Conferences and Rounds

Our dynamic, interactive half-hour conferences are held on Mondays for senior residents, Thursdays for PGY-1s and Fridays for all residents. Sessions are varied and include:

• General internal medicine case presentations
• Specialty case presentations
• Board review
• Journal club
• Gamification (Jeopardy, etc.)
• EKG reviews
• Imaging reviews
• Evidence-based medicine topics
• Show and tell
• Note writing, billing/coding sessions
• Clinical reasoning
• Chalk Talks

Case presentations are interactive, moderated by an attending physician and enhance knowledge in generating a differential diagnosis, clinical reasoning, evaluation and management, prevention of diagnostic error, and cost-effective decision making.

Board review and gamification sessions are team-based and assist with preparation for the ABIM examination.

Evidence-based medicine (EBM) topics are delivered by the residents rotating on EBM elective and address new society guidelines, answers to clinical questions or review of evidence pertinent to a patient care topic. Journal Club is used to enhance critical appraisal skills.

EKG reviews are moderated by cardiology faculty and fellows, imaging reviews by specialty faculty and are engaging. Show and Tell sessions are designed to review interesting and unexpected findings.

Note-writing, billing and coding sessions provide opportunities to enhance skills pertaining to the practice of medicine.

Clinical diagnostic and therapeutic reasoning are part of a longitudinal curriculum to enhance residents’ skills in clinical reasoning.

Chalk Talks are delivered as part of the residents as educators elective.

Our popular weekly Academic Half-Day (AHD) conference is one half-day/per week of protected time (patient care at the hospitals sites is covered). This core curriculum integrates case and evidence-based ABIM-directed inpatient medicine and subspecialty topic reviews focused on practical and patient centered approaches. Topic specific gamified board reviews are also included. Sessions occur every Wednesday for all PGY levels and are delivered using active learning techniques, including small-group learning, simulation and point-of-care ultrasound workshops. Sessions are delivered by our academic hospitalists, subspecialists, or both.

We have incorporated residents-as-educators, research/scientific literacy, career preparedness, wellness, health equity and quality improvement sessions. These will help residents develop practical, teaching, and investigational skills, as well as develop an understanding of health care disparities and quality improvement.

Additionally, AHD provides our residents from all levels an opportunity to collaborate weekly in this highly educational, interactive, and collegial environment rich for enhancing camaraderie, near-peer learning, wellbeing, and resiliency at work and outside the hospitals.

Independent Self Study Half Day

This innovative initiative occurs 4 times/year in lieu of the traditional AHD. The program provides residents with protected time for independent self study which can be used to study for ABIM Exam, review current guidelines, or research current literature. Residents are expected to share individual learning points with colleagues in the following scheduled morning report.

During ambulatory week, on Thursday afternoons, residents participate in a unique near-peer, interactive learning session focusing on coverage of commonly encountered outpatient medicine topics. Residents are divided into small groups with various PGY levels, and remain fixed. Components of residents as educators, board preparation and evidence-based medicine are included within. An attending physician serves as a facilitator and content expert.

Practice of medicine-based topics are also included: motivational interviewing, billing and coding, physical examination workshops, etc.

Our program is dedicated to training physicians who are culturally responsive, provide care that is equitable, and confront factors that drive racism, hate, and bias in health care. Sessions are held longitudinally throughout the year during AHD, ACES and morning report and cover a spectrum of various topics including health equity. Guest speakers and patients themselves often present.

A forum in which members of a multidisciplinary health care team engage in objective, non-judgmental review of adverse outcomes and commit to systemic process change. Each PGY-3 will be expected to present a case of their choice under the guidance of faculty members. The objectives of these conferences include the following:

• To engage internal medicine residents in patient safety case work and improve skills in identification, mitigation and resolution of patient safety events.
• To provide a venue for internal medicine residents to review resident-selected case events, whether near-miss, error, or actual harm was committed
• To provide a culture of safety where residents can engage in case discussions in an open and transparent manner.

MS 4 - PGY-1 Transition (Intern Boot Camp)

New PGY-1 residents participate in both a pre-arrival 6-week virtual longitudinal boot camp and a post-arrival interactive 8-week longitudinal boot camp.

