MacNeal Internal Medicine Residency Overview

Overview of the Internal Medicine Residency Program

Program Mission

The MacNeal Internal Medicine Residency program at Loyola Medicine honors the esteemed legacy of Dr. Arthur W. MacNeal. As a physician, Dr. MacNeal strove to meet the needs of the community and from his home founded what became MacNeal Hospital. At Loyola MacNeal internal medicine program we seek to preserve the tradition of service and inspire within our residents a passion for patient care and a deep fund of intellectual curiosity and give back to community. This philosophy extends to our learning environment, where both faculty and residents are dedicated to creating safe, meaningful spaces that foster community and growth.

Today, the modern day MacNeal Hospital continues to remain committed through partnership with Loyola Medicine to meet the unique needs of our growing community.

We achieve these goals by immersing our residents in diverse patient populations, a variety of learning sites, and a wide range of specialties. Our robust didactics and layered mentorship provide continuous support to ensure our learners' success.

Core rotations for our residents take place at Loyola MacNeal Hospital, but we also offer our senior residents the opportunity to engage with more complex cases through 4-6 weeks of elective rotations at Loyola, broadening their clinical exposure and deepening their expertise.

Unique Offerings

Our Internal Medicine Residency program has many special features, and we hope you will visit us – either in-person or virtually – to get to know about us more. Some unique features of our residency include:

• "4+2" Scheduling System that allows expanded education in ambulatory medicine and longitudinal elective experiences
• Intern Boot Camp to help our interns start off strong
• Mock Code Training in a state-of-the-art simulation center held annually
• Point of Care ultrasound training in form of Didactics, workshop and hands on experience in ICU.
• Free board review course and MKSAP for residents
• Annual Retreats – off campus events for reflection and community building for each of our resident classes
• A commitment to Diversity and Equity
• Dedicated Curriculum in Quality Improvement and Patient Safety
• Dedicated Curriculum for Community Medicine Elective
• Dedicated Curriculum for Clinician Educator Track

Internal Medicine Residency Curriculum

Ambulatory Curriculum

Welcome to the Internal Medicine Ambulatory (+2) Week! An important part of our "4+2" system, our residents are offered diverse experience in both primary care and subspecialty medicine fields in a setting that allows for regular continuity while not conflicting with inpatient responsibilities. Loyola MacNeal provides diverse experiences through a range of ambulatory rotations, ensuring our residents develop into strong internists. These rotations offer comprehensive training in outpatient care, which serves as a critical foundation for well-rounded internal medicine practice. By working in various clinical settings, our residents gain the skills needed to excel in managing a broad spectrum of patient conditions. 

• Addiction Medicine
• Cardiology
• Community Medicine
• ENT
• General Medicine
• Geriatrics
• Geriatrics for Spanish Speakers
• Hematology and Oncology
• Medical Spanish
• Metabolic and Obesity Medicine
• Musculoskeletal Medicine
• Nephrology
• Otolaryngology
• Palliative Medicine & Hospice Care
• Physical Medicine and Rehabilitation/Orthopedic Surgery
• Pulmonology
• Practice Management
• Primary Care for Spanish Speakers
• Research
• Sports Medicine
• Women's Health 

Ambulatory Week Sample Schedule – MSK 

Metabolic and Obesity Medicine 

The resident will be immersed in the holistic approach to caring for patients with obesity. Throughout the rotation residents will see patients and focus on the needs of patients with obesity and metabolic disease through various specialties.

Goals:

1. Awareness of weight bias
2. Common contributors to obesity
3. Complications and comorbidities of obesity
4. Basic nutrition education/ strategies for treatment of obesity
5. Physical activity guidelines
6. Behavioral management interventions for obesity
7. Pharmacologic treatment of obesity
8. Awareness of shared-decision making and realistic expectations for gradual change 

Inpatient Service Rotations

• Core rotations for our residents are all based at Loyola MacNeal Hospital. These include:
• Emergency Medicine for interns
• Inpatient General Medicine Service for all residents
• Intensive Care Unit for all residents 

Emergency Medicine

All PGY-1 residents rotate through the emergency room. This is a two to four weeks curriculum.

This rotation provides an excellent opportunity to assess and triage patients with rapid development of differential diagnoses and patient management.

Intensive Care Unit

Residents receive invaluable training under the mentorship of our experienced pulmonary critical care physicians in the ICU, ensuring hands-on learning from the best in the field. We have no 24-hour call system.

The ICU team is composed of

• One on call senior Resident
• One Non call Senior
• One Consult Senior
• 3-4 rounding interns  

The Seniors are on call every other day from 7 a.m. to 7 p.m. we have no 24-hour call day. Sign out occurs at 5 pm on weekdays and it occurs at 3 pm on weekends, The on call senior gets help from the consult senior if the census of the team is 13 or more after 3 pm on weekends and 5 pm on weekdays.

The average number of admissions per team per 12-hour call day is 8-10.

• The day begins with a sign-out from the night team at 6:45 AM, followed by pre-rounds to prepare for the day's activities. Residents then meet with the attending physician to review cases and plan care.

