Internal Medicine Residency

Program Overview

The Internal Medicine Residency at Penn State Health Milton S. Hershey Medical Center is a categorical three-year, ACGME-accredited program that admits 20 residents per year. In addition, the Preliminary Medicine Residency is a one-year, ACGME-accredited program that admits five residents per year.

Program Director’s Welcome

Welcome to the Penn State Internal Medicine Residency! I hope as you explore this website you will learn more about our philosophy for graduate medical education, our commitment to focus on your individual goals as developing physicians, our dedication to providing you with robust training in both the inpatient and ambulatory care components of internal medicine, and about the opportunities available to you at our institution and through our training program.

Just over 15 years ago I first visited the Penn State College of Medicine campus as an undergraduate student applying for admission to medical school. I noticed immediately how it had a different “feel” from many other places I had interviewed. Walking through the halls, faculty and students stopped to chat – even those clearly on route to patient care duties. I was made to feel a member of the community, despite my obvious status as an “interviewee.” That same welcoming spirit and collegial atmosphere marked my follow up visits, solidifying my choice to pursue medical training here. As my time at Penn State progressed and my role in the institution changed from student to resident to faculty, the one thing that did not was the collegiality, collaborative spirit, and sincere commitment to my professional growth and personal well-being that I sensed and experienced as an applicant so many years ago. This spirit marks our current students, residents, and faculty, and has been a driving force behind my desire to continue to make this community my home.

In the pages that follow we invite you to explore our educational and clinical offerings. You will hopefully be able to envision how we can assist you in meeting your personal and professional goals in residency and beyond. We look forward to meeting you, and showing you in person the comradery that makes our program, and our institution, a great place to train and work.

Our Team

Program Mission and Highlights

It is our mission to train superior clinicians with the broad skills and knowledge necessary to be successful physicians, physician scientists and educators in the rapidly changing field of 21st-century medicine. Our goal is to provide a rigorous clinical education in all aspects of internal medicine, while balancing the acquisition of core knowledge with the ability to customize your educational experience. Our residents are integral members of the health care teams in general and subspecialty medicine, and provide comprehensive primary care services to the population of central Pennsylvania. A culture of professional accountability and collegiality is fostered in an environment that promotes individual growth and learning. Opportunities for scholarship in basic, translational and clinical sciences, along with the availability of research in medical education, quality improvement, and healthcare epidemiology allow for a well-rounded experience that prepares residents for their future career endeavors, whether they are in fellowship, private practice, or hospitalist medicine. Our program has the reputation of training excellent internal medicine physicians, while continuing to be very successful in preparing those who choose to pursue subspecialty training or enter into academic medical positions following their residency training.

At the Center of Medical Care in the Region

Our unique location as the only academic medical center in central Pennsylvania makes us the referral center for all the complex medical cases in a wide radius from our home institution. We are able to gain experience working with the diverse pathology seen in our urban, suburban, and rural areas of referral, and our expanding partnerships with local hospitals will only increase this exposure in the future. Read more about our institution here.

A Dedication to Mentorship and Professional Development

Named in honor of the first Chair of the Department of Medicine, Dr. Graham H. Jeffries, the goal of the JEMS program is to enhance the professional and personal development of Internal Medicine Residents through longitudinal relationships with a dedicated group of highly skilled faculty. The program features:

  • Regular 1:1 meetings of residents and faculty, held during Ambulatory Blocks approximately every six weeks for interns, with more flexible scheduling for second- and third-year residents.
  • Longitudinal, protected relationships between residents and faculty members, designed to address learner-driven coaching and mentoring needs. This may include self-identified areas of learning need, capitalizing on strengths and successes, work-life balance, career planning including networking support (e.g., helping to find a mentor in chosen field), and scholarship.

The Office for Support in Learning and Teaching Excellence (SLATE) offers programs for residents and faculty to strengthen their skills as educators, preparing interested residents more completely for a career in academic medicine. Our program partners with the faculty from SLATE to provide a robust offering of “Residents as Educators” curriculum across the three years of training. 

