Internal Medicine Residency

The Department of Internal Medicine offers a three-year residency in Primary Care Internal Medicine and a one-year preliminary program for those going on to specialty training. Both programs are fully approved by the Accreditation Council for Graduate Medical Education.

Academic Programs

The Residency Training Program in Internal Medicine and Primary Care Internal Medicine  operates with three basic goals in mind. These are:
 
  • Train clinicians to provide excellent medical care for a broad range of patient’s problems. Clinicians are expected to be able to synthesize information from a wide variety of sources, use a rational approach to decision making and develop the clinical skills required for superb care.
  • Prepare trainees to function in the rapidly changing environment of medical care. It is now recognized that clinicians need to understand the management of medical care as well as the science. Our graduates will be trained to take leadership roles in an environment of quality health care with fiscal responsibility.
  • Facilitate teamwork and collegiality in the clinical and educational process, supporting a life long process of learning in the practice Medicine.
 
Programs Offered/Number of Resident Positions
Ten Preliminary Interns in a one-year program for physicians going on to other specialties; Twenty-one (21) Residents in each of the three years of regular or categorical medical residencies. The Department of Medicine also provides training for rotating PGY-1s from Psychiatry, as well as for Osteopathic Interns. Brookdale’s department of Medicine has Fellowships in Nephrology and Hematology/Oncology.
 
Divisions/Sections
In addition to general internal medicine, the department has divisions of cardiology, endocrinology, gastroenterology, hematology/oncology. Infectious disease, nephrology, pulmonary/critical care medicine and rheumatology.
 
Staffing
Full-time faculty of 40 physicians, of all of whom are board-certified in Internal Medicine and in their respective subspecialties. All are also members of the faculty of the State University of New York Health Science Center at Brooklyn.
 
Facilities
The department provides an excellent base for Resident training through a very active 230-bed inpatient service (including a 16-bed MICU, a 6-bed CCU, and a 30-bed Telemetry Unit), rotation through one of our six primary care satellites in the community (Brookdale Family Care Centers) a complete roster specialty clinics, and a very active Emergency Department.

Mission Statement

"Training the next generation of leaders in medical care"

 

The Mission Statement of the Department of Medicine is in line with the hospital's overall mission.  We are the focus of a healthy community. By this we consider the local community in which we serve, the community at large in New York City and it's boroughs, the academic community of scientists with whom we collaborate, and the community of students and trainees who depend on us for quality training in health care. To these ends, the Residency Training Program in Internal Medicine and Primary Care Internal Medicine operates with three basic goals in mind. These are:
 
To train clinicians to provide excellent medical care for a broad range of patient problems. Clinicians are expected to be able to synthesize information from a wide variety of sources and to use a rational approach to decision making.
 
To prepare trainees to function in a rapidly changing environment of medical care. It is now recognized that clinicians need to understand the management of medical care as well as the science. Our graduates will be trained to take leadership roles in an environment of quality health care with fiscal responsibility.
 
To minimize wasted time; that is to pledge that every experience of a house officer be an educationally valuable one. If no educational value can be derived from an activity, its experience will be minimized in the residency program.

Postgraduate Medicine Course Outline

Elliott Bondi, MD, FACP

The department has a full-time faculty of 40 physicians, all of whom are board-certified/board eligible in Internal Medicine and in their respective subspecialties. The house staff of the department includes 10 preliminary Interns in a one-year program for physicians going on to other specialties, and 21 Residents in each of the three years of regular or categorical medical residencies.
 
The Department of Medicine also provides training for rotating PGY-ls from Psychiatry and for Osteopathic Interns. The department is responsible for a total of 230 inpatient beds, including a 10-bed MICU, a 6-bed CCU, plus a 30-bed Telemetry Unit. There are approximately 11,000 medical admissions per year, with an average length of stay of 7 days. Each medical floor is staffed by a team of eight PGY-1s who care for 36 patients under the direct supervision of a 2 senior residents and Attending physicians. Approximately 50 percent of the patients are private and 50 percent are covered by the Hospitalists Program. All patients are included in the teaching program. The Residents in the program participate in the care of patients in one of our six hospital-sponsored family care centers.
 
