FAQs

Q:  How does the program provide appropriate balance between faculty supervision and resident autonomy?
A:  Our program follows the program's supervision policy which aligns with the ACGME Program Requirements. 

All patients on the team are assigned to an individual intern and/or senior resident who follow that patient throughout their admission. 

Direct supervision of the intern is by the senior resident assigned to that service who is immediately available. Direct supervision consists of repeating initial intake history and physical, reviewing documentation, checking orders, discussing assessment and plan, and supervising discharge plans and documentation. An attending physician is responsible for each patient's care. 

Direct supervision of the PGY1 by supervising attendings occurs through daily rounding or staffing with the team, interviewing and examining patients assigned, and discussing and approving plans for that patient. The attendings and senior residents read the documentation of the PGY1s and provide feedback. Supervising attendings are available via telephone to discuss new patients admitted after rounds and to answer questions that arise. The attending physician is available via AMS if not physically present in the hospital (i.e., in clinic), and available to return to re-evaluate patients. 

Q:  How does the program maintain quality of education curriculum and training?
A:  The Loyola Medicine MacNeal Hospital educational curriculum includes an appropriate balance between supervised patient care responsibilities, clinical teaching, and didactic educational activities. 

Each resident is part of a healthcare team that works in an inter-professional fashion to improve patient outcomes. In addition, each rotation is structured in a way that there is absolutely zero conflict between inpatient and outpatient responsibilities, thanks to our 4+2 curriculum. 

Over the 3 years of residency, each trainee will be exposed to at least 10 months of inpatient experiences (Including general medicine floors, critical care medicine); 2-4 months of inpatient electives); and 10 months of outpatient clinical experiences. Each trainee experience can be customized to include multiple elective rotations, including but not limited to:

- Addiction Medicine (Outpatient)

- Cardiology (Inpatient and Outpatient)

- Community Medicine (Outpatient)

- Diabetes & Metabolic Medicine (Outpatient)

- Endocrinology (Inpatient and Outpatient)

- Gastroenterology (Inpatient)

- Geriatric Medicine (Outpatient)

- Hematology and Oncology (Inpatient and Outpatient)

- Infectious Diseases, including HIV clinic (Inpatient and Outpatient)

- Medical Spanish or Primary Care for Spanish Speakers (Outpatient)

- Musculoskeletal (Outpatient)

- Nephrology (Inpatient and Outpatient)

- Neurology (Inpatient)

- Palliative (Inpatient)

- Practice Management (Outpatient)

- Pulmonology (Inpatient and Outpatient)

- Women's Health (Outpatient)

Each resident will have approximately 5-10 hours of protected time per week for educational conferences which cover a diverse array of topics. During outpatient rotations, you will have a half day of dedicated didactic experiences covering topics in outpatient internal medicine.

Q:  How does the program help prepare residents for fellowship training?
A:  The MacNeal Internal Medicine Residency Program offers a comprehensive foundation for future fellowship training. Residents at MacNeal benefit from a unique blend of experiences, combining inpatient elective rotations at MacNeal with the opportunity to complete electives at Loyola University Medical Center during their PGY-2 and PGY-3 years. This dual-site exposure exposes residents to diverse patient populations, a wide range of medical pathologies, and invaluable mentorship, enriching their learning journey.

Residents actively participate in crafting their annual schedules, allowing them to tailor their elective rotations over the three years to gain a well-rounded understanding of various medical sub-specialties. Beyond academic pursuits, the program also emphasizes training in quality improvement, patient safety, research, leadership skills (as cohort chief, GMEC representative, multiple committee memberships), and extracurricular activities. These experiences equip residents with multifaceted skills needed to excel in future fellowship endeavors.

Furthermore, each resident is paired with an advisor when they start the program, providing continuous guidance and support throughout their three year journey. This mentorship assists residents in shaping their future career plans and strategically planning resources for success in the world of fellowships.

The PGY2 annual retreat includes a half-day session for a CV workshop and how to request letters of recommendation. The program organizes a fellowship panel with fellowship program directors from various subspecialties to answer questions related to interview and fellowship. The program also hosts a session for residents to practice virtual interviews before their interviews. The program is flexible in organizing the jeopardy schedule during the time of fellowship interviews to support PGY3s who are applying for fellowships. Program alumni who have matched into fellowships provide mentorship to the residents.

Q:  What does the call schedule look like on various rotations?
A:

• Internal Medicine Services: Residents are on call every fourth day. Residents take up to 10 admissions from 7AM to 7PM on call days. The on-call interns take sign-out from their peers around 4:30PM. The on-call interns are responsible for cross-coverage of patients until they sign out to the night team at 7PM. The on-call team attends rapid responses/code blues from 5-7PM on these days, except for Wednesdays or Thursdays when covered by another service. 
• Intensive Care Unit: Interns are on call every 3^rd to 4^th day, and seniors will be on call every other day when on this service. The on-call residents are responsible for evaluations and admissions from 7AM-7PM. The on-call interns will take sign-out from their peers starting at 4:30PM on these days, providing cross-coverage for patients until the night team comes in at 7PM. The on-call team responds to rapid responses and code blues on the floor. 
• Night Float: All night shift rotations start at 7PM and end at 7AM. Interns will only be on night float during their ICU rotations. Senior residents are scheduled for night float ICU along with night float for the internal medicine services. When on night float for the internal medicine service, seniors are responsible for up to 8 admissions along with cross covering patients on the 4 internal medicine service teams. The seniors on night float are responsible for rapid responses and code blues that are called overnight.