Systems That Work

We have embraced a “6+2” Block Structure, with residents alternating between six weeks of inpatient service and two weeks of ambulatory blocks. This gives our residents the opportunity to truly focus on their respective rotations while maintaining continuity of care in the residents’ continuity clinics. We believe the days of residents fracturing their care by leaving their service at least one half-day a week to staff a clinic should be long gone.

During the ambulatory blocks, Internal Medicine resident physicians will develop a panel of patients follow their patients for the duration of their residency, as a true primary provider. They additionally will be exposed to the ambulatory aspects of medicine subspecialty care. Those resident physicians interested in primary care internal medicine may use elective time in the second and third years to focus and refine their primary care skills and fund of knowledge with additional clinic time spend with a dedicated primary care faculty mentor.

Curriculum

Explore curriculum highlights from the Internal Medicine Residency programs.

Inpatient Teams and Call

General internal medicine teams at Penn State Health Milton S. Hershey Medical Center comprise one senior resident and one intern with a team size of 10 to 12 patients. Teams are on call every fourth day. Admissions are triaged-based on complexity and admitted by the teaching or hospitalist services based on patient census. After 7 p.m., a night team of house officers and night floats take over all admission and cross-cover responsibilities.

The Lebanon VA Medical Center teams consist of one senior paired with one intern, with the team size capped at 10 per team. Teams are on call every third day. After 7 p.m., a night float is responsible for all admission and cross-cover.

PGY-1 (Categorical)

On the inpatient service, the first-year resident physician functions as the patient’s primary physician.

Interns work under the supervision of a senior resident and an attending physician on the general internal medicine, cardiology, critical care, and hematology/oncology inpatient services.

Categorical PGY-1 residents complete an average of:

  • 12 to 16 weeks of inpatient general internal medicine
  • Four weeks of inpatient cardiology
  • One block of ICU
  • Four weeks of hematology or oncology
  • Four weeks of night cross-coverage
  • 12 weeks of ambulatory medicine

PGY-2/PGY-3

The second- and third-year residents complete an average of:

  • Eight to 12 weeks per academic year as a supervisory resident inpatient general internal medicine
  • Four to eight weeks per academic year as a supervisory resident in the Medical ICU
  • Four weeks each of inpatient cardiology or oncology and hepatology
  • Two to four weeks per year as House Officer
  • 12 to 16 weeks of ambulatory medicine

In addition, the senior residents interested in hospitalist medicine have the opportunity to complete a four-week rotation at Lancaster General Hospital (LGH), a large community-based hospital. The resident will function as a hospitalist for the internal medicine inpatient service with flexible roles as admitting physician, inpatient rounding and night medicine physician.

Electives

Electives can be selected from a wide variety of inpatient and outpatient subspecialty and general medicine rotations including rheumatology, pulmonary medicine (including further specialization in cystic fibrosis, interventional pulmonology/bronchoscopy), cardiology (with opportunities for further specialization for interested residents in electrophysiology, echocardiography and interventional cardiology), gastroenterology (endoscopy, inflammatory bowel disease etc. for interested residents), hepatology, benign and malignant hematology, oncology, infectious disease, allergy/immunology, palliative/hospice medicine and more.

Additional electives such as research electives and electives in faculty development, medical education, epidemiology and preventative medicine, quality improvement, or other topics can be tailored to the individual resident’s interests.

Locations

Educational Tracks

Learn more about the educational tracks available in the Internal Medicine Residency.

Primary Care Track

Our primary care track enables residents with an interest in primary care to obtain more experience in the outpatient setting. In addition to their own clinic, primary care track residents spend additional time working one to one with experienced primary care physicians. They also receive protected time to participate in our longitudinal outpatient quality improvement projects, as well as a two-week experience as Junior Faculty.

This block rotation allows our residents to work closely with the ambulatory training director, organizing educational activities such as the academic half-day and improving on our outpatient curriculum.

