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Rotations

The Internal Medicine Residency Program at Morristown Medical Center offers the following rotations:

Specialty Focus Floor Team

Our specialty focus floor teams are organized either geographically or by hospitalist team to enhance teaching, patient care and communication. Although each floor has a subspecialty focus, admissions are typically from a variety of disciplines. House staff work with a dedicated hospitalist and the necessary subspecialists to provide compassionate, evidence-based care to a diverse group of patients.

  • Atlantic Medical Group Teams
    Our Atlantic Medical Group rotations are highly-rated experiences. Two teams, consisting of one PGY-3 "junior attending" and two interns, work with academic hospitalists to admit and manage a panel of patients on a respiratory floor and a general medical service. A third, smaller team of one intern and one PGY-2 resident admits and manages a smaller number of patients at Gagnon Cardiovascular Institute. Our patient population is both insured and uninsured, and the diversity of pathology is impressive, rivaling university and inner-city programs. Teams round at the bedside with the attending daily, and residents are encouraged to develop independence in assessment and management skills. Medical students and pharmacy residents are frequently an integral part of these teams.
  • Step Down Unit Team
    The Step Down Unit is an intermediate care unit, providing a level of care between a general medical floor and an intensive care unit. Two fluid teams consisting of a PGY3, PGY2 and several interns round with an academic hospitalist and an intensivist to care for acutely ill patients. Residents become especially skilled at transitions of care during this rotation.

Night Float Team

To mimic how attending hospitalist physicians work, we have moved to a Night Medicine Team concept for night coverage. A PGY-3 Medical Resident On Call (MROC) admits patients to the Atlantic Medical Group teams and cross-covers Atlantic Medical Group inpatients. A PGY-2 Medical Admitting Resident (MAR) triages patients from the emergency department to the appropriate teaching or non-teaching team throughout the hospital. Night Float and Medical Admitting interns cross-cover Step Down Unit patients and assist the MROC with nocturnal admissions. A "nocturnist" (nocturnal hospitalist) is present for resident support and supervision.

Critical Care

In our critical care rotation, residents work 12-hour shifts in both the 10-bed medical intensive care unit (MICU) and the 10-bed cardiac care unit (CCU). Patients may overflow to our Surgical Intensive Care Unit, if needed.

The MICU offers interdisciplinary collaboration on many levels. Residents round with a full-time intensivist and work in conjunction with respiratory therapists, pharmacists, and highly-trained nurses. Patients are regularly transferred to Morristown Medical Center by helicopter for tertiary care. The CCU offers similar educational experiences in a cardiac setting, with additional rounds with cardiology fellows and a dedicated intensivist team to enhance the academic experience. Residents in both units become comfortable doing procedures, presiding at codes, and providing excellent critical care to a variety of very ill patients.

Medical Admitting Resident

Our Medical Admitting Resident (MAR) is a PGY-3 resident who works five to six days per week as a triage resident. The MAR evaluates patients in the emergency department and on the floors to assist in determining patient placement on a "teaching" or "non-teaching" service, as well as confirming or determining the appropriate level of care. This rotation can also provide an opportunity for senior residents to serve as a general medical consultant for patients on non-medical services such as surgery, gynecology and psychiatry when the consult residents are not in the hospital.

Consultation Rotations

Internal Medicine residents directly experience consultative medicine during their training. They have opportunities to round with geriatrics, palliative care, diabetes mellitus and neurology teams at various points during their 3 years. Other opportunities can be created for interested residents. 

Emergency Medicine (EM)

Senior residents have a four-week rotation in the emergency department, where they optimize the skills needed for the next step of the journey. This rotation is supervised by full-time EM attendings, and residents are exposed to patients experiencing a spectrum of problems, ranging from simple to life-threatening.

Electives

Elective rotations are available in all subspecialty areas and are selected by personal preference and learning needs. Residents may also seek "away electives" with prior approval from the program director. For example, some residents decide to participate in away electives as an "audition" for a program to which they wish to apply for fellowship, while others seek experiences not available locally (tropical medicine, for example). Categorical residents are required to take electives in nephrology and hematology and oncology at some point during their training. During electives, residents work additional half-day clinic sessions.

Y Block

Categorical residents each have 2 weeks of ambulatory medicine during their Y blocks. Our outpatient practice, Internal Medicine Faculty Associates, is less than one mile away in a private medical office building. Residents are exposed to various pathologies ranging from urgent care center-like problems to chronic disease management. A wide variety of ancillary services are available, including on-site social workers, nurses and medical assistants, and we have been awarded designations including CPC-Plus and Patient Centered Medical Home Level 3. We use the Epic electronic medical record to facilitate management of care across out- and in-patient spectra. During their Y blocks, residents have sessions dedicated to their continuity panel of patients (4 to 5 sessions per week), administrative time (for panel management), module time and other subspecialty experiences. Wednesday mornings are dedicated to the academic half-day, and all residents are given a wellness session weekly.

Medical Student Rotations

Currently enrolled students at medical schools in the United States are welcome to schedule a visiting elective. Please call our Graduate Medical Education office at 973-971-6442 for more information. Students interested in our program may choose elective in one of our subspecialties or even complete a sub-internship with us. Atlantic Health System does not permit observerships.

Observerships

As stated above, Atlantic Health System does not permit observerships. Our institutions have responsibilities for the education of students from Sidney Kimmel Medical College of Thomas Jefferson University, Rowan University School of Osteopathic Medicine and St. George’s University School of Medicine.