IM Residency Program FAQ's
ABIM (‘Board’) Certifying Examination Pass Rate
Program Director - Dr. Sima Desai
Fellowships: Preparation for Fellowship Match
Patient and Program Diversity
Scholarship and Research Opportunities
The Department of Medicine is fully committed to compliance with the new ACGME duty hour standards and fully implemented changes to address them during the 2011-12 academic year.
The Department had long anticipated many of these changes and implemented call schedules and assignments that reduce the duration of shifts while optimizing and, where possible, reducing transitions in care (‘hand-offs’).
The Department created work groups that have addressed the impact of the new duty hour requirements on all acute care services. As with all changes in our program, residents have a strong voice in helping us design and implement any needed change to the call systems. We are continuing to tweak our call rotations as needed to address any duty hour issues that may arise.
Graduating residents from the Department of Medicine have been highly successful on the American Board of Internal Medicine certifying exam. Over the past decade, our 3-year rolling pass rate has been 95%. We attribute this success in large part to the quality of our residents, who are very bright and intellectually curious, but also credit their overall training experience and the associated curriculum at OHSU.
To assist our residents in assessing their medical knowledge and preparing for the ABIM exam, we annually administer the In Training Exam to all PGY-2 and PGY-3 residents. This exam was developed jointly by the American College of Physicians and the Association of Program Directors in Internal Medicine, and its results are used solely for self-assessment and formative feedback. The exam results provide highly detailed information that assists residents and their faculty advisor in focusing their ongoing reading and studies.
Sima Desai, MD, FACP has been the Internal Medicine Residency Program Director for the OHSU Department of Medicine since 2010. The previous Program Director Tom Cooney, MD, MACP stepped down after 26 years as Program Director in 2010 and continues in his role as Vice Chair for Education. Dr. Cooney continues to remain involved and highly visible with all aspects of education in the Department of Medicine.
Dr. Desai was an Associate Program Director from 2004-2010 and was a Resident and Chief Medical Resident here at OHSU. She joined the OHSU Department of Medicine faculty in 1998 as a Hospitalist Clinician Educator in the Division of Hospital Medicine. She previously was Section Chief of the University Section of the Division of Hospital Medicine from 2005-2010.
OHSU’s performance in the Fellowship Match has been excellent, with residents routinely matching in the most competitive subspecialty fellowship programs, including cardiology, gastroenterology, and hematology-oncology. While similar to other academic institutions in that many of our residents choose to remain at OHSU for their fellowship training, we strongly encourage residents to pursue specialty training at other institutions to broaden their training experience. We believe every resident desiring a competitive fellowship will be able to obtain one and achieve their long term professional goals. We have willing and capable subspecialty and generalist mentors available to assist residents navigate that path and many OHSU faculty members welcome residents who are interested in doing research during their residency.
Our program offers both formal and informal mentorship and career counseling opportunities for resident trainees. The formal mentorship structure consists of twice yearly meetings with the resident’s linked program director. At the beginning of internship each resident is linked to one of the five associate residency program directors. The Associate Program Director not only reviews the resident's rotation and self evaluations, but also offers guidance to enhance their continuing development and career planning. The Associate Program Director helps to connect residents with subspecialty research and/or career mentors who work collaboratively to create a good balance between becoming an expert clinician and leading a healthy, fulfilling life outside of residency.
With respect to informal mentorship, we have found that the faculty at OHSU to be warm and invested in our residents. They are receptive to residents who approach them seeking guidance and collaboration. Many have chosen to spend their careers here because of their deep interest in students and residents. Residents often develop professional and personal friendships with faculty members with whom they have served rotations or done research that focus on the resident's growth and happiness. Most residents have several advisors and mentors.
Diversity is a top priority at OHSU and is one of the six goals of our institution’s strategic vision, Vision 2020 . Diversity at OHSU means creating a community of inclusion. We honor, respect, embrace, and value the unique contributions of and perspectives of all employees, patients, students, volunteers and our local and global communities. The President of the University created the Diversity Advisory Council (DAC) which advises the President and Executive Leadership Team on enhancing diversity, multiculturalism, and equal opportunity for all aspects of the University's missions. This council includes among many people, a resident representative. In addition, OHSU has a Center for Diversity and Multicultural Affairs (CeDMA) that supports and works in collaboration with academic units, hospitals and other communities promoting an environment that value and nurtures an inclusive environment of diversity. CeDMA is hosting all inclusive reception events to encourage all diverse groups to come together from residents to students to faculty. OHSU also sponsors CHASM, the Coalition for Health and Affirmation of Sexual Minorities. CHASM’s goal is the full and harmonious integration of all persons in the academic, social and professional life of OHSU regardless of sexual orientation or gender identity. OHSU also collaborates with the global health community via the Global Health Center.
