Q & A Responses

We hosted a Virtual Q&A information session for prospective applicants. Some questions were submitted ahead of time with responses added below. Additionally, some of this information is embedded on its respective page on our website.

Wards & ICU

The 4+2+2 block system is a different take on the “X+Y.” Each block is a month long and the “4” is the in patient month. This is when our residents will be on in-patient wards or ICU. The “2+2” is separated into two weeks of clinic and two weeks of elective. We have eliminated half day continuity clinics during the year so our residents can focus on outpatient medicine during the two weeks. The second two weeks consist of elective or vacation. During these two weeks the residents will do night float. With this system in place it has allowed our residents to have a great work/life balance as during the clinic and elective weeks, they do not work weekends

Our Training is separated across various clinical centers in order to broaden our understanding of different hospital systems and workflows. However, our primary training site is Georgetown. An intern can expect to rotate once thru the VA wards, once at VHC wards, and once at a CCU at Fairfax or WHC for the most part, all other inpatient rotations are mainly at Georgetown.

Georgetown Wards encompasses a broad and diverse population of patients. Our patient’s range from members of congress to the under-served population of DC. Since we are a tertiary referral center, a cancer institute and a transplant center, Georgetown residents become well versed in the pre & post transplant patient as well as all aspects of hematologic and oncologic care. At Virginia Hospital Center, we see a more community based population that allows our residents to see “bread and butter” medical management. At the VA we see veterans with bread and butter issues but also with some more complex problems given the DC VA is a referral hospital for VAs throughout the region.

Our program incorporates a multitude of call styles, owing to the fact that rotate at different hospitals. In-patient at Georgetown is a night float system and new patients are admitted via a daily dedicated admission team. Our ICU’s function as a night float system as well. Our affiliated sites; such as VHC, have a Q4 long call system where the teams admit new patients every 4 days. As residents, our CCU rotations still do an overnight call q4 days. At the VA we do drip admissions with q3 day long call until 6pm.

At Georgetown and VHC, the team consists of a one resident one intern team. This team is usually accompanied by one fourth year medical student as well as two, third year medical students. Our residents become well versed at managing a team as well as their own patients. When our residents rotate at the VA, the teams consist of a 2 intern, 1 resident team.

At Georgetown, we pride ourselves on medical education. Our hospitalists are all dedicated educators and seek out teaching opportunities. Usually the faculty will discuss topics pertinent to patients while on rounds and will reinforce that education in the afternoon with a more formal discussion. While on wards, we also have various subspecialists who attend morning report and provide medical pearls there. On top of this, there is a dedicated teaching attending who provides another facet of medical education while on wards.

Training Tracks

The MACE track is a longitudinal curriculum dedicated to fostering clinician educators during residency. The track includes formal didactic sessions, hands-on teaching, and a capstone research project. You apply midway through one’s intern year and begin the curriculum at the start of PGY2 (if a Med Peds applicant, you can apply as a PGY1 or PGY2). There are dedicated half-day lectures during residents’ clinic blocks and there are a variety of teaching opportunities throughout the PGY2 and 3 years. Please see additional information on their webpage. 

Our Global Health Track is a rich program dedicated to developing skills to be effective practitioners for diverse populations both here in the US and abroad. You apply midway through intern year and begin the curriculum at the start of PGY2 (if a Med Peds applicant, you can apply as a PGY1 or PGY2). There is a longitudinal curriculum during clinic blocks over two years, a 2 week Global Health Bootcamp covering practical skills for low-resource environments like ultrasound skills, and traditionally two month long international electives. In the setting of COVID, the track is offering opportunities to work with the DC DOH to support our local patients in need and is working to establish safe opportunities for travel domestically and abroad, at the earliest in Spring 2021 (which will be modified pending the ongoing pandemic). Lastly, this program is open to a variety of residency/fellowship programs, so you are able to work with residents and fellows from a variety of disciplines including Dermatology, ID, and several others. Please see additional information on their webpage.

Education & Mentorship

Residents develop teaching skills and grow as educators throughout their three years. We have formal didactics discussing how to be an educator including topics like “Giving feedback” during noon conference lectures throughout the year and each PGY class has an end of year retreat discussing various topics including the transitions between years. For example , the PGY1 retreat has didactic sessions on how to lead a team and assuming that leadership role. In addition, there is an Argy elective offered during your PGY3 year that is a one month block dedicated to honing teaching skills where residents give lectures to M3 and M4 students on their medicine rotations as well as lead morning report sessions and a noon conference. Residents at the VA will have the opportunity to be Teaching Resident, a resident that focuses on one to one teaching with medical students as well as working with the chief residents on creating larger noon conferences and intern reports with one to one feedback and support. Last (but definitely not least!), we have a Clinician Educator Track called the MACE track that offers a longitudinal curriculum teaching adult learning theory as well as providing hands on teaching opportunities.