Rounds and Conferences
Formal rounds are conducted five times a week. All newly admitted patients are formally presented to the Attending physician for discussion and review of diagnostic interventions and management. Formal rounds are conducted bedside. During this time, the attending is responsible for in depth teaching and over all patient management. This includes in-depth discussions and teaching of differential diagnosis at greater length.
 
In addition to these rounds, the full-time subspecialist conducts teaching rounds with house staff on designated floors twice weekly. Teaching conferences dealing with pathophysiology and clinical aspects of disease entities, including integration of the most recent advances and review of current literature, are held daily at noon for the entire house staff. When indicated, the Departments of Radiology and Pathology also participate in these conferences. Each subspecialty has weekly conferences targeted at its Fellows, residents and its full-time faculty.
 
Early in the academic year there is a series of lectures concerned with skills valuable for primary care physicians. This includes medical interviewing, psychosocial aspects of disease, cross-cultural interaction, and the treatment of psychiatric and psychologic diseases in primary care. This series of lectures is conducted jointly with the Department of Psychiatry. Some of the curriculum will be conducted with individualized learning packets. These prepared handouts will outline the important aspects of the syndrome of importance, provide an up-to-date reference and include a set of CME-type questions. Learning packets have the advantage of being administered in "real time," that is the time that an actual patient is being discussed. The learning packets allow interactive conferences to be conducted during the day, which will enhanced the house officer's ability to think critically and make better decisions. In addition, there are seminars and discussions at each ambulatory care session, conducted by the full-time preceptors. Since much of the resident's time will be committed to an ambulatory care site, an equal amount of curricular activity will be conducted in the ambulatory setting. This will maximize the educational value of ambulatory care.
 
Clinical Responsibilities
In addition to in-hospital care and management of patients, the house officer attends two half-day clinics a week at one of our Brookdale Family Care Centers, PGY-1 seeing three to five, PGY-2 seeing four to six and PGY-3 seeing more than four patients per session.. The patient population consists of recent hospital discharges, newly enrolled patients and long-term patients. The house officer serves as the primary care physician at a Brookdale Family Care Center and is supervised by an Attending physician who sees every patient with the Resident. There is one preceptor for every five residents.
 
Yearly Rotations
The first postgraduate year is divided into 13 four-week periods during which there are rotations through the Medical Intensive care Unit (MICU), Coronary Care Unit (CCU) and General Medicine. The general medicine rotations include units with special emphasis on infectious diseases, cardiology, stroke and pulmonary.
 
The second postgraduate year consists of block rotations of one month through the MICU, the CCU, the Emergency Department and General Medicine, plus a one-month period of free choice elective, and one month of block time in Ambulatory Care.
 
The third postgraduate year consists of rotations in one month blocks. Five rotations of free choice electives, a two-month assignment in medical consultation, primary care continuity clinics and related specialty clinics (dermatology, otorhinolaryngology, gynecology, rheumatology, ophthalmology, urology, orthopedics and adolescent medicine), and one month as the night float Resident and two in critical care.
 
Call Schedules
Since the institutions of laws by New York State limiting the total number of work hours for house officers, the Department of Medicine has implemented the following on-call schedule and night float system.
 
All PGY-1 Residents are on call no more than every fourth night and are permitted to leave the following morning after attending rounds, they are limited to 12 hour shifts. When residents are on call they cover only their own team and keep every patient they admit.
The on-call frequency for PGY-2 and PGY-3 Residents is approximately every fourth or fifth night and every sixth night, respectively. Each on-call duty ends at 10 p.m. except for Friday and Saturday evenings when the Resident on call works through the night and then goes home first thing in the morning. Residents on call from Sunday through Thursday are relieved by a designated night float Resident at 9 p.m.
 
Medical Student Training
The Brookdale University Hospital and Medical Center is a major affiliate of SUNY-HSCB, and the Departments of Medicine of the two institutions are closely interrelated. Most of the Attending staff at Brookdale have academic appointments at SUNY-HSCB. Second-year medical students from SUNY-HSCB receive training in "Preparation for Clinical Medicine (Bedside Diagnosis)" at Brookdale, third-year students are assigned clerkships in Medicine and fourth-year students may arrange electives in medical subspecialties, as well as subinternships in Medicine at the hospital.