General Medical Ward Service

This is a classical inpatient medical service. We have 4 ward teams, each with their own individual attending, a senior resident and 2 interns. Each team also has medical students.

The average number of admissions per team per 12-hour call day is 8-10. 5 new admissions per intern. We don't give any new patients to the post call team.

Each team is on call every fourth day from 7 a.m. to 7 p.m. We have no 24-hour call day.

Call teams manage admissions from 7:00 AM to 6:00 PM and are on call every fourth day. On weekdays, the call team receives sign-out from non-call teams at 5:00 PM and handles cross-cover duties until 7:00 PM. On weekends, the call team receives sign-out from other teams at 3:00 PM.

Night Float Experience

• PGY-1 Residents: During their ICU block months, PGY-1 residents do 4-5 night shifts. They work under the supervision of a PGY-2 or PGY-3 resident and an ICU hospitalist, gaining essential overnight experience in critical care.
• PGY-2 and PGY-3 Residents: These residents manage admissions to general medicine wards during their night float shifts, with a maximum of 8 patients per night. They handle a variety of overnight cross-coverage issues, all under the guidance of program faculty.
• Support Structure: PGY-2 residents are required to staff overnight admissions with faculty for the first 6 months of their PGY-2 year. Faculty are available throughout the night to assist with any patient care concerns, ensuring a robust support system.
• Shift Hours: Night float shifts run from 7:00 PM to 7:00 AM, providing a comprehensive overnight training experience.

Inpatient Consults

Loyola MacNeal offers robust elective experiences both at MacNeal and Loyola Medical Center. These electives provide residents the opportunity to work with specialized physicians in a community setting while also gaining exposure to advanced, tertiary care at Loyola’s main campus. This combination allows our residents to build a strong foundation in general practice while deepening their expertise in specialty care.

Inpatient Elective Rotations offered at MacNeal 

•  
  
  • Cardiology
  • Endocrinology
  • Gastroenterology
  • Infectious Disease
  • Nephrology
  • Neurology
  • Palliative Care
  • Pulmonary and Critical Care 

Inpatient elective rotations daily schedule: Your daily schedule begins between 8 – 9 AM and ends at 4 – 5 PM Monday – Friday. Residents are expected to see consults on their own to develop history and physical exam skills, clinical reasoning skills and differential diagnoses. Residents have the opportunity to attend noon conferences for didactics while on these rotations. 

Inpatient Elective Rotations at Loyola Medical Center

We are proud to be a community-based program separate from Loyola’s main campus, but our residents benefit from the unique opportunity to rotate through electives at the main campus. This allows them to gain additional experience in specialized patient care and exposure to complex pathophysiology.

For example, our residents can engage in Cardiology rotations, where they encounter advanced cardiovascular cases and work alongside experts in the field, enhancing their understanding of both routine and complex cardiac conditions. This blend of community-based training with tertiary care exposure equips our residents with a well-rounded clinical skill set. 

• Cardiology
• Nephrology
• Hematology-Oncology
• Gastroenterology
• Endocrinology
• Infectious disease
• Hepatology
• Rheumatology
• Palliative Care at VA Hines

Internal Medicine Conferences

The educational experiences of MacNeal Internal Medicine residents are enriched by a robust didactic series and interactive conferences. Below is a template for weekly conferences:

*For Ambulatory Rotations

Med Talks (8 AM – 12 PM)

• During the ambulatory 2-week blocks, residents benefit from a dedicated half-day of learning with a comprehensive mix of educational sessions designed to enhance their practice in evidence-based medicine and individualized patient care. The key components of this learning experience include: 
• Ambulatory Lecture Series called Bite Size Teaching: A resident-led series focusing on the diagnosis and management of medical problems relevant to primary care, aimed at deepening understanding and practical application.
• Code Blue and Rapid Response Team Review: Simulation cases that provide hands-on practice in managing acutely ill patients, preparing residents for code blue and rapid response scenarios in the hospital.
• Evidence-Based Medicine Sessions: Training on using medical literature and biostatistical measures to address specific clinical questions and enhance patient care.
• High Value Care: An interactive lecture and small group series that emphasizes cost-conscious medicine. Residents collaborate with various hospital staff, including nurses, pharmacists, and finance professionals.
• Journal Club: Facilitated by a senior resident and a core faculty member, this session involves group discussions and critical appraisal of selected articles to enhance analytical skills.
• Procedure Workshops: Hands-on learning sessions for performing bedside procedures, including arterial blood draw, arterial line placement, lumbar puncture, paracentesis, peripheral blood draw, pelvic exam, thoracentesis, ultrasound-guided central venous line placement, and ultrasound-guided peripheral IV line placement.
• Quality Improvement and Patient Safety: A lecture series on quality improvement principles, designed to inspire residents to initiate their own quality improvement projects and focus on patient safety.
• Clinical Reasoning Cases: Interactive sessions where residents engage in detailed case discussions to enhance their diagnostic and analytical skills, focusing on applying clinical reasoning principles to complex patient scenarios.
• Simulation: Root Cause Analysis and Filing Voice Reports: Interactive simulations focused on performing root cause analyses to identify underlying issues in patient care and provide instruction on accurately filing voice reports to document clinical findings and improve communication.
• Health Disparity Case: An in-depth case study focused on understanding and addressing health disparities, where residents examine how social determinants of health impact patient outcomes and explore strategies to provide equitable care.
• Mandatory ACGME-Required Wellness Topics: Essential sessions covering fatigue mitigation, sleep deprivation and strategies for physical and emotional well-being, designed to support residents' overall health and resilience in their demanding roles.

