CATEGORICAL

Overview of the Internal Medicine Residency

Introduction
The University of Illinois at Chicago has a 60-year history of having an ACGME accredited residency in Internal Medicine. Our overarching goal is to prepare future physicians for a wide range of career paths, including primary care and subspecialty academic and clinical practice. We also are committed to an education packed year for our preliminary residents to assist them in having an excellent performance in their advanced programs.

Depth of Leadership and Faculty
The Department of Medicine is home to 222 faculty. All faculty are salaried by the State of Illinois to teach and provide patient care. None of them are in private practice. They do not see patients at other institutions nor are they paid directly based on the volume of patients they see. This allows them to concentrate their efforts on residency mentorship, research, and education. Also, all faculty must maintain an academic appointment at the University of Illinois College of medicine. This assures that they maintain excellence in the three prongs of academia: Patient Care, Research, and Education. Thus, all faculty are actively conducting research which facilitates trainees creating new projects or joining already existent projects. Faculty are evaluated by the housestaff on their teaching abilities on an annual basis to assure they remain excellent educators.

In addition to the Program Director, program leadership also includes five Associate Program Directors who bring with them decades of experience in mentorship as well as five Chief Residents chosen for their leadership abilities to help oversee and facilitate education.

Residency Size and Demographics
In addition to the 119 categorical and preliminary internal medicine residents, the Department of Medicine Faculty assist in the education of 16 residents in our combined internal medicine/pediatrics program, 15 residents in our combined internal medicine/emergency medicine program, and residents in our neurology residency who join us for the first year of their training. Thus the internal medicine residency at the University of Illinois at Chicago exists in a family that in total has 155 residents. This makes us one of 46 “large” programs in the country (those with more than 100 trainees). There are several advantages to large programs. There is more flexibility in obtaining rotations that you desire, in scheduling vacation during the weeks that you request, the ability to schedule a three day holiday of your choosing, and our ability to grant two wellness days off each year.

The geographic location of the medical schools from which our residents come from is broad. The majority (66%) of our trainees are from medical schools outside of the Chicago area from all over the United states, literally from Washington state to Puerto Rico. Twenty nine percent of our residents trained at the many excellent medical schools in Chicago with 12% being from the University of Illinois College of Medicine. Every year we match international graduates from excellent schools outside of the United States and currently these make up 5% of the residency.

Cultural, racial, and ethnic diversity abound across our campus. The University of Illinois College of Medicine is the most diverse medical school in the country. Our residency program meshes nicely with this commitment to diversity on campus. Currently, 24% of our residents are from underrepresented minorities. This is considerably above the national average for internal medicine residencies in the United States which is 14%.

Training Sites
There are two inpatient facilities and associated ambulatory sites on campus. One is the University of Illinois Hospital (UIH) and the other is the Jesse Brown VA (JBVA). These are three blocks away from each other and a half block away from public transportation by train. Both institutions render primary through tertiary care. The University of Illinois Hospital serves a diverse patient population. One third of our patients are African American, one third are Latinx and one third are from a wide variety of ethnic and racial groups that are representative of the Chicago population as well as the entire nation. The JBVA provides free care to our veterans that have served our country. The majority of patients there are also from underrepresented minorities.

As evidence of our commitment to serve the underserved and promote health care equity, only 25% of the patients at the University Hospital have private insurance that pays anywhere near the full cost of their care. Another 25% are on Medicare and 50% are on public aid or self-pay. In addition to opening our doors to everyone in the community regardless of ability to pay, we also have a Chicago Street Medicine program through which participating residents and medical students provide care to the undomiciled on the streets of Chicago. This program brings food, medical supplies, and medical care to the homeless of our city.

Additional Schools on Campus
The University of Illinois is one of the largest College campuses in the Midwest. It consists of several programs in addition to the School of Medicine which are the Schools of Public Health, Pharmacy, Social Work, Law, Nursing, and Applied Health Sciences. This supplies a tremendous number of resources related to patient care and research. The School of Pharmacy provides Pharm.D.’s on all inpatient services and the ambulatory settings. The School of Nursing provides Advanced Practice Nurses to many of the services and we also train students in their program. The School of Public Health offers numerous online classes that residents can take for free. This permits residents to obtain Certificate Degrees or a Master’s Degree in Public Health during their residency training.

The Program Director
The program director has over 30 years of experience as a program director and has trained over 700 residents in his career. He places an emphasis on teaching and is actively involved in patient care and daily conferences with the resident physicians. He strives to be a role model as an educator and has been honored to receive the Attending Physician of the Year award, as voted on by the medicine housestaff, 15 times and is a Golden Apple recipient, as voted on by the medical students, 13 times. He feels strongly that the best way to learn medicine is to teach it and that our best teachers are our patients. The patients are always telling us sufficient information to make diagnoses but have not read the text books. This is because they actually wrote the textbooks. Brilliant physicians before us observed various signs and symptoms of disease entities and coalesced them into publications and textbooks to train future physicians. Thus, the patients teach us everything and we thank them by giving them the best care we can. Another philosophy is that we are all colleagues and medical education should never be a hierarchical process. We learn from each other regardless of how many years of experience we have had on the wonderful journey through medical education and in the practice of medicine. Faculty emulate this on teaching rounds by allowing residents to have whatever autonomy they are comfortable with in the decision-making process with the assurance that any uncertainties will be addressed with by the faculty supplying the recommendations. Faculty take residents out for team dinners, participate actively in breakout sessions, and welcome them into their homes for family–style journal clubs.