Contact the Program

For Academic Information or information about Residencies, please contact:

 

 

Program Director - Conrad Thomas Fischer, MD

Associate Program Director - Anjula Gandhi, MD

Associate Program Director - Herman Lebovitch, MD

Associate Program Director & DIO - Chris Paras, DO

Medical Subspecialties

In addition to General Internal Medicine, the Department is divided into divisions such as Cardiology, Infectious Disease, Rheumatology, Endocrinology, Dermatology, Gastroenterology, Hematology/Oncology, Nephrology, Critical Care and Pulmonary Medicine. These divisions are headed by physicians who are board-certified in Internal Medicine and in their respective subspecialties. These physicians are responsible for the teaching to both Internal medicine residents and subspecialty Fellows.

Division of Cardiology

Co-Directors - Hal L. Chadow, MD & Moshe Gunsberg, MD

 

The staff of the Division of Cardiology comprises eight full-time and 16 visiting staff physicians and is subdivided into four sections:

 

The Consultation Service advises in the management of cardiology problems for both inpatients and outpatients. Consultations are provided by Fellows in conjunction with their Attending physicians and involve bedside teaching of the house staff. Consultants also guide patients through the complex maze of cardiac diagnostic techniques and procedures offered by the hospital. Elective rotations are available for house staff.

 

The Coronary Care Unit includes six coronary care beds, and 30 monitored beds exclusively for cardiac patients. A Cardiology Fellow is assigned to this unit to provide continuous, on-site specialty guidance to house staff, and Attending rounds are made daily.

 

The Non-Invasive Cardiac Laboratories provide color-flow Doppler echocardiography, electrocardiography, stress testing and Holter monitoring for patients, and work in close conjunction with Nuclear Medicine to offer an array of Nuclear Cardiology diagnostic studies. The staff is available to discuss and review indications and results of studies with house staff. Elective time is provided for those interested.

 

The Cardiac Catheterization Laboratory performs more than 600 cardiac catheterizations and coronary angiograms each year. A new state-of-the-art electrophysiology testing system for sophisticated evaluation and treatment of cardiac arrythmia including ablacions is also now available in the Laboratory.

 

There is a weekly Cardiac Conference, as well as a Journal Club. Patient beside rounds and work conferences are held daily in all the sections.

Division of Endocrinology

Director  - Joel Goldman, MD, FAAP

 

The Division of Endocrinology consists of two full-time endocrinologists and voluntary staff. The division provides consultations for inpatients for a wide spectrum of endocrine and metabolic disorders. In addition, there are two outpatient clinics, one of which is devoted exclusively to diabetes and the other to various endocrine and metabolic problems. Board-certified endocrinologists supervise daily rounds and the activities of students, house staff and endocrine Fellows in the clinics.  A full range of diagnostic testing is available, including dynamic endocrine testing (such as TRH, LRH and ACTH stimulation tests, insulin and glucose tolerance testing), thyroid biopsies, nuclear medicine testing and CT scanning.

 

Conferences include a weekly morning case presentation, a weekly afternoon conference that rotates between two Journal Clubs each month, and endocrine imaging conference and an endocrine pathology conference, as well as regularly scheduled conferences on various topics in endocrinology. Weekly conferences are also held during the academic year at the Division of Endocrinology at SUNY-HSCB. There are two fellowship positions available, and house staff and medical students may take elective rotations in the division.

 

Opportunities exist for experience in the clinical immunoassay laboratory, the renal hypertension service and the gynecologic endocrinology service, and for clinical research projects under the direction of Attending endocrinologists.

Division of Hematology/Oncology

Director - Vladimir Gotlieb, MD

 

The Division of Hematology/Oncology has a faculty of 10 physicians, three of whom are full-time, one is geographic full-time and six are voluntary. All are board-certified in hematology or medical oncology or both. The division maintains well-equipped research laboratories under the direction of two of its full-time members, where ongoing investigations deal with the pathogenesis of myelofibrosis/myeloid metaplasia and with the responses of tumor cells to anti-cancer drugs. The hospital Blood Bank is under the direction of one of the full-time faculty, as is the special coagulation laboratory. The fellowship program is a combined one in Hematology and Medical Oncology and is fully accredited. Fellows get broad clinical experience in both disciplines, and all 10 faculty members participate in teaching.

