At the heart of any residency experience is the patients. At Wakefield, you will learn from patients who reflect the diversity and complexity of the Bronx. You will be grounded in “bread and butter” medicine but will be surprised by the unusual conditions and situations you encounter. You will truly be your patients’ primary provider and advocate.
Inpatient
Your Inpatient Team: each team (day team and night medicine) is composed of a PGY2 or PGY3 resident, 2 interns and medical students. The night medicine teams are not traditional night float teams; they participate in teaching and bedside rounds each day and will present patients they admit directly to the day team. You and your team are the primary physicians for your patients; your supervising attending is there to guide and teach but we believe that your growth depends on progressive independence, i.e. supervised autonomy.
Geographic Units: all your patients are located together on a single unit, minimizing the time spent “commuting” within the hospital and maximizing your efficiency on work and teaching rounds. You will work collaboratively with your Interdisciplinary Team (nursing, social work and case managers) on the unit. Each team is capped at 18 patients, with a census typically closer to 16.
Subspecialty Electives: electives are available in all the medical subspecialties and Neurology, and take place on the Wakefield Campus.
Non-Wakefield rotations: all residents participate in an inpatient Oncology rotation at the Moses Campus and a Cardiac Care Unit (CCU) rotation at the Weiler Campus.
Off-site Elective: all PGY2s have the opportunity to apply for an off-site clinic or research elective at any Montefiore Medical Center site to gain additional experience. Examples of previous electives include: advanced heart failure, hepatology, patient safety, transplant ID and palliative care.
Hospitalist rotation: all PGY3 residents participate in our Hospitalist rotation. This rotation is designed to prepare you for post-residency work (whether as a generalist or fellow) by introducing you to topics such as hospital finance, billing, high value care and inpatient quality.
ICU Rotation: The Wakefield ICU is a 16-bed, closed ICU where all residents and interns rotate every year. The team consists of upper level residents and interns, a fellow, and an attending who is on-site 24/7. The entire team participates in rounds to deliver evidence-based care, including the incorporation of POCUS, procedure rounds once a week, journal clubs, and additional didactic experiences.
Point of Care Ultrasound (POCUS)
Point of Care Ultrasound (POCUS): Throughout the year there will be a core lecture series on point-of-care ultrasound technique and image interpretation that is led by Dr. Joseph Hong, Associate Program Director. The purpose of these lectures is to familiarize all house staff with the principles of ultrasound (I.e., “knobology”), the standard bedside ultrasound views taken of the heart, lungs and abdomen, and goal-directed binary interpretation of these views.
For hands-on experience, POCUS techniques will be taught at bedside during the Medicine consult rotation with POCUS faculty and the consult resident. Teaching will be done one-to-one using patients admitted to the hospital as examples of normal and abnormal findings. Residents will also have exposure to POCUS image acquisition and interpretation during their ICU rotations and while serving on the critical care consultation service.
Outpatient
Clinic Rotation: your outpatient clinic is located at the Wakefield Ambulatory Care Center, just 1 block away from the hospital. The clinic experience allows you to develop skills in outpatient medicine, with more focus on preventive healthcare, chronic disease management, and some urgent care. In addition to building your personal patient panel that you will follow regularly, your outpatient clinic blocks include half days for independent learning, scholarly activity, and wellness. Your patients will follow up with you, ensuring continuity of care. You will gain a broad exposure to outpatient medicine by participating in specialty clinics, e.g. Gastroenterology, Nephrology and Rheumatology. There is a bi-weekly resident-led Journal Club as well.
Ambulatory Care Rotation: sample schedule below.
| |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
| AM |
Continuity Clinic |
Renal Clinic |
Neurology Clinic |
Journal Club followed by Continuity Clinic |
Continuity Clinic |
| PM |
Continuity Clinic |
Rheumatology Clinic |
Administrative Block |
Women’s Health Clinic |
Continuity Clinic |
Independent/Online Learning: in addition to your structured didactic sessions, we expect all residents to learn independently and develop lifelong learning skills. We have a variety of online resources on our residency webpage and provide time for study and scholarship.
Telemedicine: for patients who need care may not be able to access it in-person, as our recent experience with COVID has shown. You will learn how to “see” your patients via telephone or video visit.