Noon Conferences (12 – 1 PM)

• Clinical Pathology Conference: Led by a senior resident, this conference provides an in-depth exploration of a patient case, including its pathophysiology, diagnosis, and management. Specialists attend to offer their unique perspectives and insights.
• Morbidity and Mortality Conference: This confidential and supportive space allows a senior resident and core faculty member to present cases for discussion, focusing on opportunities for patient care improvement while emphasizing confidentiality and patient safety.
• Biweekly Board Review Conference: Regular sessions dedicated to reviewing and reinforcing key board examination topics, helping residents prepare for board exams and solidify their knowledge.
• Intern-Specific Report: Led by chief residents, this afternoon session focuses on topics and issues pertinent to interns, providing tailored guidance and support.
• Grand Rounds: Offered at both MacNeal and Loyola’s main campus, these rounds provide residents with exposure to a broad range of cases and expert insights.
• Weekly Core Lecture and Small Group Series: These sessions, held early in the academic year, focus on mastering the management of common inpatient conditions through a mix of lectures and small group discussions.

Together, these diverse educational activities ensure that residents receive a well-rounded training experience, covering a broad spectrum of clinical scenarios and educational needs.

Internal Medicine Residency Scholarly Activity

At MacNeal, our internal medicine program is dedicated to fostering residents' interest in scholarly activity. We actively encourage residents to attend and present their work at both national and regional conferences.

In recent years, our residents have showcased their research through abstracts and posters at prestigious conferences including Regional and National ACP, SGIM, ICAHO, CHEST, ATS, and LUMC Research Day. To support their participation, residents may utilize educational funds to help cover conference attendance costs.

Resident Research Day 2023

Our residents have the opportunity to showcase their scholarly activities, including quality improvement projects, clinical vignettes, and traditional research, at our annual MacNeal Scholarly Activity Day.  Modeled after a traditional conference, this event features judges and awards, offering residents a platform to present their work and gain recognition for their contributions.

Quality Improvement

Quality improvement is strongly emphasized at MacNeal. Our Scholarly Activity Curriculum is based on ACP module and IHI modules.

Every resident is given the opportunity annually to participate in a quality improvement project. Each quality improvement project is overseen by a dedicated faculty mentor. Additionally, there are dedicated brainstorming sessions throughout the year called “Quality Improvement Think Tanks.”

Recent Quality Improvement Projects Include:

• Improving Communication in Continuity Clinic: Focusing on Health Literacy
• Improving Patient Continuity in Resident Clinic
• Educating Residents about Anemia in CKD Patients
• Educating Residents about Non Alcoholic Fatty Liver Disease
• Implementing IPASS Handoff curriculum in Internal Medicine Residency
• Implementing Improved Osteoporosis screening in Residency Continuity Clinic