The virtual pre-arrival boot camp is accompanied by supplementary resources and is led by the chief residents and members of recruitment committee, with PD/APD oversight. This takes place 1 hour weekly and covers topics such as:

• Moving to Buffalo: The House Hunt
• International and Canadian Incoming Residents
• Scheduling Review
• Introduction to Written Documentation
• Daily Life on the Hospital Floors
• PGY-1 Workflow
• Residency Tips: How to Thrive
• Fighting a Pandemic: Resident Wellness and Self Care

The post July 1 longitudinal boot camp occurs weekly during academic half day for the first 8 weeks of the academic year. Sessions are interactive, and led by the PD/APDs, chief residents and members of curriculum committee. Topics covered include:

• Rapid Responses, Medical Emergencies, MICU Tips and Tricks
• Sign-out and Transitions of Care
• Note-writing
• Common Complaints and Pages
• EKG and Imaging Interpretation Basics
• Intra-professional Collaboration
• Wellness, Empathy, Delivering Bad News, Goals of Care
• Residents as Educators: Feedback, Clinical Precepting
• Introduction to Point of Care Ultrasound

PGY-1 - PGY-2 Transition

In June of the PGY-1 year, residents participate in an open panel discussion with program leadership, senior residents and faculty to address concerns about their upcoming transition. This is in an open discussion format covering new responsibilities, time management, teaching on the fly, setting expectations, and identifying/assisting struggling interns, accompanied by didactic sessions.

New PGY-2 residents participate in an 8-week interactive longitudinal boot camp led by the PD/APDs, chief residents and members of recruitment committee. This series is focused on teaching the clinical and leadership skills needed to succeed during the transition from PGY-1 – PGY-2. The goal of this series is to help new PGY-2s understand the expectations associated with their new role. 

PGY-2 - PGY-3, PGY-3 – Fellowship/Attending Transitions

In June of the PGY-2 and PGY-3 year, residents participate in an open panel discussion with program leadership, chief residents, fellows, fellowship directors and faculty to address concerns about their upcoming transition. This is in an open discussion format covering new responsibilities, time management, teaching on the fly, setting expectations, what to look for when searching for a position and identifying/assisting learners with deficits. 

Residents are also provided with dedicated sessions on financial literacy, contract negotiation, career design, etc.

Residents learn and participate in Quality Improvement (QI) during the ambulatory week as part of interactive and collaborative QI workshops. These workshops provide education on QI fundamentals, tools designed specifically for our residency, and techniques necessary for health care professionals to achieve quality improvement goals. The QI workshops also allow residents to form team projects based on shared interests and provide project work-time, collaboration and coaching from department faculty and other QI experts. These workshops are supplemented with AHDs focused on high value care and resident team project feedback. Residents present projects at our Jacobs School Research Day and many go on to present projects at national conferences. Residents may also choose to participate in the residency QI subcommittee for further distinction and development in QI.

The use of point of care ultrasound (POCUS) has significantly grown in recent years. Published data supports the use of POCUS in internal medicine training and practice. Point of care ultrasound is an excellent diagnostic tool that can be used on the medical wards and in outpatient settings. Our POCUS Curriculum includes didactic sessions, to ensure residents gain adequate understanding of the basics, and in-person workshops. Our residents have the ability to use POCUS on the wards and to perform diagnostic studies on patients to help guide their management. The goal of the curriculum is to introduce our residents to the use of POCUS and to ensure all residents feel competent using the ultrasound at the time of graduation.

During AHD, residents participate in scientific literacy/research workshops. These sessions are followed by hands on application of principles, to include evidence-based medicine skills. Sessions are conducted by a mix of faculty including primary investigators, statisticians etc. Topics include:

• Introduction to Scientific Literacy and Research Curriculum
• Critical Evaluation of Scientific Literature
• Developing Research Ideas Through Reading Literature
• Research Methodology & Design
• Sources of Bias in Research
• Introduction to EndNote and PubMed
• Introduction to Biostatistics
• Meta-Analysis: Quantitative Reviews as Sources of Knowledge and Research Opportunities
• Creating an Effective Academic Research Abstract/Poster
• Turning a Presentation/Abstract into a Publishable Paper
• Introduction to Basic Research
• Communicating with Patients, Colleagues and Community

Journal Club and a portion of the ACES curriculum also focus on critical appraisal skills.

Throughout the year on AHD, residents participate in interactive workshops focusing on the development of skills as educators. Topics include:

• Approaches to Delivering Effective Feedback and Writing Meaningful Evaluation Comments
• Clinical Precepting Models
• The Clinical Learning Environment
• How to Approach Bedside Topic-based Discussions
• The Struggling Learner: Diagnosis, Learning Climate, SMART Goal Setting
• Adult Learning Theory
• Backward Design: Writing Learning Objectives, Assessment Methods, Session Planning
• Active Learning Models
• Teaching to Various Learner Levels
• Procedural Skills Teaching
• Core Concepts for the Culturally Responsive Educator

Each day, teams on inpatient floor rotations discuss the management and sign-out aspects of their inpatients, utilizing the IPASS method. Faculty on the inpatient wards supervise these meetings.

Each subspecialty unit organizes its own regular conferences. Residents taking the elective attend these conferences and may be asked to present. Other residents are welcome as well as long as their schedule permits them to attend.