Wellness
During the challenges of a pandemic, political clashes, and social unrest, residency wellness has been a priority for our trainees. We have a structured compliance with the ACGME work hours to assist in healthy time away from patient care. We have a holiday schedule that assures residents three consecutive days off to celebrate the holiday of their choosing. We give two additional Wellness Days that residents can take off during the year. We have a rigorous Backup Policy that delineates how coverage can immediately be obtained should a resident feel less than capable of excellent patient care due to stress or personal/family illness. We have a liberal Family and Medical Leave policy that gives abundant paid time off for trainees starting or growing a family or if there is a personal or family illness. There is also a health and fitness center on campus one block away from each inpatient facility that facilitates trainees getting in healthy exercise before, after, or during the workday. Annually, each residency class attends an offsite retreat at which wellness activities are conducted as well as feedback sessions with the program leadership. They are relieved of all patient care responsibilities during the two days to insure all can attend.

Supportive Councils, Committees, and Task Forces
To maintain the diversity and wellness of the residents there are three very active groups in which you can participate. One is the Department of Medicine Inclusion Council which has faculty and resident membership that provide oversight and recommendations to maintain our diverse residency family and provide resources toward education in health care disparities, bias awareness and reduction, and resources for activism. The Women Trainee Interest Group has an internal and external mission. The internal mission is to provide resources for the unique challenges facing women trainees and the external mission is to improve care to underserved women and provide advocacy and community outreach to facilitate this. For several years we have also had a Wellness Committee populated by faculty and residents that creates annual wellness assessments, recommends systemic changes for the benefit of trainee wellness, and provides support for social events to maintain a high morale among the residents.

Bias Reduction
We were the first internal medicine residency in the country to provide training in Bias Reduction in Internal Medicine. This consists of seminars and interactive sessions designed to help recognize our implicit biases, name them and tame them, and prevent them from becoming explicit biases. This is one of several initiatives aimed at assuring that the University of Illinois is a welcoming and inclusive workspace.

Simulation and Integrated Learning (SAIL) Center
A block away from our University Hospital, the SAIL center is a newly built $23.5 million, 28,000 ft² facility that houses simulations for ambulatory, inpatient, critical care, and operating room settings. The residents avail themselves of this state of the art facility by training in procedure simulations, rapid response team simulations, and Advanced Cardiac Life Support training.

Spanish Classes
Since approximately one-third of our patients speak Spanish, and approximately half of those speak only Spanish, we feel it important to offer medical Spanish classes to the 50% of residents who do not currently feel comfortable conversing without a translator with these individuals. These Spanish classes are conducted during the regular protected educational time in the midday and thus do not require any additional time to participate in.

Fellowship Success
Very consistently over the last 20 years approximately 70% of our graduates pursue a fellowship and the remaining 30% pursue careers in academic internal medicine. With respect to the trainees who matched in fellowships, 35% match into fellowships at the University of Illinois and the remaining 65% matching into excellent programs throughout the country. Data collected over the last 12 years reveal that residents matching into fellowships have a mean distance down their fellowship match list of 1.8 with respect to the program at which they matched. This means that the majority of residents match at the first or second program on their fellowship match list.

Chicago
We are blessed to be located in a wonderful city rich in world class museums, architecture, restaurants, and with multicultural neighborhoods and events. Most residents live within 15 minutes of campus that minimizes commute time that would interfere with their abilities to return home and enjoy the bounty that Chicago brings. To further enjoy the city, the program provides free tickets to the Chicago Bulls, the Tony award-winning victory Gardens theater, and Hubbard Street dance.

Research
The vast majority of our residents actively participate in research projects that range from creation of new scientific endeavors or joining a team already pursuing a scientific question. Research productivity is facilitated by having specific research mentors, maintaining a database of ongoing projects, and the fact that all teaching faculty are actively involved in research. Protected time on research blocks are available in both of the second and third years of training to facilitate data collection, data analysis, and poster and/or manuscript preparation..

International Rotations
The program offers opportunities for international experience especially for those trainees interested in global health. We have had residents conduct research and patient care in a variety of countries such as the Dominican Republic, India, Pakistan, Guatemala and Honduras.

Our Wishes
We hope you will choose to interview and train at the University of Illinois at Chicago to enhance your personal and academic growth during the exciting next phase of your medical education…becoming a physician in this wonderful profession.

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