Our residents have many opportunities to be exposed to a diversity of patients and healthcare delivery. Because OHSU is Oregon’s only tertiary/quaternary academic medical center, we see a wide variety of both common and complex clinical scenarios. Additionally, we care for patients from many sociocultural and socioeconomic backgrounds thus facilitating our education and awareness of different cultures and health beliefs. Given the number of diverse patients, we have a comprehensive interpreter services providing language services for Bosnian/Serbo-Croatian, Chinese, Vietnamese, Russian, Spanish, and other languages including sign language. The Department of Medicine also has a number of researchers and clinicians who are interested in understanding the multiple ways that racial, ethnic and socioeconomic diversity affect health (Drs. Nicolaidis, Gregg, Englander, Saha, and Kansagara to name a few faculty).
Specific to our residency program, OHSU residents rotate through Central City Concern’s (CCC) Old Town Clinic (OTC), a non-profit agency serving individuals and families affected by homelessness, poverty and addiction. Central City Concern has received numerous awards for service to the community and patients. We have a unique collaboration with OTC where our residents gain an understanding of the effects of patients’ education levels, unemployment, poverty, housing, addiction, and lack of primary care on their health and well being by working with Internal Medicine faculty who supervise the clinic. Our residents further their understanding of healthcare issues experienced by homeless youth by participating in Outside In, a facility whose mission it is to help homeless youth and other marginalized individuals move towards improved health and self-sufficiency. Residents also have the opportunity to participate in a second clinic in multiple diverse locations including Virginia Garcia Clinic (providing healthcare in a culturally competent manner with special attention to migrant farm workers and others struggling to receive healthcare), and Portland State University Student Clinic. Finally, our residents have used their elective rotations to broaden their horizon as a physician by participating in healthcare programs in a number of countries from Ecuador to China.
It is our program’s mission to train all of our residents to be outstanding general internists, both in the inpatient and outpatient arenas. Primary care training occurs throughout the residency program, through continuity clinics, a pre-clinic conference lecture series, other didactics such as noon conference lectures and Ambulatory morning report cases, and our outpatient rotations including Ambulatory blocks (one for interns and one for upper level residents), our innovative and nationally recognized Chronic Illness Management (CIM) rotation, a new Continuity Clinic Block rotation for all of our interns, and a highly rated rotation at Kaiser Permanente. These blocks are carefully arranged to provide residents with exposure to a variety of primary care topics and venues including a unique social medicine curriculum through our affiliation with Central City Concern, training in quality improvement and population management through our CIM rotation, and clinical experiences in orthopedics, dermatology, women’s health, and health management through our Ambulatory and Kaiser rotations.
We do not offer a separate match number for our primary care program. This allows anyone who matches at OHSU who is interested in primary care to move into the Primary Care Track, which we feel is important as many residents may not have been able to commit to primary care in their fourth year of medical school. We also feel that all of our residents (categorical and primary care track) receive excellent training in outpatient general internal medicine.
Primary care track residents have a Rural Preceptorship in the second year and a two month Primary Care block rotation in the third year, with opportunities to get “selective” experiences in primary care topics of their choice (OB-Gyn, Orthopedics, Dermatology, etc). There is also primary care career mentorship and social events throughout the year to further enhance the experience.
Scholarship: What are the scholarship and research opportunities available in the OHSU Medicine Residency Program?
Defining Scholarship as the discovery, dissemination, and application of knowledge, the Department of Medicine, and Internal Medicine Residency Program have had a long standing commitment to, and productivity in scholarship. To continue to improve resources offerings and scholarly productivity, the Residency Program wants to assure all trainees have an opportunity to contribute to areas of scholarship, by formalizing access to committed mentors, writing and presentation resources, and a catalogue of current and past resident and faculty scholarship productivity. During this current academic year we are making these resources more available to our residents on an electronic platform.
