Conferences and Rounds

Our dynamic, interactive half-hour conference is held Monday, Tuesday and Friday mornings. 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

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. Journal Clubs are 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.

Our popular weekly Academic Half-Day conference integrates case-based ABIM-directed inpatient medicine and subspecialty topic reviews with interactive learning activities, 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, financial literacy, wellness, diversity/inclusion and quality improvement sessions. These will help residents develop practical, teaching and investigational skills, as well as develop an understanding and appreciation for quality improvement.

Wednesday afternoons are reserved for the half-day conferences for PGY 1s, while PGY 2-4 conferences are held on Thursday afternoons. During this time, patient care on the inpatient wards is covered, allowing for true protected time.

During ambulatory week, on Thursday afternoons, residents participate in a unique near-peer, interactive learning design 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 moderator.

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

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

New PGY 1 residents participate in both a pre-arrival 6-week virtual longitudinal boot camp and a post-arrival interactive 6-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 2 hours 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^st longitudinal boot camp occurs weekly during academic half day for the first 6-8 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, Identifying the Struggling Learner

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.

New PGY 2 residents participate in a 6-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 R1-R2. The goal of this series is to help new R2's understand the expectations associated with their new role. Topics include:

• Team Leadership
• Supervising Sign-out and Transitions of Care
• Note-writing and Billing
• Rapid Responses, Medical Emergencies, MICU Tips and Tricks
• EKG and Imaging Interpretation Skills
• Intra-professional Collaboration
•  Wellness, Empathy, Delivering Bad News, Goals of Care, Leading Family Discussions
• Residents as Educators: Feedback, Clinical Precepting, Identifying the Struggling Learner

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 struggling interns.

Residents are also provided with dedicated sessions on financial literacy, contract negotiation, 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 of 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 one’s interests and provide project work-time, collaboration, and coaching from department faculty and other QI experts. These workshops are supplemented with Academic Half Days focused on High Value Care and resident team project feedback. Residents present projects at our Celebration of Scholarship Day and many go on to present projects at national conferences. Residents may also choose to participate in the Residency QI committee for further distinction and development in QI.

The use of Point-of-Care Ultrasound (POCUS) has significantly grown in recent years. The use of POCUS was initially very popular among our Emergency Medicine colleagues, but recently, has gained significant traction in the Internal Medicine community. Recently published data has supported the use of POCUS in Internal Medicine. POCUS is an excellent diagnostic tool that can be used on the medical wards and in the 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.

Once monthly, during Academic Half Day, 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 Extant Literature
• Research Methodology & Design
• Sources of Bias in Research
• Bias & Assumptions
• 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

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

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

• Approaches to Giving Effective Feedback
• Clinical Precepting Models
• How to Approach Bedside Topic-based Discussions
• The Struggling Learner: Diagnosis, Learning Climate, SMART Goal Setting
• Adult Learning Theory
• Backwards Design: Writing Learning Objectives, Assessment Methods, Session Planning
• Interactive Learning Models
• Teaching to Various Learner Levels
• Procedural Skills Teaching

Each day, teams on inpatient floor rotations discuss the management and sign-out aspects of their inpatients. Chief Medical Residents supervise these meetings.

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