  • For faculty-resident advising, all residents are paired with a faculty advisor from the first day of intern year. This faculty member will meet with the resident at least two times per year to check in on clinical progress, provide residents with research connections as able, and insight into career choices including for fellowship and primary care positions
  • For resident-resident advising and mentorship, every PGY1 and PGY2 are paired with senior residents in their field of interest (Ex. if interested in Cardiology, you would be paired with a PGY3 resident applying into that field or if undecided, you would be paired with someone along that career trajectory as well). These pairings are meant to provide more informal guidance and to help interns navigate the hidden curriculum of residency. 
  • We also have Chief-Intern mentorship where each intern also receives a chief who is paired with them guidance on clinical rotations, when to take Step 3, and help create research or career connections.

During intern year prior to one’s first ICU block, interns will complete Central Line Training in a supervised simulation setting to get initial practice into procedures. During the ICU rotation, residents have fellow-led didactic sessions twice weekly in addition to the teaching provided by attendings during rounds and during afternoon breaks. We work very closely with our excellent ICU fellows who provide continuous teaching during the rotation.

The feedback process happens at the personal level as well at the residency level. We have a formal evaluative process through New-Innovations where evaluations are done by faculty as well as by peers (anonymously). We have a recurring conference based series about ways to give feedback and theory behind feedback. The faculty also routinely will do mid rotation feedback sessions which help provide some foundational groundwork that allows our residents to continue to grow as a clinician.

Research

The advantage of being at a program like Georgetown is that there are numerous faculty who are focused on scholarly activity. Research is a large part of our residency program and we encourage residents to participate. During your training there are dedicated electives that a resident can choose to help focus on research. We also have a significant QI team that is mostly resident driven where lots of opportunities can be found.

Residents at Georgetown get significant exposure to the various institute’s research opportunities. Since our residents rotate through Lombardi as a subspecialty clinic elective, they are able to meet numerous faculty, which opens up research opportunities.

You are able to get good exposure to all the subspecialities from intern year through your third year. We have dedicated 2 week blocks where residents rotate on inpatient subspecialty teams, working closely with faculty in their field of interest. In addition to the inpatient electives, residents have subspecialty clinic sessions during their 2 week clinic blocks where they can be paired in your intended specialty, allowing residents to have longitudinal exposure to experts in their field. Lastly, our residents through our buddy system act as excellent resources to ensure residents are supported with research opportunities. We also offer a few unique specialty rotations including an Advanced Heart Failure rotation at Washington Hospital Center, a Lung Transplant rotation at INOVA Fairfax, and on Georgetown Wards you can rotate on our specialty services for Hematology or Transplant Hepatology, working with experts in our region.

Diversity

We think it’s important to be purposeful about this goal and that we are reflective of our practices and biases for our patients, for ourselves, and our program. We have created a resident led social justice team this past June to challenge our implicit biases. We also are partaking in bias training as a program, both residents and faculty; this will allow us to be purposeful in reflecting the diversity of our community in our resident classes and leadership. Additionally, there is a Medstar working group for racial justice where several members are from the Department of Medicine. The focus of this committee is on resident and faculty recruitment, retention, and several other topics.

Wellness

  • A buddy system which pairs an intern with residents as well as all interns with a Chief is in place to make sure that there is always open communication and avenues available if things get tough, but also available as a source of mentorship to ensure interns are meeting their academic goals. 
  • Mind body medicine sessions while on clinic rotations allow for reflection and introspection as well as training in mindfulness processes. Residents also are able to use the headspace app which is currently free for healthcare workers to hone their practice outside of these sessions
  • Our social committee has planned virtual experiences to let our hair down and relax, like trivia last week!
  • Some of our residents have set up volunteer experiences at Martha’s Table which supports families and communities in DC. During the height of the pandemic multiple residents were volunteering at the DC Department if Public Health to help with the response to covid
  • The social justice team, a resident led initiative within the internal medicine program, formed in response tothe  protests that occurred in June 2020. Our goal, along with our physician mentors, is to not only bring awareness to the impacts of implicit bias on patient care but also to spearhead the development of workflow tools that our housestaff can use to dismantle our own biases.  We acknowledge that this sort of change will not happen overnight, but hope that  through these efforts we can slowly bring about a cultural work change.