Pathways and Beyond

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

The Hospital Medicine Pathway is a 2-year curriculum starting at the beginning of PGY-2. We look to recruit two residents per year. (0:39)

The key components of the Pathway include a didactic series, QI, and electives including our capstone elective where you’ll rotate on the inpatient wards at Alice Peck Day which is our nearby critical access hospital. (1:15)

Our didactics lectures are scheduled during Y-blocks and are given by our academic hospitalists, pharmacists, and other practitioners and educators here at Dartmouth Hitchcock Medical Center. The lecture topics span across cornerstone competencies covering clinical practice, QI, patient safety, risk management, and economics and leadership in medicine. (2:05)

Residents involved in the Hospital Medicine Pathway are expected to lead two reviews of updates in hospital medicine. Residents, for example, will choose from recent and practice changing journal articles or a review of a topic published in Things We Do For No Reason. (4:01)

Our QI curriculum is geared towards getting residents to identify QI opportunities in their daily clinical practice and better internalize how systemic changes occur. We additionally work to provide them with the tools and mentors needed to develop these into scholarly projects if desired. Our curriculum includes IHI training (4:30)

Our Hospital Medicine Pathway residents additionally get time on special electives including diabetes management and medicine triage as well as time at our critical access hospital Alice Peck Day to help strengthen hospitalist specific skillsets.

Anyone who is interested in Hospital Medicine should consider applying and recognize that multiple pathways can be pursued simultaneously if there is additionally interest in the medical education or JEDI programs as well.

Candidates for the residency program who wish to know more about the Hospital Medicine Pathway are invited to contact the Pathway Director Ashley Wildman via email ashley.t.wildman@hitchcock.org.

Conifer Leadership Fellow: Health Equity

Overview of program

The Health Equity track is a two-year social justice in healthcare training program available to all Graduate Medical Education (GME) residents/fellows at Dartmouth Hitchcock Medical Center, completed simultaneously with your core residency/fellowship. The program includes a series of seminars, along with leadership training and mentorship, to support participants as they build careers in medicine focused on advancing health equity, improving population health, and addressing disparities in healthcare outcomes. Prior to completion of the program (generally in year 2), participants complete a capstone project of their choosing that pertains to health equity (quality improvement, medical education, community engagement).

Goal

This program is designed to develop resident and fellow leaders with a focus on health equity, population health, and disparities and their impact on health outcomes.

Structure

Year 1 includes monthly, 1-hour meetings/seminar sessions from September to June on the first Tuesday of each month from 12 to 1 pm. Seminars are chosen according to interest of the first-year cohort. These sessions may include:

• Introduction to the program
• Seminars run by experts in the field of study. These sessions are often determined by the interests and needs of the current fellows. Examples of past sessions include:
  • Race in research
  • Gender and sexual minorities in medicine
  • Air pollution and environmental health
  • Healthcare payment structure
  • Food security
  • Opportunities for advocacy, how to be involved in policy work as a physician
  • How to conduct QI work for medical education
• Attendance at the second-year capstone poster session

Year 2 consists of:

• A capstone project of the participant’s choosing, which will have a component related to subjects they are learning in the Health Equity pathway. Each fellow will have a faculty mentor who will serve as their project advisor to help provide structured support for their work.

Contact

Please contact the Faculty Program Director Pam Trio, MD at pamela.s.trio@hitchcock.org for questions.

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 clinical 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.

Internal Medicine residents have been involved in projects that span the spectrum of preclinical basic and translational science (T0 and T1), clinical trials (T2), translation to clinical practice (T3), and community-based research (T4) in a diverse group of disease processes. Programs available to residents that showcase the research expertise at Dartmouth Health and Geisel School of Medicine at Dartmouth include: The Dartmouth Institute for Health Policy and Clinical Practice, The Center for Aging with Serious Illness, The Walter and Carol Young Center for Digestive Health, The Center for Rural Healthcare Delivery Science, The Dartmouth Cancer Center, The Heart and Vascular Research Center, The Dartmouth Cystic Fibrosis Research Center, and The Center for Precision Medicine and Artificial Intelligence.

The most recent graduate of this pathway is Daniel Aridgides, MD PhD. Dr. Aridgides performed his research in the laboratory of Dr. Alix Ashare and subsequently completed his Pulmonary and Critical Care Fellowship training in 2022. While the exact timeline of events in this pathway has some flexibility, Dr. Ardigides completed his Internal Medicine clinic training in 25 months. He then joined Dr. Ashare’s laboratory for 23 months. After completion of approximately 18 months of fellowship training, he returned to the laboratory and finished his postdoctoral research studies while continuing some pulmonary clinical responsibilities. During that time, he received a prestigious career development award from the Cystic Fibrosis Foundation. He then joined the faculty as an Assistant Professor of Medicine in 2022. He is currently a physician scientist and Director of the Adult CF Program at Dartmouth. His current research involves investigation of innate immune cell dysfunction in people with cystic fibrosis.

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