Publications and Presentations from Recent Year 2023 – 2024

• Nishant Tiwari, Jaykumar Oza, Mounika L Allam, David Zamora, Riya Gupta, Andrea Parades, Zubin Mahajan, Zohaib Haque – When fatigue and myalgias are more than just fatigue and myalgias: A case of statin induced autoimmune myopathy. Oral Vignette presented at MacNeal Scholarly Activity Day May 2024
• Angelina Molkina, Jaykumar Oza, Karan Kumar, Priyanka Sultania Dudani – Syncope? Don't forget to check skin: A case report of Lyme carditis. Oral Vignette presented at MacNeal Scholarly Activity Day May 2024
• Santosh Adhikari and Luis Sanchez-Ato, Aditi Puri – Navigating Uncharted Territory : Incidental Discovery of IUD Migration. Oral Vignette presented at MacNeal Scholarly Activity Day May 2024
• Jemina Navarez, Shweta Mahesh, Sowmya Bhashini, Madelina Ionescu – Myxedema Heart Unveiled. Oral Vignette presented at MacNeal Scholarly Activity May 2024
• Aesha Patel, Jaykumar Oza, Mounika L Allam, Zubin A Mahajan, Nishant R Tiwari, Priyanka Dudani – Known unknowns: An unidentified etiology for recurrent strokes in a young female. Oral Vignette presented at MacNeal Scholarly Activity Day May 2024
• Coralia Castillo, Nehemias Guevara, Luis Sanzhez-Ato, Jemina Navarez, Jason L Peng, Ashok Sapkota, Michael Markos, Jessica Johnson – Invasive Mucinous Adenocarcinoma (IMA): Presenting as Cavitary Lung Disease: A Case Report. Oral Vignette presented at MacNeal Scholarly Activity Day May 2024
• Carla Valencia, Maria Fernanda Ayau, Xochitl Moreno, Alejandro Villafranca, Andrew Kowalski – From dry mouth to muscle wasting: An unexpected cascade of events in case of psychogenic polydipsia. Oral Vignette presented at MacNeal Scholarly Activity Day 2024.
• Francisco lorzano Arvizu, Carla Valencia, Maria Ayau, Aditi Puri – Acute Intermittent Porphyria Complicated by Syndrome of Inappropriate Antidiuretic Hormone Secretion. Oral Vignette at MacNeal Scholarly Activity Day 2024
• Jessey Matthew, Shefaly Jacob, Priyanka Dudani - A QI initiative for bridging the health literacy gap by Educating the Internal Medicine Residents on the four pillars of Health Literacy at a community Hospital. Quality Improvement Project presented MacNeal Scholarly Activity May 2024
• Sarah Lahud, Ashok Sapkota, Ashok Sapkota, Shefaly Jacob, Sowmya Popuri. Jennifer Sardonne – Elevating the Cancer Screening Rate at MCIM. Quality Improvement Project Oral Presentation MacNeal Scholarly Activity May 2024.
• Asad Rehman, Riya Gupta, Coralia G. Castillo, Vaishnavi Modi, Priyanka Dudani – Improving Interdisciplinary Communication through Implementing an Interdepartmental Reporting System: A Quality Improvement Project. Quality Improvement Project Oral Presentation MacNeal Scholarly Activity May 2024.
• Vaishnavi Modi, Hazel Khosa, Molly Leavitt - Optimizing Patient Resident Continuity At MCIM Clinic. Quality Improvement Project Oral Presentation MacNeal Scholarly Activity May 2024.
• Francisco Lozano, Jose Prieto, Carla Valencia, Jemina Narvaez, Maria Ayau, Angela Alcarraz, Aditi Puri - Outpatient evaluation and management of anemia in patients with chronic kidney disease by residents of a community internal medicine residency: a Medical Education Quality Improvement Initiative. Quality Improvement Project Oral Presentation MacNeal Scholarly Activity May 2024.
• Alejandro Rana Custodio and Goodarz Danaei – Quantifying Uncertainty in the Prediction of Cardiovascular Disease Risk in National Populations. Research Project Oral Presentation MacNeal Scholarly Activity May 2024.
• Boppana, S.H., Ravula, N.R., Kutikuppala, L.V.S., Sivaraj, N., Hamsa, C.H.R., Mahajan, S., & Chaitanya, P.S.. (2023, Mar). - Prevalence of resistant hypertension and its relation with plasma lipoprotein-associated phospholipase A2.: International Journal of Noncommunicable Diseases., 8(1), 46-50.
• Singh, J., Kaur, N., Sodhi, M., Singh, V., Singh, J., & Mahajan, S.. (2023, Apr). - Adherence to the iron chelation therapy among transfusion-dependent beta thalassemic pediatric patients - A cross-sectional study at a tertiary care hospital in North India.: International Journal of Life-Sciences Scientific Research, 12(2), 2302-2307.
• Kimmick, G., Mahajan, S., & Moore, H.. (2023, Jun). Squamous cell cancer after capecitabine use in metastatic breast cancer - Accepted for publication: Journal of Cancer Research and Practice
• Sharma, V., Bagrodia, V., & Mahajan, S. (2023, June 02). - Transfusion-dependent anemia in a patient of Sheehan Syndrome with complete recovery after hormone replacement therapy:  Indian Journal of Research.
• Sharma, V., Mahajan, S., & Bagrodia, V. (2024, Feb.) - Isolated Knuckle Hyperpigmentation Associated with Bosutinib: BMJ case reports.
• A. Harisingani*, M. Allam , N. Tiwari, P. Dudani Mantle Cell Lymphoma Presenting as Bullous Pemphigoid: A Rare Paraneoplastic Syndrome; Poster presentation at Society of Hematologic Oncology 2024
• N. Batra*, R. Mishra, M. Srinivasan, A. Harisingani, M. Sukaina, T. Garg, S.P. Kaur, S. Ansar, S. Deshmukh, A.A. Khosla, M.S. Faisal, K. Jatwani – PROMising Developments: Trends of Patient-Reported Outcomes in Waldenstrôm Macroglobulinemia Clinical Trials: Poster presentation at Society of Hematologic Oncology 2024
