Vanderbilt’s residency program features a robust series of educational conferences that are designed to solidify or expand residents' knowledge of clinical medicine; develop their analytical, critical thinking, and teaching skills; and engage their drive to pursue scientific discovery.
|8:00 AM||Grand Rounds|
|10:30 AM||Morning Report||Imaging Rounds (VA)||Morning Report||Morning Report|
|11:00 AM||Professor Rounds|
|12:00 PM||Core Lecture Series||Fox & Hedgehog||Board Review||Journal Club/Ethics/MM&I|
Inpatient Morning Report: During inpatient rotations at Vanderbilt University Medical Center and the Nashville VA Medical Center, residents attend separate inpatient morning reports three times weekly. Inpatient morning reports are led by the inpatient chief residents and are regularly attended by program leadership and core faculty, including Dr. Brown, Chair of the Department of Medicine; Dr. Christman, Chief of Medicine at the VA; and Drs. McPherson and Sergent, our current and former program directors.
We typically begin morning report with two cases recently admitted to the teaching services, presented in rapid succession. Residents work through the cases out loud and often as a group, developing differential diagnoses and practicing clinical reasoning. Team members presenting the case often benefit from hearing experts in the room chime in on the differential diagnosis. A third case is then presented by an upper-level resident, followed by a prepared 15-minute discussion on the pathophysiology and molecular and cellular mechanisms of the disease in question. On select days, autopsy conferences and case competitions replace typical case presentations. Pagers are covered by our program staff, allowing for protected learning time.
Professor Rounds: Residents on inpatient rotations at Vanderbilt University Medical Center attend Professor Rounds on Thursdays. With the assistance of the inpatient teams, Dr. Brown, our Chair of Medicine, critically thinks through a challenging case. The focus is on developing skills in clinical reasoning. Advanced questions particular to the disease being discussed are directed towards an expert faculty ringer in the audience.
X-ray Rounds: Interns on inpatient rotations at the Nashville VA Medical Center attend Imaging Rounds on Tuesdays. The Chief of Medicine at the VA, Dr. Christman, builds intern confidence in reading chest X-rays and other imaging studies.
Academic Half-Day: While on ambulatory blocks, interns and upper-level residents participate in our academic half-day that occurs on Thursday mornings. This is a three-hour interactive session that incorporates case-based learning, physical exam skills, journal club, and other didactic sessions. This is led by the ambulatory chief residents and is regularly attended by program leadership. The core curriculum includes advanced general internal medicine and medical subspecialties. This is taught by faculty from the various divisions of internal medicine, guest lecturers from other departments, and our current residents. Academic half-day focuses on a “theme” for each block, which is typically a medical subspecialty area (i.e. Rheumatology, Cardiology, Infectious Diseases, etc.). This allows our interns and residents to focus their learning within one subspecialty while actively concentrating on evidence-based approaches to outpatient medicine. Residents also have the opportunity to present patients at our ambulatory intake, which allows for resident-led case discussions focused on outpatient medicine. Academic half-day also serves as a time for discussions in ethics, resiliency, and high-value care.
Ambulatory Intern Didactics: During the first part of the year, the interns receive didactic lectures in general internal medicine which are taught by faculty from the Division of General Internal Medicine and Public Health. Following this, the interns join the residents for the core curriculum; although throughout the year, there are additional didactic sessions reserved for interns for training sessions on the management of a primary care clinic and a didactic series in geriatrics.
Quality Improvement Didactics: PGY-2 residents have time reserved during academic half day to participate in a longitudinal quality improvement curriculum. Residents receive training in the principles of quality improvement and acquire the essential tools to perform quality improvement. They then apply these tools in two ways: (1) to improve outcomes for their cohort of continuity clinic patients and (2) to solve system-level problems identified during program morbidity, mortality, and improvement (MM&I) conferences. Residents present the outcomes of these projects in a program-wide conference at the end of the academic year. Resident-generated projects can result in changes that impact the entire hospital.
Core Lecture Series: The inpatient didactics series takes place on Mondays at noon. It is a set of foundational lectures given by core faculty directed at clinical problems commonly encountered by residents on the wards. The pathophysiology of hallmark diseases is reviewed in an interactive manner, and the presenting faculty use a “chalk talk” approach – PowerPoint slides are strongly discouraged. Subsequently, the management of these diseases is reviewed according to best evidence with the added goal of familiarizing residents with the most often-cited studies in internal medicine and its specialties.
Fox & Hedgehog: Fox & Hedgehog takes place on Tuesdays at noon and is the highlight of the weekly noon conference schedule. The chief residents present some of the most compelling cases from residency and explore the scientific questions that are fundamental to the cases at hand. Expert faculty ringers are then invited to comment on the cases. Select Tuesdays are reserved for Clinicopathological Conferences (CPCs) and Departmental Morbidity, Mortality, and Improvement (MM&I) Conferences.
Board Review Series: Upper-level residents attend a Board Review Series on Wednesdays, which is division-themed so that a faculty expert from the featured division can be present to address any questions that may arise.
Intern Report: Intern Report takes place on select Fridays at noon and is dedicated time for Vanderbilt University Medical Center administrative leaders to hear intern feedback on processes relevant to day-to-day clinical operations. Many operational improvements have emerged from this conference.
Journal Club: Residents attending journal club receive robust training in clinical epidemiology and review landmark articles in internal medicine.
Ethics and Professionalism Series: The Ethics and Professionalism conference series takes place monthly on Fridays and focuses on clinical ethics, communication skills, and value-based care, among other topics.
Medicine Grand Rounds: Medicine Grand Rounds takes place on Thursday mornings. The entire department gathers to learn about the latest in disease management and patient care from top faculty at Vanderbilt and invited speakers from across the nation.
Jamison Norwood, M.D.
VA Ambulatory Chief Resident
As part of your clinical education at Vanderbilt, you will participate in a variety of conferences on your inpatient and outpatient rotations that are part of a comprehensive curriculum. While on inpatient services, you will have the opportunity to participate in our morning report, which is regularly attended by faculty, program directors and the chair of medicine. While at morning report, pagers are held to allow for dedicated learning. Our noon lecture series is attended by residents on inpatient and outpatient services and encompasses pathophysiology, resident wellness, board review, and social medicine. Vanderbilt has now moved to an academic half-day for residents on outpatient rotations, which allows for an interactive learning environment where residents can work on problem-solving, critical thinking and their own teaching skills. These conferences prepare our residents for their future roles as clinicians, teachers, researchers, and leaders.