Finally, primary care track residents spend two to four weeks at a community-based outpatient practice, where they function with a high level of independence, managing common ambulatory conditions.

Hospitalist Track

Hospitalist medicine is one of the most rapidly growing and highly demanded areas of internal medicine. With a focus on the acutely ill, hospitalized patient, along with consultative medicine and perioperative management, residents on the hospitalist track will experience different care delivery, and management models. Additional rotations include Hospitalist Medicine rotations at Lancaster General Hospital, medicine consultation service, and pre-operative clinic as well as educational and elective opportunities such as quality improvement and systems based practice.

Longitudinal Research Track

Intended for those physicians interested in pursuing a career in basic, clinical or translational sciences, the research track offers dedicated residents protected time during their residency training to complete research with a dedicated research mentor. There are ample opportunities for basic and clinical research through the academic resources of the medical center, Penn State Heart and Vascular Institute and Penn State Cancer Institute, as well as Penn State College of Medicine. In addition to research opportunities during residency training we support the designated extended research tracks offered and supported through the ABIM.

ABIM Internal Medicine Research Pathway

The ABIM Research Pathway is an integrated program that combines training in research with training in clinical internal medicine. This pathway is intended for physicians who intend to pursue a career in basic science or clinical research.

ABIM Subspecialty Research Pathway

The ABIM also offers residents a “Subspecialty Research Pathway” requiring 24 months of Internal Medicine and a further 12 to 24 months in sub-specialty training, after which a subspecialty or added qualification (AQ) examination may be taken in the fall of PGY-6 or PGY-7 (dependent on specialty).

Ambulatory Training

Our program successfully implemented an ambulatory block schedule in the spring of 2013 to take the place of traditional weekly clinic sessions.

Our ambulatory block system enables residents to provide longitudinal patient care and reduce the number of clinic sessions during busy inpatient rotations, while still meeting ACGME requirements for outpatient training. This has significantly increased our residents’ satisfaction with ambulatory training.

During any two-week ambulatory block, residents provide longitudinal care for their patients in our primary care clinic but also spend time in other subspecialty clinics in order to experience the full spectrum of outpatient care and prepare for a career in primary care or any other subspecialty. Each ambulatory block has a general theme, based on the predominant area of outpatient medicine that it focuses on. For example, the musculoskeletal block includes exposure to sports medicine, rheumatology, podiatry and spine clinic. The hematology/oncology block includes sessions in palliative care clinic and clinical pathology, besides hematology and oncology clinics. Other outpatient blocks have a predominant focus on women’s health, endocrinology, gastroenterology, cardiology, geriatrics, allergy and immunology, mental health etc.  Our ambulatory curriculum also includes sessions in outpatient procedure clinic, clinic for the underserved, adolescent weight management clinic and the hospital M and M conference.

The ambulatory blocks include protected time for self-study, quality improvement projects, as well as half a day per week purely dedicated to medical education (academic half-day). Our academic half day features parts of our innovative curriculum in Evidence-Based Medicine (EBM modules and EBM consult) and the ACP High Value Cost Conscious curriculum. During the academic half day, residents engage in problem-based learning and have the opportunity to assume the role of teachers for their peers.

Direct observations (mini-CEX) and resident evaluations are integrated into the residents’ outpatient clinic schedule and allocated specific time, which ensures their completion.

Our longitudinal care clinic is a level III patient-centered medical home and is supported by our experienced staff. Our residents treat patients with a wide variety of disorders, ranging from routine primary care and prevention to more complex and esoteric problems.  Our residents also enjoy a very low patient no-show rate in their clinic, which allows them to quickly build and follow a patient panel.

Primary Care Track

Learn more about the Primary Care Track here.