• A. Vyas*, A. Khosla, A. Thomas, A. Desai,  C. Fadul, A. Harisingani, R. Singh – Assessing the Utilization of Palliative Care in Advanced NSCLC Patients with Brain Metastases: Poster presentation at World Congress on Lung Cancer 2024
• Guillen CE, Allam M, Mahesh S, Ionescu M. American Association of Clinical Endocrinology. Poster presented: GD hyperthyroidism management in a patient with chronic idiopathic neutropenia: a therapeutic challenge. New Orleans, LA, United States of America; 05/09/2024.
• Guillen CE, Lahud S, Allam ML, Arima C, Mahesh S, Buenaventura-Collazos DC. American Thyroid Association. Poster presented: Si lent Storm - Apathetic hyperthyroidism: a case report. Chicago, IL, United States of America; 10/30/2024
• Guillen CE, Lozano F, Rocha A, Ionescu M. American Association of Clinical Endocrinology. Poster presented: Pleural Effusion as an Atypical Presentation of Panhypopituitarism. New Orleans, LA, United States of America; 05/11/2024
• Guillen CE, Mahesh S, Sanchez L, Allam M, Arima C, Ayub T, Arce A. Endo Society. Poster presented: Silent Danger: Euglycemic Diabetic Ketoacidosis in the shadow of SGLT2 inhibitors. Boston, MA, United States of America; 06/01/2024
• Guillen CE, Patel A, Rocha A, Arima C, Molkina A, Robles L, Arce Gastelum A. Endo Society. Poster presented: Presence of Hispanic/Latino physicians in academic research. Are we there yet?. Boston, MA, United States of America; 06/02/2024.
• Guillen CE, Sanchez L, Ionescu M. American Association of Clinical Endocrinology. Poster presented: Hepatic glycogenosis, vicissitude in the diagnosis. New Orleans, LA, United States of America; 05/10/2024.
• Guillen CE, Sanchez L, Llanes S, Arima C, Duvvada S, Ionescu M. American Association of Clinical Endocrinology. Poster presented: Persistent lactic acidosis following a DKA resolution in a young individual with uncontrolled T1DM. New Orleans, LA, United States of America; 05/10/2024.
• Guillen CE, Sanchez LA, Patel A, Molkina A, Ayub T, Arce A. Endo Society. Poster presented: Osteoporosis Associated with Antiretroviral Therapy - Case report. . Boston, MA, United States of America; 06/03/2024.
• Allam ML, Duvvada S, Guillen CE, Arima C, Mahesh S. American Thyroid Association Conference . Poster presented: A rare presentation of complete molar pregnancy complicated by concurring severe hyperthyroidism and preeclampsia in a perimenopausal woman. Chicago, IL, United States of America; 10/30/2024
• Arima C, Mahesh S, Guillen CE, Allam M, Fatima S. American Association of Clinical Endocrinology. Poster presented: A rare case of decompensated liver cirrhosis-induced hypercalcemia. New Orleans, LA, United States of America; 05/10/2024.
• Ahire,P.,Iyer,N., & Gada,P.B. (2023, Feb) - Complication of Hepatic Hydatid Cyst Surgery Presenting as Obstructive Jaundice. Cureus: Journal of Medical Science, 15(2), e35410
• Iyer, N., Hussein, S., Singareddy, S., SN, V.P., Jaramillo, A.P., Yasir, M., & Nath, T.S. (2023, Sep). Sotagliflozin vs Dapagliflozin – A Systematic Review Comparing Cardiovascular Mortality. Cureus: Journal of Medical Science, 15(9), e45525.
• Jaramillo, A.P., Yasir, M., Iyer, N., Hussein, S., & SN, V.P. (2023, Aug) - Sudden Cardiac Death: A Systematic Review. Cureus: Journal of Medical Science, 15(8), e42859.
• SN, V.P., Jaramilo, A.P., Yasir, M., Hussein, S., Singareddy, S., Iyer, N., & Nath, T.S. (2023, Sep). Hyperuricemia and its Association – With the Severity and Complications of Congestive Heart Failure: A Systematic Review. Cureus: Journal of Medical Science, 15(9), e45246.
• Singareddy, S., SN, V.P., Jaramillo, A.P., Yasir, M., Iyer, N., Hussein, S., & Nath, T.S. (2023, Aug) - Artificial Intelligence and its Role in the Management of Chronic Medical Conditions : A Systematic Review . Cureus: Journal of Medical Science.
• Alexa Allen, Luis Sanchez, Safeer Shah, James Gagermeier, Unveiling the Rare Complication: Chylothorax Following Radical Nephrectomy: A Case Report. ACP Southern California Annual Meeting, CA. Poster finalist, October 5, Orange, 2024.
• Luis Sanchez, David Berrios Irizarry, Hazel Khosa, Coralia Castillo, Sergio Antonio Llanes Somellera, Christopher D. Ochoa. Cryptococcal pleural effusion in a cirrhotic patient: challenges in diagnosis and medical management. Loyola Medicine, MacNeal Hospital, IL. Poster, Chest, October 6-9, Boston, 2024.  
• Luis Sanchez, Trevor Thompson, Hazel Khosa, Akhya Sharma, Kevin P. Simpson. Unveiling primary cavitary sarcoidosis: A diagnostic conundrum requiring comprehensive management. Loyola Medicine, MacNeal Hospital, IL. Poster, Chest, October 6-9, Boston, 2024. 
• Coralia Castillo, Nehemias Guevara, Luis A. Sánchez-Ato, Jemina Narvaez, Jason L. Peng, Ashok Sapkota, Michael Markos, Jessica Johnson. Invasive Mucinous Adenocarcinoma (IMA) Presenting as Cavitary Lung Disease: A Case Report. Loyola Medicine, MacNeal Hospital, IL. Poster, Chest, Hawaii 2023
• Sánchez-Ato L, Ce. Guillen et al. I Can’t Feel My Legs: 2 Case Reports of Vaccine Associated Transverse Myelitis (VATM). Loyola Medicine, MacNeal Hospital, IL. 2023. Poster Finalist ACP San Francisco 2023
• Additional 20 poster clinical vignette presented at MacNeal Scholarly Activity Day Mya 2024 

