Our program is not interested in resting on its laurels. While we have a tradition of excellence, we are always looking for ways to improve. Programmatic change is steered by grass-roots resident involvement, which is supported by attentive faculty leaders and backed up by a generous department budget. Below are a few of the many innovative programs our residents participate in.
The Integrated Teaching Unit (formerly Intensive Teaching Unit) is a core general medicine rotation for all housestaff that was the result of an innovative research project in medical education. The service is uniquely designed to provide more time for teaching by creating a team structure that allows for more clinicians to care for each patient. The team is comprised of two attendings (one generalist and one specialist), two residents, four interns and two medical students; the teams have the same cap as the GMS teams, which results in fewer patients for each intern and more time to be present on rounds. The team is led by one the residents, with the other resident focusing on the more mundane tasks enabling the interns to focus more on their presentations and learning from the attendings and teaching resident.
One of the incredible strengths of the ITU is the ability to learn from multiple senior clinicians discuss patient care approaches, and teach about physical exam findings, cost-effective medicine and clinical reasoning on many patients. Additionally, having a specialist on the services allows for a unique insight into that specialty’s approach to patients and consults. Finally, the Chief Residents also rotate as attendings on this service.
As part of the ambulatory medicine curriculum, junior residents can elect to participate in a second and novel weekly clinic with a senior subspecialist. Current longitudinal clinics include, but are not limited to: cardiology, endocrinology, gastroenterology, genetics, hematology, infectious diseases and pulmonology.
Brigopedia was developed by housestaff as an interactive educational website to coordinate curriculum and content over three years of training and beyond. Some of the useful resources include:
Developed by recent graduates and actively maintained by the current housestaff, the Night Float Curriculum is an innovative approach to making night float rotations more educationally valuable. The curriculum consists of more than twenty case scenarios designed to be worked through in resident-intern pairs. Each scenario begins with a common overnight page and walks through the diagnostic and therapeutic steps to be taken and is followed by an evidence-based approach to the problem.
Multiple pathways have been developed (and will continue to emerge) as Brigham residents and faculty address new societal challenges precipitated by rapid changes in the healthcare delivery system. Examples include Medicine-Genetics, Global Health Equity, Medical Leadership and the John McArthur Program for Medicine Leadership. Each of these programs was designed by residents and attest to the proactive role trainees take in leading program innovation.
This series began in 2009 and was developed by one of our alum, Dr. Jennifer Brody. Dr. Brody has worked to create a new longitudinal curriculum in this field to help primary care residents better understand the interactions of social inequalities and health. The curriculum is taught by a wide range of clinical and research faculty, as well as community advocates and practitioners, during ambulatory rotations throughout the 3-year primary care residency, and it was recently adapted and implemented as part of the categorical ambulatory curriculum as well. The program includes lectures, workshops, clinical electives, and community site visits designed to enhance residents' capacity to care for vulnerable and underserved patients in our community.
Brigham places a strong emphasis on humanism and has a dedicated curriculum for all interns and junior residents. Interns meet once a month in small groups to go through readings, articles on burnout resiliency, and have facilitated discussions around stressors and coping strategies that housestaff face on the wards. The curriculum is extended into junior year, where the focus is on leadership and the responsibilities that come with it, particularly modeling an environment that facilitates vulnerability and authentic engagement in patient care. Additionally, all residents have free access to the Museum of Fine Arts, have facilitated teambuilding exercises at the Museum during their integrated teaching unit experiences, and have reflective explorations at the Museum with their humanistic curriculum group once during their intern year.
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