Junior and Senior Residency
Residency solidifies clinical and teaching skills and allows trainees to experience leadership of a medical team. Junior residency provides the first opportunity for residents to supervise housestaff teams on general medical services and in the medical and cardiac intensive care units. Senior residency promotes consolidation and refinement of these skills, with attendings allowing increasing autonomy. The resident on the service is looked on as the team leader and assumes primary responsibility for teaching of the team.
Residency also provides opportunities for increased elective time to sample subspecialty rotations. This assists is career planning and provides additional specialty training in areas of interest. The elective opportunities are diverse, ranging from electrophysiology to musculoskeletal medicine to health policy. Residents also have the opportunity to participate in one of several “tracks” within the residency program if interested in additional specific training resources and experiences.
Teaching as a Resident
As mentioned above, residents are viewed as some of the primary teachers within the Department of Medicine. Some of these teaching opportunities will also be observed by department faculty to help the resident refine the style and effectiveness of their teaching. Teaching opportunities will include:
Leading inpatient medicine rounds:
- Residents are in charge of running ward rounds. Medical students and interns present to the resident during rounds. The attending hospitalist is considered the resident’s consultant, with the resident retaining the primary decision-making role for the patients on their service.
- During the months on medical wards, the Chief Residents and Firm Chiefs are assigned to do walk round once each week with one of the residents on their Firm. They will observe the resident running the ward rounds and provide feedback on the teaching skills observed during rounds.
Leading teaching attending rounds:
- During every rotation on the medical wards, each resident will lead one to three attending rounds sessions. The two teaching attendings help provide feedback on the resident’s small group discussion and teaching skills.
Small group presentations:
- During ambulatory weeks, residents will lead a majority of the pre-clinic conferences, typically presenting either a challenging ambulatory case or ambulatory-based topic.
- Once during residency, each junior resident will also present a journal article of ambulatory care significance at ambulatory journal club to a small group of their peers.
Senior Teacher Rotation:
Residents may choose to do the 1-3 week senior teacher elective as Junior or Senior residents. Opportunities will include the following:
- Leading a weekly lecture to the 3rd year medical students rotating on the inpatient medicine wards.
- Leading a weekly lecture to the 4th year medical students rotating on the SIRS medical service.
- Leading one intern report under the mentorship of the Chief Residents.
- Precepting interns in continuity clinic, under the supervision and mentorship of the primary care faculty.
- Performing observation of full clinical skills examinations for interns on ambulatory rotation and providing feedback to those interns.
- Leading weekly small group teaching seminars with ambulatory interns.
- Attending the residency educational conferences and recording education “pearls” from each talk to disseminate to the medical housestaff.
Senior Residency Additional Rotation Opportunities:
- Serving as the Medical Consult Resident performing medical consultations for patients on surgical and other non-medical services.
- Serving as one of the Stoneman Quality Improvement residents evaluating systems based problems and gaining formal education in quality improvement.
- An optional chief residency rotation at West Roxbury Veterans Administration Hospital (see below for more information).
- An optional "Area of Concentration" rotation with the opportunity for protected investigational time to work on a scholarly project or pursing an international training rotation.
Senior Residency Additional Teaching Opportunities:
- Senior Talks/ Lecture: Each senior resident is required to present one 20-30 minute talk to the entire housestaff on a clinical or basic science topic. Each resident chooses a content mentor for the talk to help create a talk of significant academic rigor that it could be presented at a more formal venue or such that the content could be published. A member of the Program rates the talk and provides feedback after the presentation.
- Preceptors in Patient-Doctor I, II: Patient Doctor I and II are courses for the Harvard medical students. Each year a number of our residents participate either longitudinally or during some weeks. The longitudinal preceptors have access to the HMS faculty development for the course.
- Tutorial Leaders for Pathophysiology: Each year several of our residents lead a tutorial of pathophysiology at Harvard medical school. This is typically in the GI unit but also at times in the Pulmonary and Renal units of the course. The residents get the HMS faculty development for the course and are evaluated by the students at the end.
- West Roxbury VA Chief Resident: Approximately ten of our senior residents each year are selected to spend some time as a Primary Care Chief Resident at the West Roxbury VA Medical Center. Their duties include administrative work, numerous teaching conferences including resident reports, and bedside teaching. They also help precept ambulatory care visits at the West Roxbury outpatient clinics. They are mentored by on-site VA physicians who have appointments on the Harvard and Boston University faculties.