Steward Health Care System

Didactics

Grand Rounds

Grand Round presentations are delivered every Wednesday from September to June. The speakers comprise national and international experts as well as members of the St. Elizabeth’s Medical Center Department of Medicine Faculty. The talks provide updates in areas of interest to internal medicine practitioners as well as the latest breakthroughs in diagnostics, therapeutics, and clinical and translational research.

Attending Rounds

These lectures are given on Tuesdays and Thursdays to residents rotating on the wards, with a goal of having small group discussions of interesting cases. The third-year resident identifies two to three cases, which are than presented by the medical students and the interns to the attending on Tuesday. Following the discussion about the case, residents are designated to complete a literature review on two to three topics or questions raised during the discussion. These topics are than discussed on Thursdays. Topics related to ethical, social and health system issues are also discussed if relevant to the cases presented. These rounds are scheduled such that the same attending is present both days of the week for continuity.

Morning Report/ Noon Conference

Morning report is held every morning for 45 minutes. Two residents (PGY-2 and PGY-3) are assigned to present a case. The rest of the group will generate questions and a broad differential diagnosis and try to solve the case.  The chief residents are the mediators of the morning report, but there is also an attending present. There is a PowerPoint presentation in the last 15 minutes regarding that case. The resident strengthens his/her skills in literature review, PowerPoint slide preparation, and public speaking (the lecture is presented to the interns, residents, program directors and sub-specialists involved in the case which is being presented).

Noon conferences are primarily Monday, Wednesday and Friday for all residents and interns. The lectures are given by the attending from different specialties on a variety of subjects.

Resident Board Review

This is a weekly session run by the chief medical residents where carefully chosen questions are discussed with the emphasis on evidence-based medicine. The Department of Medicine purchases MKSAP and Med Study board review books for residents during their PGY2 year.

ICU Conferences

These happen three days a week for the residents rotating in the ICU. Topic may include Journal Club, M&M and a variety of critical care cases. Attendings from other specialties are also invited to deliver lectures.

Journal Club/Case Conference

Apart from Journal Club presentations incorporated in the teaching rounds and ICU conferences, the residents during their ambulatory and elective rotations present and critique key recent articles in the presence of a senior member of the teaching faculty of the department of medicine. Journal Club is an academic activity designed so that residents learn to clinically appraise a journal article. Each resident chooses a mentor and a study design (RCT, meta-analysis, diagnostic, cohort and case control studies). Residents should meet with their mentors at least one month prior to their presentation, so that the mentor can guide them in the article selection, analysis and discussion of the article. Residents present the journal club to the rest of the residents (who should have read the article a day before so they come prepared) in the presence of their mentors and there is a discussion at the end of the presentation.

Morbidity and Mortality Conference

Quality Improvement Conference focuses on adverse outcomes and medical errors. Cases are presented anonymously so that discussions are open and cordial. The goal is to provide a supportive atmosphere where residents and attendings can improve their skills in self-assessment and practice improvement.

Sub-Specialty Conferences

Each sub-specialty division offers a number of weekly conferences focusing on clinical cases, clinical research and basic science research. A yearly Research Day Conference highlights the research projects and accomplishments of faculty, fellows, and residents.


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