On inpatient services, Medicine-Pediatrics residents are exposed to the full range of clinical disorders and gain experience in primary, secondary, tertiary and quaternary care. Because Einstein Medical Center is a referral center for area hospitals, Medicine-Pediatrics residents receive hands on training in the care of patients with the full spectrum of complex illnesses.

Medicine

General medicine services are the core of the adult inpatient experience in the Medicine-Pediatrics residency.

General medicine services are organized by a firm system and are geographic. Patients referred from the Department of Emergency Medicine are evaluated by the medical admitting resident, who works with a nurse facilitator to admit patients to the appropriate firm.

Each firm consists of four inpatient teams, and each team includes one to two medical students, one to two PGY-1 residents, one senior resident, and a full-time teaching attending. Each firm is assigned to a single hospital floor. The firm system allows residents to establish collaborative and continuous partnerships with nurses, social workers, pharmacists and clerks. The firm system also allows for continuity of care with the patients admitted to each firm.

PGY-1 residents on the general medicine service have primary responsibility for six to 10 patients and receive close supervision and substantial teaching.

A full-time faculty member supervises patient care activities on each team and conducts daily bedside teaching and management rounds.

In order to ensure that the residency program remains focused on its educational mission, the Department of Medicine sponsors a nonteaching service. Patients admitted for routine proceedures and those admitted after the firms are full are admitted to the nonteaching service. The non-teaching service guarantees that residents have responsibility for a limited number of critically ill patients and ensures an appropriate workload. Physician assistants and dedicated hospitalists provide full-time coverage for the non-teaching service.

Medicine: A Typical Day

Pediatrics

Medicine–Pediatrics residents at Einstein Medical Center rotate on the pediatric inpatient service for five months during their four years of training. The Einstein pediatric inpatient service admits patients to the Einstein Service at St. Christopher's Hospital for Children. The variety of illnesses reflects common pediatric medical problems as well as a mix of surgical, oncologic and other subspecialty pediatric problems. Floor teams are composed of two senior residents and two first-year residents. A full-time faculty attending from Einstein heads the team and provides guidance in a setting that fosters learning and independent thinking. The presence of two senior residents on the team ensures close supervision of junior residents and enhances the learning environment.

In addition, Medicine-Pediatrics residents spend one month rotating in the pediatric Intensive Care unit at St. Christopher's. On this rotation, our residents care for critically ill children with a wide variety of medical and surgical problems. This inpatient rotation provides exposure to patients with a more complex mix of pediatric illnesses and helps to broaden the experience of Medicine–Pediatrics residents.

Pediatrics: A Typical Day