one month), and the Emergency Department (one month). The PGY-2 participates in a continuity of care session in the form of two half-day per week at one of our community-based outpatient centers. In addition to an Emergency Room rotation, a one-month block ambulatory care rotation with exposure to Adolescent Medicine, Dermatology, Gynecology, Ophthalmology and Orthopedics is required. The PGY-2 also has 2-3 months available for electives.

Third Year
In the last year of training the PGY-3 residents begin to reach their full decision-making and leadership potential. This year is characterized by greater participation in subspecialties and general medical consultation services. In addition, the PGY-3, on rotation, serves as the Administrative Medical Resident (AMR), overseeing medical admissions and consultations to other services, on nights and weekends. The PGY-3 rotates through a variety of the medical subspecialties (5 months), medical wards including the Oncology unit, the ICU, CCU, Geriatric inpatient service (one month), inpatient medical consultation service (one month) and Ambulatory Care (one month). The PGY-3 also participates in the outpatient services for two half-days per week. An elective rotation in Primary Care Internal Medicine at both community-based centers or in private offices is also available.

VIII. Subspecialty Fellowships
Subspecialty fellowships are available in Cardiology, Endocrinology, Gastroenterology, Hematology/Oncology, Infectious Diseases, Pulmonary, and Rheumatology. These subspecialties have strong fully accredited training programs and offer residents organized electives with full written curricula. Each subspecialty division is fully represented by distinguished faculty who are involved in ongoing research activity.

IX. Research and Publications
Research and scholarly activities are an important component of the residency program, as the large numbers of papers published by the trainees within the last several years indicate. Residents are often involved from the conception of the project to the writing and publication of the paper. Facilities and faculty guidance and supervision are easily available. Our residents are encouraged to participate in national presentations and publications in peer-review journals. We have an extensive library with computer access for literature searches. A training program with a syllabus for computer literacy is available at Cabrini Medical Center. Programs in statistical methods are readily available. Research seminars are regularly scheduled as part of noontime conferences and journal club.

X. Mission of Excellence and Caring
Advances in medicine occur on a daily basis. Choosing a residency in internal medicine at Cabrini Medical Center requires a commitment to a lifetime of learning. The slope of the measure of accrued knowledge and clinical judgment will be greatest in the first five years of residency and fellowship. It is expected however that you will pass your boards and continue to be recertified throughout your career. As you constantly read from the medical literature and learn from your colleagues and teachers so you will be expected to teach the medical students from Mount Sinai School of Medicine and other schools who rotate through our wards and clinics. Training in medicine remains an apprenticeship system and an atmosphere of support and cooperation permeates this medical center. As you progress through the residency you will become a better teacher as well as a better physician and a better human being.

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