Internal Medicine Residency Program Overview

Overview of the Internal Medicine Residency Program

Mission

Loyola MacNeal Internal Medicine Residency Program honors the esteemed legacy of Dr. Arthur W. MacNeal. As a physician, Dr. MacNeal strove to meet the needs of the community and from his home founded what became MacNeal Hospital. Today, the modern day MacNeal Hospital continues to remain committed through partnership with Loyola Medicine to meet the unique needs of our growing community. Our Internal Medicine program seeks to preserve the tradition of service and inspire within our residents a passion for patient care and a deep fund of intellectual curiosity. We equally believe our residents’ breadth of exposure to complex internal medicine disorders and the opportunity to encounter the first presentation of rare disorders culminate in the creation of well-rounded physicians ready to meet the needs of tomorrow’s patients.

Values

Residents’ well-being is a priority for the Residency Program. The education provided to residents is learner-centered. The patient care provided in the hospital and in the clinic is safe, effective, timely and always compassionate. 

Internal Medicine Residency Curriculum

MacNeal Hospital’s Internal Medicine Residency curriculum is designed to enhance specific skill sets in each academic year of training. This structure allows a progressive increase in outpatient and elective rotations as a resident grows from intern to senior resident. The rotations are generally four-week blocks, with occasional two-week rotations on day float, night float, ENT, and rehab medicine. Vacation can be taken in a single four-week block, or split into 2 two-week vacations.

Each resident has a continuity clinic one half-day per week throughout the three years of residency.

PGY1:

The intern year at the MacNeal Internal Medicine Residency Program focuses on developing skills in general internal medicine, both in the Continuity Clinic and on the Inpatient Medicine Service (IMS). There are rotations in the ICU and Emergency Room to develop patient care skills in critical and emergent settings. The overall goal for the intern year is to attain patient care skills, develop interpersonal communication skills, build one’s foundation of knowledge, and learn medical documentation skills. At the end of the year, interns are skilled in making patient management decisions in collaboration with the senior resident and attending physicians.

PGY2:

During the second year, residents transition to being leaders of the internal medicine team. Residents learn to be independent in critical thinking and medical decision-making skills. Second year residents independently lead an Internal Medicine Service team, and work alongside PGY3 residents in the Intensive Care Unit. Residents also have an opportunity for cross cover and night admitting during their night float rotations. Residents may choose to do an elective away rotation this year.

PGY3:

The third-year resident has an increased number of rotations in ambulatory care and electives. This year is meant to enhance the resident's clinical knowledge in outpatient medicine and in subspecialties in preparation for the ABIM board examination and potential fellowship applications. At the end of the PGY3 year, residents are well balanced and confident in both inpatient and outpatient management of patients. Residents are well-prepared to take the noard exam.

Example 3 Year Schedule

Block

PGY1

PGY2

PGY3

1

IMS

IMS

ICU

2

Rehab Medicine / Vac

Vac / Night Float

Primary Care

3

ICU

Neurology

Night Float / Day Float

4

IMS

Endocrinology

Vac / GI

5

Cardiology

IMS

Night ICU

6

IMS

PC 5 / Day Float

Hematology / Oncology

7

Vac / ENT

Night Float

Geriatrics

8

ICU

Cardiology

Rheumatology

9

Nephrology

Day Float / PC 5

Night Float / Pulm

10

IMS

Vac / Night Float

IMS

11

IMS

IMS

Day Float / Vac

12

Emergency Medicine

Away

Primary Care

13

IMS

ICU

IMS

We offer a variety of subspecialty and ambulatory rotations.

Subspecialty Rotations

  • Cardiology
  • Endocrinology
  • Gastroenterology
  • Geriatrics
  • Hematology/Oncology
  • Infectious Diseases
  • Nephrology
  • Neurology
  • Pulmonology
  • Rheumatology

Ambulatory Rotations

  • Allergy/Immunology
  • Community Internal Medicine
  • Dermatology
  • Office Gynecology
  • Office Orthopaedics
  • Ophthalmology
  • Otolaryngology
  • Pain Management
  • Physical Medicine & Rehabilitation
  • Sleep Medicine

Internal Medicine Conferences

The educational experiences of MacNeal Internal Medicine residents are enriched by a robust didactic series and interactive conferences. Below is a template for weekly conferences:

  Monday Tuesday Wednesday Thursday Friday
12-1 pm Noon
Conference
Noon
Conference
Noon
Conference
Noon
Conference
Noon
Conference
3-4 pm Resident
Report
Clinical
Assessment
Rounds
Resident
Report
  Board
Review

Noon Conferences (12-1 PM)

  • Clinical Pathology Conference – a senior-resident-led conference that features in-depth exploration of the pathophysiology, diagnosis and management of a patient case. It also offers the unique perspectives of specialists who attend and provide rich and insightful commentary about the case.

