The goal of our residency program is to train individuals to become excellent physicians and leaders in an increasingly complicated and demanding health care environment where good clinical skills are necessary but no longer sufficient to provide the best patient care. To accomplish this goal, our program has structured a curriculum that (1) integrates the educational features required to develop the lifelong skills and knowledge needed by leaders in health care, regardless of their specialty, and (2) enlists our talented faculty, many of whom are leaders themselves in their own fields, to mentor and guide the housestaff.
As part of the Educational Innovation Project (EIP), we have created a curriculum of clinical experiences, didactic activities, and unique exposures that utilize the exceptional resources available at the University of Pittsburgh Medical Center (UPMC). These resources include an extensive electronic health record system (UPMC is one of the most wired academic health centers in the country), high-quality simulation training (at the WISER Institute, a leader internationally in procedure simulation), excellent research opportunities (the University of Pittsburgh is ranked fifth in funding from the National Institutes of Health), and first-rate teaching by faculty from one of the largest divisions of general internal medicine in the country.
Our curriculum is based on six themes or components identified in Crossing the Quality Chasm, a groundbreaking report published in 1999 by the Institute of Medicine. This report established the need for a major re-engineering of how health care is delivered and soon became the standard by which health care is measured. It has also become the standard by which the residents in our program learn. However, because medicine and the health care system are ever-evolving entities, our program and its curriculum undergo a continuous review process by residents and faculty to ensure that any necessary modifications are made to meet the demands of training physician leaders for the 21st century.
Our innovative curriculum focuses on the following components, all of which contribute to the knowledge, skills, and attitudes we feel are critical for residents to develop:
Continuous Healing Relationships—Our program has an electronic health record system that encourages communication and follow-up with patients between visits. It also has ambulatory blocks that enhance the continuity experience with patients and a communication skills curriculum that prepares residents to meet the challenges of the diverse needs of patients.
Patient Safety and Quality Improvement—In addition to including morbidity and mortality conferences in a variety of venues, our program includes supervised quality improvement projects in which residents learn a systems approach to health care and become agents of change, not only to improve the care of individual patients but also to improve the care of populations.
Chronic Disease Management—Through performance measures, a curriculum based on Wagner's chronic disease model, interdisciplinary experiences to develop skills of coordination of care, and opportunities for reflection, our residents learn how to provide the best care to their patients with chronic diseases and also how to actually measure the benefits that their patients are receiving from this care.
Innovative Teaching Methods—Our curriculum has evolved to include a variety of teaching methods, including simulation training for procedures and communication skills, use of Web-based resources, scholarly projects, and opportunities for faculty to observe the performance of residents and give them direct feedback to improve. In addition, as opportunities to perform have expanded, our ability to provide constructive assessments from multiple vantage points has evolved.
Information Technology—UPMC is one of most wired health care systems in the country. All of our patient records are completely electronically based. Our physicians are able to access the records of patients seen in many of the UPMC hospitals and facilities and directly view their imaging studies, thereby decreasing duplication of services and ensuring a smooth transition in care. The Health Sciences Library System (HSLS) at the University of Pittsburgh offers a wide array of information services, educational opportunities, and resources in print and electronic format to faculty, medical staff, students, and researchers in UPMC and the schools of the health sciences (schools of medicine, dental medicine, pharmacy, nursing, health and rehabilitation sciences, and public health).
Individualizing Careers—The Department of Medicine offers diverse career opportunities that allow every internist to find a niche that meets his or her talents, interests, and continued stimulation. Our traditional categorical residency program provides a strong foundation for any career path, including subspecialty practice or general practice. Additionally, the program offers a variety of tracks for residents who are committed to general medicine (Generalist Track), residents who are interested in research careers (Clinical Scientist Track), and residents with a special interest in gender-based care (Women's Health Track), the care of older adults (Geriatrics Track), or the care of underserved populations in developing countries (Global Health and Underserved Populations Track). None of these tracks preclude further subspecialty training. Most important, every resident can develop an individualized training program to meet his or her interests and needs through the tremendous resources of UPMC (see our course catalog), flexibility in scheduling, and the strong guidance of a well-developed advisor program.