 2022-2023

• Maldonado G, Chacko A, Lichtenberg R, Ionescu M, Rios C. Nailfold capillaroscopy in diabetes mellitus: a case of neo-angiogenesis after achieving normoglycemia. Oxf Med Case Reports. 2022 Sep 26;. PMID: 36176947; PMCID: PMC9514106.
• Farooq U, Franco D. The Sound of My Voice. Acad Med. 2023 Jan 1;98(1):16. . Epub 2022 Oct 11. PMID: 36222527.
• Tai W, Wahab A, Franco D, Shah Z, Ashraf A, Abid QU, Mohammed YN, Lal D, Anwer F. Emerging Role of Antibody-Drug Conjugates and Bispecific Antibodies for the Treatment of Multiple Myeloma. Antibodies (Basel). 2022 Mar 24;11(2):22. PMID: 35466275; PMCID: PMC9036234.
• Goyes D, Trivedi HD, Curry MP. Prognostic Models in Acute-on-Chronic Liver Failure. Clin Liver Dis. 2023 Aug;27(3):681-690. Epub 2023 Apr 23. PMID: 37380291.
• Goyes D, Barba R, Medina-Morales E, Saberi B, Patwardhan V, Bonder A. Waitlist mortality in patients with autoimmune liver diseases. Ann Hepatol. 2022 Nov-Dec;27(6):100742. Epub 2022 Jul 11. PMID: 35835366.
• Sierra L, Barba R, Ferrigno B, Goyes D, Diaz W, Patwardhan VR, Saberi B, Bonder A. Living-Donor Liver Transplant and Improved Post-Transplant Survival in Patients with Primary Sclerosing Cholangitis. J Clin Med. 2023 Apr 11;12(8):2807. PMID: 37109144; PMCID: PMC10145248.
• Arshad MA, Reier LS, Fowler JB, Hadi H, Khan H, Beg U, Fiani B. Report of cerebral vasospasm as a complication of intracranial subarachnoid hemorrhage following traumatic lumbar puncture. Surg Neurol Int. 2022 Apr 8;13:128. PMID: 35509586; PMCID: PMC9062947.
• Espinoza G, Maldonado G, Narvaez J, Guerrero R, Citera G, Rios C. Beyond Rheumatoid Arthritis Evaluation: What are We Missing? Open Access Rheumatol. 2021 Mar 25;13:45-55. PMID: 33790666; PMCID: PMC8007602.
• Intriago M, Maldonado G, Soriano E, Toro C, Moreno L, Ríos C. Burnout in Rheumatologists in Latin America. J Clin Rheumatol. 2022 Jan 1;28(1):1-6. PMID: 34670993.
• Intriago M, Maldonado G, Guerrero R, Soriano E, Moreno L, Rios C. LARS study: Latin American rheumatologist survey. Clin Rheumatol. 2021 Jan;40(1):377-387. Epub 2020 Jun 22. PMID: 32572803.
• Jaiswal V, Mukherjee D, Batra N, Ruchika F, Susheela AT, Chia JE, Mukherjee D, Naz S, Victor AA, Pokhrel NB, Song D, Seen T, Almas T, Saleh MA, Bansrao AS, Mansoor E. Acute pancreatitis as a rare adverse event among cannabis users: A systematic review. Medicine (Baltimore). 2022 Jul 1;101(26):e29822. PMID: 35777067; PMCID: PMC9239618.
• Susheela AT, Vadakapet P, Pillai L, Thampi S. Familial chylomicronemia syndrome: a case report. J Med Case Rep. 2021 Jan 8;15(1):5. PMID: 33419463; PMCID: PMC7791813.
• Naz S, Susheela AT, Jaiswal V, Quinonez J, Patel S, Shrestha AB. Klippel Feil Syndrome presenting with tricuspid regurgitation and cardiopulmonary distress secondary to dysplastic thoracic cage and spine: A case report. Ann Med Surg (Lond). 2022 Sep 8;82:104546.PMID: 36268408; PMCID: PMC9577450.
• Rios C, Maldonado G, Vargas S, González J, Vera C, Zuñiga A, Martínez J, Castillo M, Jervis R, Ventura R, Guevara S, Torres G, Uguña F, Messina OD, Neyro JL, Fernándz D, Guerrero R, Moreno M. First Ecuadorian statement consensus for the evaluation and treatment of osteoporosis. Arch Osteoporosis. 2023 Jun 15;18(1):81. PMID: 37316765.
• Maldonado G, Guerrero R, Intriago M, Rios C. Autoinflammatory/Autoimmunity Syndrome Induced By Adjuvants (ASIA) Due to Silicone Incompatibility Syndrome. Case Rep Rheumatol. 2021 Aug 16;2021:5595739. PMID: 34434590; PMCID: PMC8382526.
• Sharma A, Mahajan Z, Madhyastha SP, Mehta V. Critical approach to atypical spectrum of melioidosis: a case-series based literature review. BMJ Case Rep. 2022 Jun 6;15(6):e249417. PMID: 35667698; PMCID: PMC9171171.
• Valencia C, Prieto J, Jara J, Pesantez P. Esophagogastric Complications After Caustic Ingestion: A Case Report. Cureus. 2022 Jul 11;14(7):e26762 PMID: 35967175; PMCID: PMC9366041.