  • Evidence Based Medicine Sessions – residents learn how to use medical literature and basic biostatistics measures and apply the findings to specific clinical questions and patient care.

  • Journal Club – a senior resident along with a core faculty member facilitate group discussion and critical appraisal of the selected article.  

  • High Value Care Conference – an interactive lecture and small group series focused on teaching the practice of cost-conscious medicine. Throughout the series, residents gain exposure to different members of the hospital staff including nurses and nurse supervisors, pharmacists and individuals from the finance department.

  • Morbidity and Mortality Conference – a senior resident along with a core faculty member engages in the presentation of a case with the intent to create a safe space for review of patient care improvement opportunities. This conference emphasizes confidentiality and promotes patient safety and excellence in patient care.

  • Weekly Core Lecture and Small Group Series – a series that occurs early in the academic year and focuses on the mastery of managing common inpatient conditions.

Internal Medicine Residency Scholarly Activity

At MacNeal, our internal medicine program strives to nurture resident interest in research and scholarly activity. Residents are encouraged to attend and present at national and regional conferences. In recent years, our residents have presented abstracts and posters at conferences such as Regional and National ACP, SGIM, ICAHO, ACR, ASH, and AACE. Residents are provided an annual stipend to assist with costs associated with conference attendance.

Pinar Smith

(left) Pinar Smith R3 at American Association of Clinical Endocrinologists Conference, 2017.


Our residents have an opportunity to showcase their research or clinical vignettes at our annual Resident Research Day. Awards are presented for first and second place clinical vignette posters and oral research presentations.

Quality improvement is emphasized at MacNeal. Every resident participates annually in a quality improvement project, overseen by a dedicated faculty mentor. Quality improvement projects are also presented at Resident Research Day.

Recent Quality Improvement Projects Include:

  • Evaluation of HbA1c ordering in MCIM Clinic
  • Improvement of central line documentation rates
  • Decreasing the incidence of hypoglycemia amongst inpatient population in the hospital through educating RNs and PCTs regarding the timing of insulin administration
  • Achieving 90% compliance with using flashcards reflecting appropriate management of patients admitted for COPD exacerbation
  • Decreasing the quantity of controlled substance (CS) prescribed in 25% of patients who are currently on chronic CS treatment plans in the MCIM clinic by utilizing resident-directed interview scripts and physician questionnaires
  • Improving the quality of discharge summaries to include all required elements as per the IMRP guidelines
  • Increasing advanced directive discussions in the MCIM clinic by 50%
  • Improving screening rates for colorectal cancer in the MCIM clinic through the use of flyers and handouts for patients
  • Reducing hospital-acquired C. difficile infections by reducing staff isolation non-compliance

Internal Medicine Resident Publications and Presentations from Recent Years:

2018

A conspicuous lung mass with an inconspicuous diagnosis. Ranju Kunwor, Ann Marie Canelas. Presented at ACP Northern IL 2017.

A Rare Case of Tumor Lysis Syndrome in Metastatic Renal Cell Carcinoma treated with Pazopanib. Prachi Jain, Paola Sanchez, Farah Ciftci, Lauren Sullivan.

Brodifacoum Laced Synthetic Marijuana Toxicity: A fight against time. Sanjay Kumar, M.D, Christine Junia, M.D.

Carcinoid – An Interesting Differential to IBS. Richard Fernandes MD, Claudia Rodriguez MD, Christine Junia MD.

Epigastric pain post-PCI: A rare atheroembolic complication of a common procedure. Ranju Kunwor, Ann Marie Canelas, Presented AT CSCTR/AFMR Meeting, April 2018.

Flecainide Toxicity: Slowing down to Speed Up. Sri Mahathi Kalipatnapu MD, Robert Lichtenberg MD, Charles Kinder MD, Christine Junia MD.

Gingival Hyperplasia Secondary to Amlodipine Use. Claudia Rodriguez MD,  Farah Ciftci MD.

It can always be Lupus! Pseudo pseudo-meig syndrome without ascites in Systemic Lupus Erythematosis (SLE), a rare initial presentation. Priyanka Sharma MD, Lauren Sullivan DO.

Methamphetamine induced vasculitis: A matter of life and limb. J. Bandaru, C. Junia. Presented at ACP Norther IL Meeting, IL. 2017.

More danger than we knew - Hypokalemic periodic paralysis triggered by alcohol consumption. N. Doshi, P. Sanchez, C. Junia.

