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Program Summary

Internists of the 21st century must be equipped with a wide variety of clinical skills that will allow them to care for patients in multiple settings. Our mission for Lahey Clinic's Internal Medicine residency program is to supply our residents with those skills.

We are proud to offer the unique opportunity to train in an environment that can easily combine the challenges of medicine in a tertiary care setting with a highly developed ambulatory system and curriculum. Our trainees take part in a rich variety of clinical rotations, including hospital medicine, primary care ambulatory clinics, subspecialty ambulatory clinics, community medicine and emergency medicine.

Lahey Clinic residents are intimately involved in every aspect of the program, serving on important departmental and hospital committees. In addition, residents take part in continuing medical education programs that are given by Lahey Clinic at resorts throughout New England.

The cornerstones of our educational process are our ambulatory rotations and hospital-based months. Our residents can spend a large percentage of their training in outpatient settings, with the remainder in inpatient rotations.

Inpatient Programs

Inpatient rotations take place on ward medicine, medical intensive care unit (MICU), and coronary care unit (CCU).

The ward team consists of one R2 or R3 resident, two R1 residents, either a third or fourth or year student from Tufts University Medical School and rotating pharmacy and physician assistant students. A selected attending is assigned to each team. There are strictly adhered-to caps on daily admissions ( three new patients per intern every other day). Call is every fourth day and a night float system is in place, thereby eliminating overnight call on the wards.

Our Ward attendings are hand selected from our General Internal Medicine faculty, subspecialty departments, or from our Hospitalist service. The responsibility of these attendings is to supervise patient care with members of the team and coordinate attending rounds with interesting case presentations and discussion of the latest literature.

As an intern, our resident spends a month at the Lemuel Shattuck Hospital in Boston-the premier public health hospital in the state. This experience exposes our residents to an underserved population with a multitude of disease pathology.

The ICU team consists of two R2 or R3 residents, one R1, a pulmonary critical care fellow and a pulmonary critical care attending staff physician. This busy unit is a highlight of the inpatient experience. R1 residents perform many procedures including pulmonary artery catheters, central venous lines, arterial lines, thoracentesis and intubations.

The CCU team consists of two R2 or R3 residents, one R1 resident, a cardiology fellow and a cardiology attending staff physician. Residents are exposed to a wide spectrum of cardiovascular disease including "bread and butter" cardiology, advanced interventional procedures, electrophysiology and clinical trials. R1 residents can perform all procedures in the CCU.

There is overnight call in both the MICU and CCU. Residents have single, comfortable on call rooms with private baths. In addition, on call residents are given both dinner and breakfast meal tickets.

Outpatient Programs

Lahey residents may spend up to 50 percent of their time in outpatient settings including continuity clinics, ambulatory rotation blocks, community medicine blocks, and electives.

In continuity clinic, residents function as partners in our large General Internal Medicine practice in Burlington. They work closely with a single attending physician throughout their three years, fostering a unique mentoring relationship. Nursing and secretarial support for these residents is identical to that for the staff physician. In addition, a diverse patient population offers residents early and frequent exposure to managed care and multi-disciplinary disease management.

During ambulatory rotation blocks, residents spend four sessions per week under the preceptorship of General Internal Medicine performing a wide variety of clinical activities including consultations, urgent care, referrals and primary care. In addition, outpatient sessions are selected from a menu that includes medical subspecialties such as Dermatology, Gynecology, Pediatric and Adolescent Medicine, Neurology and Sports Medicine. At the completion of each ambulatory block, residents are required to present a clinical topic.

Residents also undertake block rotations at community practices within the Lahey network. During these rotations, trainees work closely both with primary care physicians who practice in suburban centers and with physicians at our Lahey Clinic Medical Center, North Shore, facility. There, residents work in such varied settings as our Women's Health Center, Breast Cancer Clinic, Ophthalmology and Otolaryngology.

Unique opportunities available to residents are travel abroad as part of the Global Outreach Program, a broad spectrum of elective opportunities, and participation in the resident run Free Care Clinic for the town of Burlington.