2021-2022

• Daniela Goyes – Higher Waitlist Mortality among Patients with Autoimmune Liver Disease under the MELD-NA Allocation System. Presented at DDW
• Genessis Maldonado - Nailfold Capillaroscopy in Diabetes Mellitus: A Case of Neoangiogenesis after Achieving Normoglycemia Microvascular Assessment of DM Patients by Nailfold Capillaroscopy. Presented at ACP and European Society of Endocrinology - ECE 2022
• Krupa Shingada - Persistent hypoxemia after shoulder arthroplasty - a diagnostic challenge. Presented at DSGIMDW
• Ammy Susheela – Diagnostic Value of POCUS in Acute Appendicitis: A Systematic Review and Meta-analysis. Presented at DDW
• Ammu Susheela and Umer Farooq – Does Health Literacy Influence the Selection of Colorectal Cancer Screening Methods? A Cross-section Study. Presented at DDW.
• Roberto Guerrero – LGI1-Antibody Limbic encephalitis presenting as recurrent generalized Tonic-Clonic Seizures. Addressing Data Gaps: A Gabapentin Withdrawal Case Report. Presemted at SGIM.
• Quraish Rababah – Does My Athelete Have Hypertension? Presented at ACP and  Mayo Clinic Annual Sports Medicine for the Clinician
• Alejandro Rana Custodio, Lisseth Beltran Torres, Coralia Castillo Moreno, Asad Ur Rehman, Michael Markos – Neurological Outcomes in Targeted Temperature Management after Adult Cardiac Arrest: Systematic Review and Meta-Analysis. Presented at CHEST.
• Diana Franco – A uncharacteristic case of severe thrombocytopenia. Presented at Mayo Clinic Annual Sports Medicine for the ClinicianThe Trending Injury: E-cigarette and Vaping Associated Lung Findings. Jasti M, Farooq U, Sanchez P, Shingada K, Junia C. Presented at SGIM 2020
• If the Test Fits: Diagnosis to Aid in the Treatment of Influenza. Raul Rodriguez M.D.; Diana Espinoza M.D.; Christine Junia M.D. Presented at ACP Northern IL Regional Conference 2019
• Mind the Gap: Inpatient Management for Elevation in the Globulin Gap. Shelden Rodrigues MD, Buddhi Hatharaliyadda MD, Christine Junia MD. Presented at ACP Northern IL Regional Conference 2019
• Outcomes of Vasoconstrictor Induced Non-occlusive Large Bowel Ischemia: A Systematic Review. Umer Farooq MD, Manasa Jasti MD, Zahoor Ahmed MBBS, Muhammad Tayyeb MBBS, Farhan Khalid
  MBBS, Natalie Tapaskar MD, Daniel C Hidalgo MD. Presented at MacNeal Resident Research Day
• Factors that may increase the odds of requiring home oxygen upon discharge in patients admitted for COPD exacerbation. Diana Espinoza, Sindhu Joseph, Manuel Manrique, Swathi Rao. Presented at CHEST 2019
• Euglycemic diabetic ketoacidosis in a newly diagnosed type 2 diabetic treated with Empagliflozin. Robert Lichtenberg, Paola Sancez, Swathi Rao MD. Presented at ACP Northern IL Regional Conference 2019
• "Just some dizziness", or is it? A case of brainstem AVM presenting as central vertigo. Fanny Giron, Farah Ciftci-Olsen, Swathi Rao. Presented at SHM 2019
• Is Colonoscopy Necessary after an Acute Diverticulitis Event, in Adults less than 50 years old?.Published in Gastroenterology, Volume 156, Issue 6, S-253. Daniel Alcantar, Richard Fernandes, Christine Junia MD. October 2019
• Ustekinumab for Concomitant Crohn's Disease and Psoriasis. Umer Farooq. Presented at ACG 2019
• The emerging role of frailty as a prognostic model in end stage liver disease: A Systematic Review. Amlish B. Gondal , Umer Farooq , Pushpa Khanal , Khush Bakhat MD. Presented at DDW 2020

Internal Medicine Residency Educational Resources

MacNeal’s Internal Medicine Residency Program is continually striving to identify unique learning opportunities to prepare our residents for the demands of clinical practice.