Pneumocystis pneumonia with Acute respiratory distress syndrome - A rare initial presentation of Human Immunodeficiency Virus. Anusha Yanamadala, M.D; Ann Marie Canelas, M.D.

Pulmonary Embolism, a diagnosis to remember in Sickle Cell Disease. J. Munoz Mejia, N. Gandham, C. Junia. Presented at ICAHO 2017.

Salmonella empyema: a rare complication associated with immunocompromised state resulting in sepsis. Anusha Yanamadala, M.D; JuanPablo Portocarrero, M.D; Ann Marie Canelas M.D. Presented at ATS International Conference, CA 2018.

That Ground Glass! Diffuse Parenchymal Lung Disease(DPLD) in patients with Rheumatoid arthritis (RA); Importance of differential diagnosis. Malvika Kaul MD, Lauren Sullivan DO. Presented at SGIM Annual Meeting 2018. CO.

The uremic heart: Role of echocardiogram in diagnostic evaluation and monitoring of uremic pericarditis and myocardial involvement. Anusha Yanamadala, M.D; Christine Junia, M.D.

2017

Hrudya Abraham MD, Jacquelin R Chua MD, Ailda Nika MD. (2017) Gouty panniculitis: A rare manifestation of gout. To be presented at: National SGIM, Washington, DC. National SHM, Las Vegas, NV.

Hrudya Abraham MD, Sajan Thomas MD Amit Srivastava MD. (2017). Sump Syndrome: A rare complication of choledochoduodenostomy. To be presented at National SHM, Las Vegas, NV. (2016). Presented at Brooklyn Hepatology Symposium, Brooklyn, NY.

Ann Bunyan MD, Isha Shrestha MD, Ann Marie Canelas MD. Fatty blood: Role of Insulin Infusion and Plasmapheresis in Hypertriglyceridemia-Induced Acute Pancreatitis.

Ming H Lee MD, Hrudya Abraham MD, Farah Ciftci-Olsen MD. (2017). A Hidden Killer: Complete Dissection of the Ascending and Descending Aorta Induced by Gram Negative Aortitis. Presented at National SHM; Las Vegas, NV and National ACP; San Diego, CA.

Anmol Baranwal MBBS, Sindhu Joseph MD. (2017). Quality and Value-Focused Decision Making in Heparin-Induced Thrombocytopenia: The Impact of the American Society of Hematology’s Choosing Wisely Initiative. Presented at American Society of Hematology National Conference; San Diego, CA.

Serin Edwin MD, Sindhu Joseph MD and Rashmi Rodrigues MD, PhD. (2017). Coping Self-Efficacy in HIV-positive patients: What the numbers look like. Poster to be presented at: SHM's Annual Meeting, Las Vegas, NV.

Serin Edwin MD, Anmol Baranwal MD, Mrinmayee Naik MD, Swati Gobhil MD, Srilatha Mulamalla MD and Joseph Frasca MD. (2017). The Infection in Inflammation: Diagnosing Clostridium Difficile in Inflammatory Bowel Disease. Poster to be presented at: National SHM Conference, Las Vegas, NV.

Swati Gobhil MD, Sindhu Joseph MD. A Different Take on Cholecystitis: Let’s go back to the Anatomy Lab. (2016, 2017). E-Poster accepted at: ACP Northern Illinois; Chicago, IL. Poster presented at: National SHM. Las Vegas, NV.

Malvika Kaul MD, Ann Bunyan MD, Kenneth Lee MD, Lauren Sullivan DO. (2017). Severe Diffuse Axonal Polyneuropathy and West Nile Virus Infection. Poster to be presented at: National SGIM 2017; Washington, DC.

Molecular Imaging and Precision Medicine in Head and Neck Cancer. Mena E, Thippsandra S, Yanamadala A, Redy S, Pattanayak P, Subramaniam RM. PET Clin. 2017 Jan;12(1):7-25. doi: 10.1016/j.cpet.2016.08.009. Review.

The Value of FDG PET/CT in Treatment Response Assessment, Follow-Up, and Surveillance of Lung Cancer. Sheikhbahaei S, Mena E, Yanamadala A, Reddy S, Solnes LB, Wachsmann J, Subramaniam RM. AJR Am J Roentgenol. 2017 Feb;208(2):420-433. doi: 10.2214/AJR.16.16532.

The Current and Evolving Role of PET in Personalized Management of Lung Cancer. Mena E, Yanamadala A, Cheng G, Subramaniam RM. PET Clin. 2016 Jul;11(3):243-59. doi: 10.1016/j.cpet.2016.02.010. Review.

2016

Michael Abendroth MD MBA, Ann Bunyan MD, Eugene Kligman MD. (Nov 2016). Rhabdomyolysis and Legionnaire's Disease: Diagnosis Disguised by a Mechanical Fall. Poster presented at the ACP Northern Illinois Chapter Residents' and Medical Students' Day; Chicago, IL.

