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.
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 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. 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 conference 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. Professor Rounds places our Chair of Medicine, Dr. Brown, in front of an electronic white board. With the assistance of the inpatient teams, Dr. Brown critically thinks through a challenging case. 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 X-ray Rounds on Tuesdays. The Chief of Medicine at the VA, Dr. Christman, builds intern confidence in reading chest X-rays and other imaging studies.
Ambulatory Morning Report: While on their ambulatory blocks, interns and upper-level residents attend separate ambulatory morning reports for the first three months, after which the interns join the upper-level residents in a combined ambulatory morning report four times weekly. Ambulatory morning reports are led by the ambulatory chief residents and are regularly attended by program leadership, including Drs. Peterson, Smith, and Yakes. For the first three months, interns participate in a core curriculum in general internal medicine that is taught by faculty from the Division of General Internal Medicine and Public Health. Upper-level residents participate in a core curriculum in advanced general internal medicine and the medical specialties that is taught by faculty from the various divisions of internal medicine, guest lecturers from other departments, and members of our Resident Teaching Academy—a group of third-year residents selected for their aptitude at teaching.
In upper-level ambulatory morning report, Monday and Tuesday mornings feature interactive faculty-led teaching sessions that focus on the "theme" of the block, i.e., rheumatology, nephrology, endocrinology, cardiology, etc. On Wednesday mornings, residents generate their own questions for members of the Resident Teaching Academy who are then tasked with answering the questions the following week. Fridays feature resident-led case discussions, similar to inpatient morning report only directed at outpatient problems. On select days, ethics roundtable discussions and other didactic sessions replace typical case presentations.
Ambulatory Intern Didactics: Thursday mornings for interns on their ambulatory blocks are reserved for additional didactic sessions, including training sessions on the management of a primary care clinic and a didactics series in geriatrics.
Quality Improvement Didactics: Thursday mornings for PGY-2 residents on their ambulatory blocks are reserved for 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.
Inpatient Didactic 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 the best 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: Journal Club takes place on Wednesdays at noon. 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, value-based care, among other topics.
Senior Talks: In the latter half of the year, graduating third-year residents deliver presentations known as Senior Talks on select Wednesdays and Fridays. These talks are a perennial hit among housestaff, often highlighting graduating seniors’ research endeavors, extracurricular activities, personal interests, and career aspirations. Previous talks have covered a variety of topics, from Pregnancy during Residency to the Hygiene Hypothesis; from e-cigarettes to current dietary trends; and from the RAND Health Insurance Experiment to the emergence of mobile and electronic health technology.
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.
Lauren Hartman, M.D.
A robust number of conferences support the clinical education that Vanderbilt residents receive in the inpatient and outpatient settings. These conferences make up a comprehensive curriculum that prepares our residents for their future roles as clinicians, teachers, researchers, and leaders. We strive to make our conferences interactive to promote further discussion and group problem solving in order to increase engagement, build critical thinking and analytic skills, and increase content retention. Our faculty, programs directors, and chair of medicine are regularly in attendance for morning report, and many of our conferences are led by the upper-level residents to provide opportunities to improve teaching skills. We remain committed to providing two conferences per day for both inpatient and outpatient residents, and conference time is built into the daily schedule to allow for regular attendance. Pagers are held during the morning conferences for our inpatient teams.