OHSU has consistently been in the top 30 institutions nationwide in NIH research funding, with NIH grants currently totaling nearly $263 million, and total research funding of well over $300 million. The Department of Medicine receives the most research funding of any OHSU department, followed by Medical Informatics and Clinical Epidemiology, departments which offer natural collaboration opportunities. All subspecialty divisions in the Department of Medicine offer strong research opportunities for fellows as part of their accredited training programs. The rich and diverse research culture in these divisions, and their joint research efforts in collaboration with strong basic science departments, not only provide outstanding research experiences for fellows, but also extend to residents research and scholarly opportunities. Applicants with an interest in research opportunities may contact Dr. David Jacoby, Vice-Chair for Research, Department of Medicine.
In addition there are excellent opportunities in basic science labs, with an exceptional set of opportunities in translational and clinical research available to our housestaff. These are offered through our NIH sponsored Oregon Clinical and Translational Research Institute (OCTRI), Eric Orwoll Director, and includes both opportunities for research projects and also more formalized training through our long standing Human Investigations Program directed by Dr. Cynthia Morris. This outstanding program offers a combination of coursework, mentored projects, and academic survival skills aimed at training the next generation of clinical and translational researchers. OHSU is also particularly strong in Medical Informatics and Clinical Epidemiology, and within this Department houses the OHSU Evidence Based Practice Center under the direction of Dr. Mark Helfand. There are currently five institutional K awards at OHSU (K12) and approximately 80 individual career development awards.
Some divisions in the Department accept residents through the ABIM Research Pathway,. This is well suited to highly motivated residents with a strong commitment to a career in academic medicine and research. Please let us know if you have this interest and we can help guide you in the process.
Many programs offer a wide variety of 'Electives', but for many, these are really opportunities to 'select' sub-specialty rotations (‘Selectives’). Thus, while our program routinely offers 'Selectives' so that residents can rank their desired subspecialty experiences, we also assign an elective block to every PGY2 and PGY3 during their training (4 weeks of elective time per upper level training year). Residents may choose to fill this time with either local, national, or international clinical or research experiences.
On-campus elective opportunities range from general internal medicine and sub-specialty consult experiences to rotations in other OHSU or affiliate departments (such as radiology or orthopedics). Many residents who are pursuing sub-specialty training will decide to use their elective month to conduct research. Faculty from each Medicine sub-specialty are available for current residents to serve as research contacts. Residents have been extremely successful in their research endeavors, often presenting at national meetings and publishing their work in peer reviewed journals.
Off-campus opportunities include a wide variety of options. Some residents choose to take advantage of OHSU IM residency alumni, and travel to other states to complete clinical electives in unique health care environments such as the Indian Health Service. Additionally, many residents use elective time for international experiences, both to hone clinical skills and develop language skills (medical Spanish, for example) as well as lay groundwork for research opportunities. While advanced planning is needed, OHSU residents have completed international electives in Argentina, Cambodia, China, Costa Rica, Ecuador, Ethiopia, India, Kenya, New Zealand, Peru, Spain and Tanzania.
OHSU collaborates with the global health community via the Global Health Center . This center promotes quality and equity in healthcare worldwide. The Global Health Center partners with domestic and international communities and develops programs for students, faculty, staff and partners promoting global health awareness, research, education and advocacy.
Residents use their Elective Time during their PGY2 and PGY3 years to pursue some form of a global health experience. Some residents choose to enroll in intensive language courses in places such as Costa Rica and Peru while others have traveled to experience health care in a different setting. In the last year five residents traveled to Africa, developing a formal relationship between OHSU and the teaching hospital in Gondar, Ethiopia. Residents have also travelled to China and India to learn about medical care in those countries. The residency program is supportive of residents who wish to do research or clinical electives in other international venues.
Kaiser Permanente - is a not-for-profit HMO where residents rotate both inpatient and outpatient. For the outpatient clinics, residents see patients in both internal medicine clinics located throughout Portland as well as medicine and surgical subspecialty outpatient clinics. The hospital at Sunnyside in Southeast Portland is a 233-bed hospital where residents are on call with a hospitalist for a few selected shifts.
Old Town Clinic/Central City Concern - is a county-funded clinic that sees uninsured and Medicaid individuals, and OHSU internal medicine faculty supervise the clinic. Residents rotate through this low-income clinic in downtown Portland on NE Burnside St (‘Downtown’) during their ambulatory rotations or for a second primary care clinic. Residents also rotate at Hooper Detox Clinic in NE Portland, where they learn about inpatient detoxification.
Outside In - Is a clinic devoted to homeless or low-income teenagers and young adults in SW Portland near PSU campus. Residents will rotate here during their ambulatory rotations or for a second primary clinic. An OHSU pediatrician with a specialization in adolescent medicine supervises the clinic.