Lahey Hospital and Medical Center is a 335 bed tertiary care medical center located in Burlington, MA. We are a major teaching hospital of Tufts University School of Medicine and the primary referral center for Lahey Health, a system of community hospitals and physicians practicing north and west of Boston. Because of the large catchment area, our patients reflect the socioeconomic diversity of our region.
Internal medicine residency training in a tertiary care medical center with a large transfer population means a lot of interesting patients. In addition to common internal medicine diagnoses, we also care for patients with advanced liver disease (we have the busiest liver transplant center in the area), and oncology patients receiving chemotherapy, including those part of research protocols and autologous stem cell transplants. The hospital houses multiple cardiac catheterization and electrophysiology labs, which were newly renovated in 2018. Cardiac and medical ICU patients are managed with mechanical support devices (intraaortic balloon pump, Impella, tandem heart, and ECMO) if needed. Patients are also transferred to our campus with acute rheumatologic, infectious, and endocrine disorders requiring specialized inpatient or intensive care.
Our outpatient population is equally interesting. The General Internal Medicine practice has approximately 124,000 visits each year. Categorical residents rotate through our residency continuity clinic every fifth week in a “4+1” system. In August 2018, the continuity clinic relocated to a large, modern facility steps away from the main hospital, which includes a large precepting room for residents. During your time in the continuity clinic, you will learn how to manage chronic diseases (ex. hypertension, diabetes mellitus, asthma, etc.) as well as more acute conditions and pre-operative evaluations. Residents often build their own patient panel during their three years in clinic. Our continuity clinic is an opportunity to practice teamwork skills, and to thoroughly understand the many guidelines and recommendations available to help optimize health.
During the continuity clinic week, residents partake in a Quality Improvement curriculum to supplement the education already in place from the institution and the program. The content of the QI curriculum provides residents with practical tools to complete valuable QI projects during residency as a team or individuals. The QI curriculum sessions are led by one of the associate program directors.
Lahey Hospital and Medical Center prides itself on its integrated group practice model. Residents work closely with all the subspecialty physicians, and rotate through each subspecialty during their ambulatory blocks.
Lahey also values the collegiality and teamwork that is palpable throughout the institution. This means that our residents work in a place where their input, energy, and efforts are recognized and appreciated. It also means that communication with attendings and other colleagues is sincere, respectful, and productive.
Training Residents in the 21st Century
Healthcare is rapidly changing and internists care for patients in a variety of settings with a wide-range of medical conditions. Our training program’s mission is to provide our residents with the skills necessary to thrive in our changing medical environment.
Because of the acuity and breadth of patients at Lahey – from intensive care to general internal medicine – our residents care for patients across a wide spectrum of disease in an efficient system inclusive of active faculty members, supportive administration, and conscientious ancillary staff.
Our residents also have a chance to participate in other aspects of hospital and ambulatory clinic activities, including serving on committees, functioning as editors of the Mall Street Journal (Lahey’s internal medicine newsletter), and participating in quality improvement projects.
Lahey offers a variety of continuing medical education programs across New England, and welcomes resident participation and attendance.
Lahey Hospital & Medical Center Internal Medicine Residency Mission Statement and Goals
- To educate our residents in providing unsurpassed care for patients with routine as well as high-acuity, complex conditions whether as a generalist or subspecialist.
- To support the professional development, personal growth and specific goals of residents and medical students.
- To educate our residents in becoming well-rounded physicians, with strong understanding of the fundamentals of Internal Medicine, evidence based practice, physical diagnosis, and quality improvement.
- To encourage the development of leadership skills that position the residents to become agents of change in the present and future. To ensure residents are well-prepared for either general internal medicine practice or fellowships.
- Support trainees as they learn how to deliver the highest quality and safest patient care using evidence-based medicine, quality improvement, patient safety tools, and a team-work approach.
- Outline and implement specific learning objectives of an educational curriculum that ensures the broad knowledge and clinical skills required of qualified physicians to provide excellent patient care, and to advance medicine through research and education.
- Promote a culture of mutual learning, respect, and education. Acknowledge diverse views that foster healthy discussions among residents, clinicians, colleagues, patients and families.
- Utilize transparent systems for timely, meaningful and constructive resident evaluation and feedback in professionalism, patient care, medical knowledge, practice based learning, communication and systems based practice that are aligned with Lahey’s mission statement of providing superior health care to our patients. At least twice a year residents will receive feedback on their road to mastery of the AGGME Internal Milestones. This feedback is based on written evaluations, direct observation, nursing input, patient feedback, and other faculty input to our Clinical Competence Committee (CCC). Input from mulitple sources provides robust information to residents, and allows us to tailor support in particular areas if needed.
- Support, guide and educate residents to provide ethical and patient-centered care and fulfill professional obligations.
- Nurture residents to become lifelong learners.
- Recruit and retain exemplary residents, medical students, and faculty.
- Maintain a balance of education, service and research, while adhering to Lahey’s internal GME committee guidelines and maintaining ACGME accreditation.
- Promote scholarly activities and opportunities for research projects while providing mentoring and supervision by faculty.
Preliminary One-Year Program in Internal Medicine
The one-year program is designed to provide residents with a comprehensive exposure to all aspects of Internal Medicine. Required hospital rotations are the same for both the preliminary and categorical program, with the exception of the required rotation at Lemuel Shattuck. Our preliminary program offers a great deal of flexibility by allowing approximately 10-12 weeks of elective time. We feel elective time is crucial to allow the preliminary year intern to tailor this time for his or her future career, and can be used for a variety of inpatient and ambulatory opportunities. Our preliminary interns are an important part of our training program, are closely integrated with the categorical residents, and have been important contributors to the Lahey Clinic. Preliminary interns have gone on to train in diverse subspecialties and at outstanding medical institutions.