We recognize the impact of experiential learning and the benefits of training with the use of simulations. Our program uses SimMan® to simulate high-fidelity immersive scenarios for our residents held at Loyola Main Campus. Simulations also help us to emphasize the importance of teamwork. When learning from simulations we prioritize the importance of listening and respecting others' point of view and maintaining confidentiality to create a safe learning environment.

Other educational resources:

• Access to a comprehensive online resource of electronic textbooks and journals through the Loyola Health Sciences Library
• ACP subscription provided by the program for online CME accredited modules
• Computer and personal device access to UpToDate
• MKSAP board review
• Noon conferences that are given by subspecialists, including those from Loyola University Medical Center and other academic hospitals, are available
• Program subscription to online modules from the American Medical Association
• Program subscription to online modules from the Institute of Healthcare Improvement
• Our program subscribes to online Johns Hopkins modules, which are allocated to residents to enhance their ambulatory knowledge on general medicine topics. These resources provide residents with valuable insights and updates on a broad range of subjects, supporting their continuous learning and professional development in ambulatory care.
• We have recently acquired the highly renowned Yale Ambulatory Curriculum to provide our residents with broad, case-based lectures in ambulatory care. This resource enhances their learning experience by offering a comprehensive view of outpatient medicine.
• Additionally, we have purchased NEJM Healer to support residents in developing clinical reasoning skills and engaging in self-reflection on their assessments.
• Our curriculum also includes extensive exposure to essential topics such as medical ethics, physician communication, billing practices, Schwartz Rounds, medical disclosure, AI in Medicine, POCUS workshops and transgender care, ensuring a well-rounded education that prepares our residents for diverse and complex patient interactions.

Teaching Internal Medicine Students

"Residents as educators not only teach the next generation of healthcare professionals but also reinforce their own knowledge and skills. In this dynamic role, they become catalysts for learning, guiding their peers and students while continuously evolving as both clinicians and mentors."

At MacNeal, we emphasize the development of teaching skills from the intern year onwards, with opportunities to mentor medical students from Loyola, Midwestern University, and St. George’s University. Interns are paired with third-year medical students or physician assistant students, while senior residents are paired with sub-interns.

This pairing system allows interns to begin honing essential skills in teaching, supervision, evaluation, and feedback before assuming leadership roles as senior residents. Senior residents, in turn, gain experience in managing larger teams. To ensure a balanced learning environment, we limit the number of students assigned per resident to one.

We encourage residents to work closely with their students, reviewing patient histories, exams, and care plans together. This collaborative approach fosters valuable learning opportunities and reinforces concepts for both the student and resident. Providing and receiving feedback is also a critical component, helping students recognize their strengths and areas for improvement.

Additionally, our Boot Camp, held during the first six weeks, includes workshops focused on residency as a teaching role. These sessions cover techniques such as the One-Minute Preceptor method and effective feedback strategies.

Internal Medicine Resident Wellness

Resident well-being is a fundamental and essential part of our program. Our program recognizes the unique challenges that residents face as they work to complete training. 

We offer our residents opportunities to engage in personal development, and recognize the importance of self-awareness, self-care, and limitations. This is provided through our wellness lecture series and also through core faculty mentorship.

We also recognize that there is no singular definition of wellness and work to support many pillars of wellness. 

The following are events and offerings designed to help our residents develop and maintain wellness and resiliency during residency:

• Quarterly Schwartz Rounds (hospital-wide) – An interactive dialogue consisting of panelists from diverse disciplines speaking about topics that affect our ability as providers to provide compassionate and comprehensive care.
• Resident Wellness Committee – A resident- led committee of Internal Medicine and Transitional Year Residents who work to address issues related to wellness and assist the program with event planning.
• Access to the Employee Assistance Program, which is a professional counseling service offering free and confidential help, including free in-person consultations for both day-to-day concerns and during difficult times.
• Annual retreats are offered each year of residency – retreats feature team building exercises, a wellness session and time to relax outside of the hospital as a resident class.
• Each resident has a core faculty member designated to meet with and mentor the resident at regular intervals throughout their time at MacNeal.
• GME Wellness Week – an entire week with planned wellness events sponsored by GME 

Additional events over the past year: Welcome BBQ, pumpkin decorating, Halloween decorations and party, Friendsgiving, Holiday Parties, Bollywood dancing lesson, Easter egg decorating, Resident Art Exhibition, Pet therapy, Ice cream social, Culture celebration.

Internal Medicine Resident Salary & Benefits

Salary & Benefits 2023-2024:

• Salary
   
  • PGY-1: $66,690.00
  • PGY-2: $71,000.00
  • PGY-3: $73,224.00
• Program-Provided Benefits
   
  • CME Money for attending conferences if resident is presenting author and for USMLE Step 3 and ABIM Board exam
    • PGY-1: $500/year
    • PGY-2: $1,000/year
    • PGY-3: $1,500/year
• Paid Days Off
   
• 20 days of vacation per year (4 weeks)
• 12 sick days