Pathways and Beyond

We are proud to sponsor a Research Pathway for residents interested in a career combining clinical practice and bi-directional translational research.

This pathway conforms with the ABIM's requirements, and combines a 2 year medicine residency, 3 year post-doctoral research fellowship, and a 1 to 2 year subspecialty fellowship. Only Dartmouth Hitchcock Medical Center PGY-1 and 2 Internal Medicine residents with MD and PhD combined degrees or MDs with considerable research experience and achievement will be considered for this track.

The Section of Cardiovascular Medicine's areas of research emphasis include cardiology clinical research, cardiovascular imaging, cardiac epidemiology, outcomes and decision analysis, therapeutic catheterization and devices, echocardiography, and electrophysiology. Multidisciplinary research centers include the Heart and Vascular Research Center and the Center for Imaging Medicine. Dartmouth Hitchcock Medical Center is a member of the New England Regional Cardiac Network.

The institution supports the Dartmouth Cancer Center, 1 of 53 National Cancer Institute-designated comprehensive cancer centers, and has ongoing research trials in the following areas: Brain, Breast, Bone Marrow Transplant, Gastrointestinal, Gynecologic, Head and Neck, Lung, Lymphoma and Leukemia, Melanoma, Multiple Myeloma, Myelodysplastic Syndrome, Pediatric, Prostate/Genitourinary, Radiation Oncology, Sarcoma, and Surgical Clinical Trials.

The Section of Gastroenterology includes centers of excellence in inflammatory bowel disease, esophageal and motility disorders, hepatopancreaticobiliary disease, and complex endoscopy. Endoscopic ultrasound, endoscopic surgical repair of reflux disease, and video capsule endoscopy are all used both therapeutically and for research purposes.

The Dartmouth Institute for Health Policy and Clinical Practice focuses on helping clinicians, policy makers, and systems leaders improve practices and develop innovative new models of healthcare delivery.

SYNERGY, our Translational Research Center, speeds the impact of discovery and translates new knowledge into practice and improved population health. By connecting researchers to critical resources, funding opportunities, technologies, research training, and expertise, SYNERGY helps investigators advance research and efficiently translate discoveries into improved population health.

Ongoing clinical trials in all areas of medicine can be explored through our Clinical Trials Office.

Dartmouth College adds additional resources to the research experiences available to our Internal Medicine residents. Many Dartmouth Hitchcock Medical Center faculty have dual appointments at Dartmouth Hitchcock Medical Center and Dartmouth College and have agreed to serve as mentors for residents in this program. A full array of research infrastructure is available, including Comprehensive Research Centers and labs in Arts and Sciences, The Guarini School of Graduate Studies including the Program in Experimental and Molecular Medicine (PEMM), The Geisel School of Medicine, The Thayer School of Engineering, and The Tuck School of Business. Support services including statistical and information technology are available both at Dartmouth Hitchcock Medical Center and at Dartmouth College.

For further information regarding this track, please email imresidency@hitchcock.org.

Our Internal Medicine Residency offers a 2-year pathway for categorical or primary care internal medicine residents with career interests in medical education. Residents wishing to participate in the Medical Education Path apply after matching to our program, during the first year of training. Up to 2 residents per year are accepted into the pathway.

Components of the pathway include:

• An enhanced didactic curriculum to build the resident’s knowledge of topics related to medical education. Residents are assigned selected readings and engage in directed reflective exercises followed by small group discussions with peers and a faculty facilitator. The Med Ed Path didactic curriculum builds on the core curriculum of the FIRE (Formal Instruction of Residents as Educators) rotation, a 2-week rotation focusing on teaching skills development for all categorical and primary care residents. Topics in the Med Ed curriculum include:
  • Assessment and Evaluation
  • Curriculum Development and Implementation
  • Feedback
  • Inpatient and Bedside Teaching
  • Large Group Teaching
  • Learning Theory
  • Problem Based Learning
  • Teaching Clinical Reasoning
  • Teaching in the Ambulatory Setting
• Application of teaching skills with dedicated mentorship and feedback. Residents receive structured feedback on their clinical and classroom teaching. They have additional opportunities for teaching medical students and first-year residents, and participate in Problem Based Learning sessions as co-facilitators in the PGY-2 year and as independent facilitators in the PGY-3 year.
• Opportunity to participate in longitudinal clinical teaching for 2nd-year medical students
• Mentored scholarly work in medical education. Each resident identifies an area of interest in medical education research, quality improvement, or curriculum development and is matched to an appropriate faculty mentor. Residents implement and disseminate their work in regional or national meetings or through publication.