Hrudya Abraham MD, Ann Bunyan MD, Mrinmayee Naik MD, Sindhu Joseph MD. (2016). Being a Medicine SuperSLEuth: Does my patient also have thrombotic thrombocytopenic purpura? Poster accepted at: ACP Northern Illinois; Chicago, IL.

Hrudya Abraham MD, Rizvi Syed MD. (2016). Heart Failure -A Rare Initial Manifestation of Systemic Lupus Erythematosus. Presented at Midwest SGIM, Cleveland, OH.

Hrudya Abraham MD, Rani Kasinchetty MD. (2016). Hidden in the Skin. Presented at: Midwest SGIM, Cleveland, OH.

Anmol Baranwal MD, Jay Patel MD. (2016). Enoxaparin toxicity masquerading as tumor lysis syndrome. E-Poster accepted at: ACP Northern Illinois; Chicago, IL.

Anmol Baranwal MD, Ann Marie Canelas MD. (2016). Perianal swelling: Is it abscess or something else? Poster presented at: International Conference on Advances in Hematology and Oncology (ICAHO); Coeur d’Alene, ID.

Anmol Baranwal MD, Venkata Puskoor MD, Sindhura Reddy MD, Ann Marie Canelas MD. (2016). Metastatic choriocarcinoma with paraneoplastic hyperthyroidism. Poster presented at: Society of Hospital Medicine: Annual Meeting; San Diego, CA.

Rani Kasinchetty MD, Lauren Sullivan DO. (2016). Typhoid Fever Presenting as Acute Pancreatitis. Poster presented at: Midwest SGIM; Cleveland, OH.

Ranju Kunwor MD, Anmol Baranwal MD, Ann Marie Canelas MD. (2016). The cruelest truth hidden behind the silence! E-poster accepted at: ACP Northern Illinois; Chicago, IL.

Pinar Smith MD, Joseph Frasca MD, Sindhura Reddy MD. (2016). Diagnosis of pituitary adenoma after bowel preparation. Resident Research Day, MacNeal Hospital.

Internal Medicine Residency Educational Resources

MacNeal’s Internal Medicine Residency Program is continually striving to identify unique learning opportunities to prepare our residents for the demands of clinical practice. We recognize the impact of experiential learning and the benefits of training with the use of simulations. Our program uses SimMan® to simulate high-fidelity immersive scenarios for our residents. Simulations also help us to emphasize the importance of teamwork. When learning from simulations we prioritize the importance of listening and respecting others point of view, and maintaining confidentiality to create a safe learning environment.  

Each ICU rotation features a simulation session containing:

  • scheduled dedicated time to become familiar with the defibrillator and review how to perform and assess quality chest compressions.
  • simulations utilizing the interactive SimMan® who features palpable pulses, manual blood pressure, lung, heart and bowel sounds.
  • simulations featuring the opportunity to interpret labs and ECGs in real time.
  • simulations to practice ACLS and RRT scenarios with an interdisciplinary team.
  • the opportunity to take on the role of code leader, recorder, compressor, respiratory support and administer medications.  

Other educational resources:

  • Our librarian, Lily Wang, MD, MS is available five days a week to assist with literature searches and to teach one-on-one sessions.
  • Access to comprehensive library collections including:
    • UpToDate (with access on your mobile device)
    • OVID eJournals – 445 titles
    • AccessMedicine – featuring 145 eBooks, guidelines, drug information and more
    • Isabel Diagnostic Support: a differential diagnostic database
    • Cochrane database of systematic review
    • VisualDx
    • MicroMedex Gateway
    • Exam Master online
    • Free interlibrary loan service to borrow books and articles.

Teaching Internal Medicine Students

At MacNeal, we have the fortune of honing our teaching skills starting intern year with medical students and physician assistant students from Loyola, Chicago Medical School, Midwestern University and Rush.

There is the opportunity for each intern to be paired with either a third year medical student or physician assistant student, and for the senior resident to be paired with a sub-intern. This will allow interns to start developing important skills of teaching, supervision, evaluation and providing feedback prior to leading a team as a senior resident, and will provide senior residents with additional skills in managing a larger team. To maintain balance and learning opportunities, we do not schedule more than one student per resident.

We encourage residents to work closely with their students to review history, exams and plans for each shared patient, and to identify learning opportunities.  Discussing learning topics together can be helpful to student and resident alike, as teaching often allows us to review and cement concepts, and test our own understanding. Giving feedback is also an important skill to practice, and will allow the students to identify their own strengths and weaknesses to improve throughout the rotation.