Q:  What is the expected size of the patient caseload encountered during the training?
A:  Loyola Medicine MacNeal Hospital cares for patients from various demographics and socio-economic backgrounds which diversifies the residents' exposure to common and rare cases we see in our practice. Our general medical floor team consists of one senior resident (PGY-2 or 3), two first-year residents, and one to three medical students. At the moment, the general medical floor team is capped at 14 patients. We also limit the number of admissions to five per call day for every intern to maintain the quality of care for the patients and maintain the well-being of our residents. The night-float floor team consists of two senior residents and is capped at four admissions per night per resident. A hospitalist team takes overflow admissions after the on-call team is capped. This ensures that we provide an appropriate balance in learning and clinical work to the residents while preserving their exposure to a variety of clinical conditions. Owing to this, our residents are generally prepared for independent practice between the end of their second year and the middle third year of residency.  

Q:  How do programs ensure flexibility to pursue electives and interests? 
A:  MacNeal Internal Medicine Residency program hosts a diverse group of residents who are deeply passionate about their varied interests, including fellowship choice, job search, and work-life balance. The program has been very supportive to the residents' pursuit of their interests. 

Each resident is assigned a faculty mentor and senior buddy who they meet with multiple times during the year to chalk out elective preferences and interests. Faculty mentors guide and provide resources for electives and help residents schedule the same. 

Each second- and third-year resident has the opportunity to schedule away rotations at Loyola University Medical Center to gain additional experience in a university environment in any specialty of their choice. Residents requests specialty or clinic interests at the beginning of the year and the program tries to grant those in accordance with ACGME guidelines. The program is very flexible with reasonable understanding when changes to schedules are needed for personal reasons. The program holds CV building workshops, job search workshops, and fellowship interview preparation workshops for senior residents to further support them in their pursuit.   

The program's 4+2 schedule gives each resident two dedicated golden weekends after every 4 weeks of inpatient rotations. These rotations are charted out before the start of the academic year. This provides the residents time to rest, recharge and reconnect with loved ones. The program organizes multiple wellness events throughout the year which helps the residents pursue their passions outside of medicine. Some recent examples include: team soccer games, yoga together, rock climbing, craft sessions, picnics, wellness retreat, Zumba, potting and planting experiences. These initiatives from the program have given our residents a family when they are away from family.  

Q:  How does the program maintain diversity of patient problems?
A:  Our residents provide care to a diverse patient population with a wide spectrum of pathologies. Residents may spend time at MacNeal Hospital, Loyola University Medical Center, and Hines VA Medical Center, which offers experience with both foundational medical cases and unique and rare pathologies. Residents also have a unique opportunity to provide support for underserved patients. We recently added a Community Medicine elective, allowing residents to practice Street Medicine.

The most recent Community Health Needs Assessment indicated mental health, age-related illness, and diabetes as the top health needs of our community. The MacNeal Hospital service area is home to more than 800,000 community members – 52% of the population identifies as Hispanic/Latino, 27% Non-Hispanic White, 17% Black, 2% Asian, and 1.2% two or more races; with 61% between the ages of 18-64. (Community Health Needs Assessment MacNeal Hospital 2022)

Q:  What are the opportunities to support and conduct research and/or attend conferences in the program?
A:  Scholarly activity is defined broadly by ACGME including research, quality improvement, didactics and teaching.

Our residents have the opportunity to present at national regional conferences. In recent years, our residents have been successful in presenting at regional and national ACP, SGIM, CHEST, ATS and LUMC research day. The program provides support for these activities through annual CME funding provided to each resident for their use annually.

We have dedicated lectures on research topics such as writing case reports. We attempt to pair residents with mentors in their area of interest.  We recently reintroduced the research committee led by residents on mentorship of projects.

Our quality improvement curriculum has been well received and residents have dedicated time to work on projects with faculty mentors

Q:  Is there a moonlighting opportunity in the program?
A:  Yes. However, PGY1s and JI Visa holders are not permitted to moonlight.
 
Q:  How many sick days and vacation days are given?
A:  The program offers 20 days (4 weeks) of vacation and 12 days of sick leave per academic year.
 
Q:  How does program support duty coverage for residents who want to attend conferences?
A:  Day off requests will be approved if the resident is the first author and presenting at a conference. Residents arrange their own coverage if the conference occurs when they are rotating on IMS, ICU, Night Float, or Night ICU. Effective communication, planning, and delegation are keys to ensuring that absences do not adversely impact rotation requirements and duty hours.