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Academics

 

 

Downstate Medical Center’s Department of Medicine, located at the geographic center of Brooklyn, the largest of five boroughs of America’s most vibrant city, epitomizes the excitement and promise of academic medicine. Housestaff rotations afford experience at our nation’s largest city hospital (Kings County Hospital Center), a state university hospital(University Hospital of Brooklyn) and a federal hospital (Brooklyn Veterans Hospital). Contributions originating within these institutions include: defining the origins of the first heart sound, participating in Linus Pauling’s discovery of Hemoglobin S, developing an effective pneumococcal vaccine, measurement of the rheumatoid factor and establishing the first federally funded dialysis facility.

What makes daily life within our Department exciting and fulfilling is the reality of facing the complexity of providing uncompromising excellence in medical care as our health care system evolves to cope with expanding costs and an aging and increasingly uninsured population. A unique benefit of hospital practice in New York City is that everyone in need of health care, including complex surgery and renal replacement is treated irrespective of personal wealth. By blending 24/7 tertiary care with a growing network of community clinic outreach facilities, Downstate has grown to become Brooklyn’s major health sustaining resource.

Our Department encompasses fellowship in each of the American Board of Internal Medicine approved subspecialities. An initiative in patient care that is now being assessed is the place of Hospitalists in a university service. A key department focus for the next several years is to devise interrelationships between university faculty and hospitalists that maintain investigative productivity. Toward this objective, we conduct a combined Internal Medicine/Emergency Medicine program leading to board certification in both specialities opening the door to a career as either a hospitalist or an academic position investigating health systems and/or outcomes research.

Other keenly motivating training opportunities within the Department of Medicine include the Internal Medicne/Master of Public Health program in conjunction with Downstate’s Department of Preventive Medicine which leads to board certification in internal medicine plus an MPH in public (urban) health for those destined for a career in public health.




Patient care occurs across a continuum from preventive care of healthy adults to care for the dying. Internists must be competent to deal with all types of health care for adults: outpatient, acute hospital, critical care unit, care in the home, skilled nursing facility or nursing home, hospice and end-of-life care. The core competencies of Internal Medicine are defined as follows:
  Patient Care: Residents are expected to provide patient care that is compassionate, appropriate and effective for the promotion of health, prevention of illness, treatment of disease and at the end of life.
  Medical Knowledge: Residents are expected to demonstrate knowledge of established and evolving biomedical, clinical and social sciences, and the application of their knowledge to patient care and the education of others.
  Practice-Based Learning and Improvement: Residents are expected to be able to use scientific evidence and methods to investigate, evaluate, and improve patient care practices.
  Interpersonal and Communication Skills: Residents are expected to demonstrate interpersonal and communication skills that enable them to establish and maintain professional relationships with patients, families, and other members of health care teams.
  Professionalism: Residents are expected to demonstrate behaviors that reflect a commitment to continuous professional development, ethical practice, an understanding and sensitivity to diversity and a responsible attitude toward their patients, their profession, and society.
  Systems-Based Practice: Residents are expected to demonstrate both an understanding of the contexts and systems in which health care is provided, and the ability to apply this knowledge to improve and optimize health care.
These are some of the ways in which we try to help our residents achieve these competencies:
  A structured curriculum during all ambulatory block months covering clinical epidemiology, statistics, evidence-based medicine, behavioral medicine, psychiatry, end-of-life care, and women’s health issues
  Use of web-based tutorials, interactive CD-ROM tutorials, programmed texts, required reading, and computerized patient simulation
  Regular sessions with a faculty member (a Master of the American College of Physicians and chair of the ACP’s evidence-based medicine sub-committee) whose primary responsibility in the institution is to promote the teaching of evidence-based medicine
  Regular sessions with a faculty member (a Master of the American College of Physicians and chair of the ACP’s evidence-based medicine sub-committee) whose primary responsibility in the institution is to promote the teaching of evidence-based medicine
Mandatory seminars on doctor-patient communication, empathy, and delivering bad news
  A detailed written curriculum covering all the learning objectives for a medicine residency
  A structured Board Review Course during the third year