As an internal medicine resident, you will obtain both the inpatient and outpatient experience needed to smoothly transition to independent internal medicine or hospitalist practice as a competent physician upon graduation. This program also emphasizes diversity of training. Each year, a number of our residents successfully obtain competitive fellowships. Over the past five years, graduates have obtained fellowship positions in:
We are the designated western campus of the University of Wisconsin School of Medicine and Public Health. We have University of Wisconsin medical students continuously rotating throughout our medical center. We also host many fourth year students from around the United States who come here for clerkships.
General medicine, cardiology and ICU teams consist of an attending, senior resident, two interns and one to two medical students, creating a familiar academic environment you have become accustomed to throughout your medical training.
Since 1970, Gundersen Medical Foundation has prided itself in providing the very best internal medicine education and training. We offer a personalized curriculum to meet your educational goals. Our personable and dedicated staff physicians make your learning a priority, offering the perfect blend of autonomy and supervision to enhance your education. Gundersen stresses a culture of mutual respect both when providing patient care and when educating residents and students.
Gundersen has a long tradition of providing the highest quality graduate-level medical education. Your success as a physician is our goal as a program, and we work tirelessly to ensure excellence within our internal medicine program. We would love to hear any questions you have and would welcome you to visit our institution.
Why do some people feel that University-based programs are the best places to do residency? Will I be able to get a fellowship and do research?
The most frequently cited reasons for choosing a University-based program are the ability to secure a fellowship, and the opportunity to do valid research projects. While we can't speak for every community-based Internal Medicine program in the nation, this is definitely not the case at Gundersen Health System.
Our program is very strong in general internal medicine, traditionally between 30-40% of our graduates go on to fellowship. Most get their top fellowship choice. For example, some of our residents have gone on to fellowships at the Sloan Kettering Cancer Center, Dartmouth Medical School, the National Institutes of Health, Mayo Clinic, Massachusetts General Hospital, the University of Wisconsin, the University of Iowa, the Medical College of Wisconsin, Indiana University, the University of Minnesota, University of Nebraska and other fine medical centers.
Opportunities for clinical research abound at Gundersen! Our residents have published research in several medical journals. Many residents have presented at state and national meetings, and in the last few years, several have won the American College of Physicians (ACP) Wisconsin Chapter resident competition. We have a full research and presentation support staff, including biostatisticians and media specialists, who are ready and willing to help you with your research project(s) as well.
Our 2011, 2012, 2013 and 2014 graduates entered fellowships in cardiology, endocrinology, gastroenterology, hematology/oncology, infectious disease, pulmonary/critical care and rheumatology. Fellowship institutions included: Mayo Health Systems (Rochester, Minn.), University of Utah, University of Wisconsin (Madison, Wis.), Medical College of Wisconsin and Aurora Sinai Medical Center (Milwaukee, Wis.), University of Minnesota (Minneapolis, Minn.), University of Nebraska (Omaha, Neb.), University of Texas-Galveston (Galveston, Texas), Case Western (Cleveland, Ohio) and Lehigh Valley Health (Allentown, Pa.).
Is your program academic enough?
Actually, this was one of the very things that attracted several of our current residents to our program. We strongly emphasize evidence-based and cost-effective medicine, basing our patient care decisions on a critical review of the literature. "Because we've always done it that way," is an unacceptable answer when asked for the proof behind a clinical decision. All of our conferences, staff teaching sessions, "curbside consults", and bedside teaching are done in this manner.
During the first year Research/Quality Improvement Rotation there is an "Evidence-Based Medicine" section to teach basic concepts as they relate to research and patient care. These principles quickly become incorporated into your medical decision-making process. We have 2-3 formal teaching conferences each day and every staff member in the hospital is involved in medical education at some level. Also, there are numerous opportunities for residents to participate in clinical research. We have a full array of research support staff available for statistics, and medical media specialists do a fantastic job helping prepare your presentations and publications. Staff physicians are more than willing to form mentoring relationships with you in areas of research.
Will I be well prepared for boards?
We developed a formal board review curricula to achieve board exam excellence.
We have a weekly board study class for all of our residents. We use the MedStudy curricula and emphasize in detail the key points each resident needs to know to achieve board exam excellence. Test taking strategy is also reviewed in detail.
The Internal Medicine In-Training Examination is administered to internal medicine residents at each PGY level. The results of this examination are used as a baseline to judge their progress in residency training, as well as to fine-tune the resident’s knowledge in preparation for the American Board of Internal Medicine Certifying Exam. The results from this examination are also used as an indicator for teaching staff in a continuing effort to modify the curricula, which ultimately enhances teaching.
As a result of our board review curricula 98% of our residents in the last eight years have passed boards.
Will I have enough autonomy?
Autonomy and supervision are two very important aspects of a residency program. At Gundersen, the staff provides an excellent blend of these two factors. Autonomy is given in a graded fashion according to each resident's ability. The staff do not micromanage and are always eager and willing to hear your impression and patient care plan.
By the second year of residency, most are able to have near complete autonomy (of course complying with the federal mandates concerning attending physician-patient contact). The attending physician is always available in person or by phone if you have any questions. Thus, residents have appropriate responsibility and autonomy, but always with the best supervision.
No "Private" Patients
Will my attending physician be in charge of all the patients on my service, or will I be working with several attending physicians, each with their own "private" patients?
There are no "private" patients on any hospital teaching service. When a patient is admitted to a team, (one staff physician, residents and a medical student), that team is completely in charge of that patient's care.
There is no need to spend valuable time going back and forth to establish diagnosis and treatment plans with several attending physicians. Our patients have become accustomed to this practice as well. Everyone feels this is the ideal environment for learning efficient inpatient medicine and optimizing patient care.
Opportunities for Procedures
Will I have the opportunity to do enough procedures?
Close bedside supervision by staff working one-on-one with the resident, along with a wide variety of elective rotations enables mastery of a number of procedures not ordinarily encompassed in an internal medicine residency program. For example, a resident may choose to take Office Gynecology to learn endometrial biopsy technique and cervical polyp removal, or may take Cardiotesting to learn to perform and interpret ECHOs and treadmill tests. There is also an elective Procedure Rotation available if a resident desires a large volume of a variety of procedures.
Residents have the opportunity to master the following procedures:
- Central venous line placement
- Arterial line insertion
- Endotracheal intubation
- Mechanical ventilator management
- Aortic balloon pump management
- Exercise treadmill testing
- Lumbar puncture
- Chest tube placement
- Skin biopsy
- Joint aspiration and injection
Critical Care Experience
How is your critical care experience?
Not only do we have an ICU rotation every year dedicated to intensive care medicine, but also all inpatient medical teams can admit and transfer patients to the Medical and Surgical Intensive Care Units. This provides intensive care experience during every inpatient month, training our residents to be exceptional critical care physicians. As a result of the excellent training here in critical care, a number of previous residents have gone on to do a fellowship in pulmonary critical care.
How much flexibility will there be in my schedule?
We offer the most flexibility possible, while adhering to the ACGME standards of residency training. A wide variety of electives are available, and you may also create an elective rotation to fit your individual needs.
Residents may take rotations outside of our facility if they wish to gain experience at other institutions or out of the country. We realize you may have interests that extend beyond traditional Internal Medicine, so we facilitate elective experiences to meet your long-term goals and the challenges of a changing medical environment.
The ability to "sculpt" your schedule to meet your future practice needs is a definite advantage for Gundersen residents. For example, you may choose electives such as CHF clinic if you are pursuing a fellowship in cardiology, or a rural medicine rotation at a regional clinic if you would like to have these skills for your General Internal Medicine practice.