Candidates for the residency program who wish to know more about the Med Ed Path are invited to contact Kelly Kieffer, the Vice Chair for Education: kelly.a.kieffer@hitchcock.org

Our Internal Medicine Residency offers a 2-year pathway for categorical or primary care internal medicine residents who develop a career interest in hospital medicine. This pathway provides residents with the skills needed to seamlessly transition into an academic hospitalist role and provides exposure to critical aspects of hospital medicine such as quality improvement, healthcare economics, billing and coding, and research stewardship.

Residents wishing to participate in the Hospital Medicine Pathway apply during the first year of training in our program. Candidates are selected through a competitive application, with a focus on small cohorts to allow for closer mentoring and greater collaboration between trainees and pathway faculty mentors.

Components of pathway

Rotations

• Additional opportunity for inpatient electives in other relevant fields to improve healthcare transitions (e.g. ICU to improve ICU triage skills, clinical pharmacy to improve anticoagulation and antimicrobial stewardship skills, neurology, etc.)
• Community Hospitalist rotation at a local community hospital to provide inpatient non-teaching clinical experience
• Hospital Medicine elective at Dartmouth Hitchcock Medical Center
• Rotation in post-hospital discharge clinic (Focus on the transition of patients from hospital to community care)
• Ultrasound elective (learn diagnostic and therapeutic procedures, with the goal of procedure certification and comfort)

Education

• Hospital Medicine Journal Club
• Hospitalist-specific didactics on practice management, coding, research stewardship, billing, working with advanced practice providers, consultation regarding pre-operative care and surgical co-management
• IHI (Institute for Healthcare Improvement) “Open School” learning module subscription
• Individual mentorship for professional development
• Inpatient QI project. Each resident will be encouraged to identify an area for quality improvement and will be matched to an appropriate faculty mentor, as they will be encouraged to implement a PDSA cycle within the course of an academic year and present their work in regional or national meetings or through publications.
• Longitudinal sessions throughout the curriculum with dedicated teaching in the areas of clinical Hospital Medicine, quality improvement, healthcare economics
• Membership in the Society of Hospital Medicine (SHM) and attendance at 1 SHM meeting
• Professional development includes CV preparation, interview skills, teaching workshops, future planning

Candidates for the residency program who wish to know more about the Med Ed Path are invited to contact the Pathway Director Sage Gale via email sage.e.gale@hitchcock.org.

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The Leadership Preventive Medicine Residency (Fellowship) (LPMR) is a unique program in quality improvement, leadership, and population health for residents and fellows already training at Dartmouth Hitchcock Medical Center. The program allows you to obtain a Master's in Public Health (MPH) degree from The Dartmouth Institute, lead a practicum focused on improving care, and be able to sit for Boards in Preventive Medicine.

Following an Internal Medicine residency, this program is 2 years in length or can be combined with any subspecialty fellowship with 1 additional year of training. The program has 3 major components:

• Academic: Participants are enrolled in The Dartmouth Institute's MPH program, which focuses on the science of quality improvement. All participants receive a full tuition waiver, and continue to be paid at their appropriate PGY level.
• Clinical: Participants continue to spend 20% of their time practicing clinical medicine, either Hospital Medicine, outpatient GIM practice, or subspecialty clinical practice.
• Practicum: Participants develop a quality improvement project: determining a quality gap, measuring that gap and exploring root causes, meeting with stakeholders, developing a quality improvement plan, leading the QI process to implementation, measuring outcomes, managing conflict, and scientifically disseminating results. Residents learn the key skill of leading change in complex systems.

Please see the Leadership and Preventive Medicine Residency Program for full details.