Program Overview

Internal Medicine Residency Program

ChristianaCare has been a top-rated academic medical center for more than a century. Our residents and fellows experience a rigorous and rewarding combination of academic training and hands-on experience.

The Internal Medicine Residency Program attracts candidates from around the country who value our challenging university-affiliated academic curriculum within a community-based setting.

Our diverse patient mix offers residents exceptional opportunities to diagnose and treat a broad spectrum of primary-care diseases, as well as tertiary-care medical conditions not routinely encountered in smaller hospital settings.

ChristianaCare appoints 12 residents to the categorical internal medicine program each year. Additionally, ChristianaCare appoints 4 internal Medicine/Pediatrics and 3 Internal Medicine/Emergency Medicine interns each year.

Innovative training blocks

The ChristianaCare Internal Medicine Residency was the first program in the country to develop an innovative 4+2 ambulatory block schedule. Each resident’s schedule thus consists of a four-week inpatient-medicine experiences alternating with a two-week ambulatory-medicine experiences.

The inpatient-medicine experiences will consist of general inpatient medicine at Christiana Hospital and Wilmington Hospital, as well as rotations in the MICU and CICU. Additionally, the inpatient based specialty rotations will occur during the 4 week blocks of time (e.g. cardiology, pulmonary, nephrology, hematology, infectious diseases and neurology).

During each 2 week ambulatory block, residents will spend 2 full days per week in their outpatient continuity practice at Wilmington Hospital. Each resident will also have a half day per week of administrative time to work on research, performance improvement, or other patient care needs, and a half day per week of academic during our protected academic half day (see didactic curriculum). The remaining four days over the two-week block will be spent on subspecialty experiences . Time is available in the schedule that will allow residents to tailor the curriculum to their individual learning needs and career goals.

Teacher-Manager-Learner

The inpatient medicine experience has adopted a “Teacher-Manager-Learner” model.  As “Learners”, PGY-1 residents do just that- learn.  Under the supervision of a PGY-3 resident and an attending physician they broadly build their knowledge in patient care, medical knowledge, communication skills, and professionalism.  Our “Manager” teams allow PGY-2 residents to work side by side with an attending physician which provides greater autonomy.  In addition to building on the knowledge they developed as “Learners”, “Managers” develop skills and knowledge in evidence based medicine, cost effective care, transitions of care, and working in a multidisciplinary team.  Finally, we consider our PGY-3 residents “Teachers” and we provide them the autonomy to lead the team in making medical decisions. Perhaps more importantly we expect them to educate PGY-1 “Learners” (as well as 3rd and 4th year medical students), and role model the skills, knowledge, and attitudes they have developed during their first two years of residency training.  We believe this graduated learning experience builds competency and confidence in our residents to become excellent physicians.

Program highlights:

  • A challenging academic curriculum in a supportive, collegial environment
  • Inpatient rotations in a 1000+ bed Level 1 trauma center and tertiary referral center with incredible patient diversity and breadth of pathology
  • Two training facilities offering suburban and urban training experiences
  • Excellent placement for our residents in competitive fellowships and post-residency jobs
  • On-site fellowships in cardiology, interventional cardiology, advanced heart failure, hospice and palliative medicine, sports medicine, clinical informatics, and quality and safety
  • Outstanding scholarly opportunities in original research and quality improvement
  • Residencies in Categorical Internal Medicine, Combined Medicine/Pediatrics, and Combined Internal Medicine/Emergency Medicine

Other unique features

  • Largest teaching affiliate of Sydney Kimmel Medical College at Thomas Jefferson University, Philadelphia and branch campus site for the Philadelphia College of Osteopathic Medicine
  • State-of-the art 9,000 square foot simulation center
  • Optional global health track, resident research training program, “pocket MBA”, advanced quality improvement elective, and leadership training opportunities
  • A culture of wellness
  • As the largest health system in Delaware, we are in invested in the health of our state and our community

Sample PGY-1 block schedule

Sample block schedule for ChristianaCare Internal Medicine Residency Program

Sample block schedule for ChristianaCare Internal Medicine Residency Program

Sample ambulatory schedule

Monday Outpatient Continuity
Tuesday Subspecialty Outpatient
Wednesday Outpatient Continuity/Admin
Thursday Academic Half Day/Continuity
Friday Subspecialty Outpatient

Night float

We have a fully integrated night float system on every inpatient rotation. Interns do an average of four weeks of inpatient floor night float and two weeks of ICU night float during the first year. Interns on inpatient rotations share “short call” (until 7 p.m.) responsibilities and on average have one of these shifts every three to four days.

A resident’s typical day

Inpatient Floor Services
0600 – 0630 “Start time.” Obtain sign in from on-call team. Critical patients are to be seen immediately.
0700 – 0900 Interns evaluate patients and write progress notes.
0800 – 0900 Medical Morning Report. Attendance is mandatory for PGY 2 and PGY 3 floor residents (optional for interns.)
0900 – Noon Team Work Rounds
Noon – 1300 Core Lecture/Board Review
1400 – 1630 Admission, chart reviews, etc.
1700 – 1800 Sign-Out. New admissions are reviewed and potential problems are identified.
Intensive Care Units
0600 – 0630 “Start time.”  Obtain sign in from on-call team.
0730 – 0930 Work Rounds. Interns and residents evaluate patients, write notes, order tests.
0930 – 1100 Teaching Attending Rounds
Noon – 1300 Core Lecture/Board Review
1300 – 1600 Admissions, chart reviews, etc.
1600 – 1700 Sign-Out. All patients are reviewed.