 

Teaching conferences for Fellows are held five times weekly. Ambulatory care experience includes not only a weekly clinic but also the Ambulatory Infusion Therapy Unit, which is under the direction of the division. Fellows supplement their direct clinical experience with selective rotations to Transfusion Medicine and to Radiation Oncology (the latter rotation at SUNY-HSCB), elective experiences in bone marrow transplant (at Memorial-Sloan Kettering or at North Shore University Hospital), and in a number of cooperative clinical therapy studies. Fellows are encouraged to enter and follow patients in these trials. Residents on elective participate in all activities of the division.

Division of Infectious Disease

Director - Richard Cofsky, MD

 

The staff of this division consists of three full-time infectious disease specialists. The section conducts rounds and consultation services to patients with infectious diseases. House officers are exposed to laboratory procedures that they can perform themselves and that are pertinent to the understanding of infectious disease. There are regularly scheduled conferences, and additional special education is provided through distribution of pertinent material from current literature.

Division of Nephrology & Hypertension

Co-Directors - Shyan-Yih Chou, MD & Warren Shapiro, MD

 

There are six full-time physicians and six visiting staff nephrologists in the Division of Nephrology and Hypertension, which has active programs in clinical renal disease, hypertension, disturbances of water electrolyte metabolism and acid-base balance. Specific activities of the division include clinics in kidney disease, hypertension and transplantation, consultations, kidney biopsies, hemodialysis, CAPD and peritoneal dialysis. Extensive laboratory and clinical research activities include basic renal physiological studies in salt and water metabolism and renal hemodynamics, treatment of renal failure, hypertension, treatment of end stage renal disease and problems relating to dialysis. House staff assigned to Nephrology and Hypertension participates intimately in all activities of the division.

 

Residents work closely with renal Fellows while rotating through the service, and Fellows who are seeing consultations keep in close contact with the general house staff for purposes of both patient care and teaching. Attending rounds are conducted daily, and there are teaching rounds three times a week on all hospitalized patients being followed by the division. There are weekly seminars in renal physiology, a weekly Journal Club, a weekly Nephrology-Urology Conference and a monthly Biopsy Conference that reviews all biopsies utilizing light and electron microscopy, as well as immunofluorescence techniques.

Division of Pulmonary Medicine

Director - Elliot Bondi, MD FACP

 

The staff of the Division of Pulmonary Medicine includes four full-time Attendings and several visiting staff. The division has responsibility for the clinical care of patients hospitalized with pulmonary disease, management of all patients in the hospital's intensive care units who require intensive respiratory care, a pulmonary outpatient clinic, direction of the Pulmonary Function Laboratory, where a wide variety of tests are performed, performance of diagnostic pulmonary procedures, chest consultations for inpatients, and supervision of Respiratory Therapy Services, including a staff of more than 30 trained therapists and technicians.Advanced training for house staff is available in pulmonary function studies, respiratory intensive care or respiratory therapy.

 

There is also a two-year Fellowship in Pulmonary Disease that covers all aspects of Pulmonary Medicine, including intensive care and advanced pulmonary diagnostic procedures. House staff rotate through Pulmonary medicine on an elective basis and participate in all division activities, with particular responsibility for consultations on hospitalized patients. House staff also make presentations and lead discussions at the several Pulmonary Medicine Conferences held each week. These conferences include a Journal Club, didactic session, radiology conference and pathology conference.

Division of Rheumatology

Director - Lawrence J. Bernstein, MD, FACR

 

This division has two full-time rheumatologists, both of whom have offices within the medical center complex. They make rounds on rheumatology inpatients and conduct private practices in their offices. There is a weekly Rheumatology clinic.Rheumatology conferences and seminars, including board reviews for house staff, are given regularly throughout the year. Rheumatology rounds are made frequently with individual and group teaching at the bedside. Residents may take elective rotations through the rheumatologic private offices, seeing both in- and outpatients under direct supervision.

 

Overall, the division offers a balance of academics, experience in musculoskeletal examinations, diagnosis and learning of special procedures and treatments.

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