Evidence-Based Medicine (EBM)

Our program places a unique emphasis on the EBM training of residents. We have developed a multi-faceted curriculum, which extends beyond traditional Journal Club:

  1. EBM scripts during academic half day enable our residents to discuss important EBM concepts such as surrogate outcomes and hierarchy of evidence, without being limited to a particular research study.  EBM scripts are based on clinical scenarios and teach such concepts in an interactive and enjoyable manner.
  2. Journal Club is held once a month during our academic half day and introduces different critical appraisal concepts for each session. Senior residents and attending physicians facilitate small group discussions, where each resident actively engages in critical study appraisal. We utilize a debate format and other interactive methods to engage our residents in the process.
  3. EBM consults during academic half day, are short (10-15 min) presentations from our senior residents, each tasked with answering a clinical question. Residents practice formulating a question, searching and appraising the literature and finally discussing findings with their peers. This allows residents to become familiar with sources of original research studies but also pre-appraised information such as the PIER modules, TRIP database etc.
  4. EBM mini-CEX allows our senior residents to practice the application of EBM principles in real time, while caring for their clinic patients.

In short, EBM scripts and Journal Club provide our residents with the necessary foundations of EBM and lifelong learning behaviors, while EBM consults and EBM mini-CEX ensure that our residents practice EBM in a format easily integrated into a busy clinical practice.

Resident Research

Our program has a rich history of resident research and scholarly pursuits, which is guided by both resident cooperation and strong faculty involvement. Resources such as the Resident Research Forum allow more clinically driven residents opportunities to produce high-quality peer-reviewed projects. The majority of our residents are completing their training with multiple achievements in the areas of research, publication, and podium/poster presentation at the regional, state, national and international level. In addition, opportunities such as our Research Track allows residents interested in pursuing research as a career protected time to devote to longitudinal research projects.

As an example, in past years our residents have presented at the following meetings:

  • ACC National Conference
  • ACG National Conference
  • ACP Regional and National
  • Allergy, Asthma, and Immunology National Conference
  • American Association for Bronchology and Interventional Pulmonology
  • American Thoracic Society & CHEST
  • American Society of Nephrology
  • Inflammatory Bowel Disease International Conference
  • International Academy of Cardiology
  • Pennsylvania Medical Society
  • Society of Critical Care Medicine
  • Society of General Internal Medicine
  • Society of Hospital Medicine

Current Projects

Current residents on the Longitudinal Research Track and a brief description of their research projects appear here.

Dr. Lionel Kankeu Fonkoua

Project title: Molecular Profiling of Gastric and Esophageal Carcinoma Cases: Examining Biomarkers with Potential Therapeutic Implications.

Mentor: Dr. Nelson Yee, Division of Hematology/Oncology.

Dr. Kankeu Fonkoua will work with his mentor to investigate a case series of a biomarker profile in gastric and esophageal carcinoma with associated treatment responses. The study aims to show associations between four targeted genes and chemotherapy response.

Dr. Simin Zhang

Project title: Cytokine Expression Profiles in Ulcerative Colitis: Providing Personalized Care and Predicting Treatment Responses

Mentor: Dr. Matthew Coates, Division of Gastroenterology and Hepatology, and Dr. Faoud Ishmael, Division of Pulmonary, Allergy, and Critical Care Medicine

Dr. Zhang will work with the mentors on a translational research project to determine whether gene expression of inflammatory mediators in colon tissue can be used as an assay to objectively measure, quantify, and characterize inflammation in ulcerative colitis. This information can be used to guide more effective treatment approaches (specifically tailored to each patient based on their inflammatory gene expression profile), predict disease outcomes, and identify inflammatory targets that may be used to generate novel therapeutics.

Conferences

Learn about the conferences that are part of the Internal Medicine Residency.

Resident Report

Led by the chief residents, resident report is held on Tuesday, Wednesday and Friday from noon to 1 p.m. Tuesday and Wednesday conferences are dedicated to clinical teaching and development of clinical reasoning through presentation of cases currently or recently admitted by the residents. A facilitated discussion about various aspects of the clinical scenario is guided by the chief residents. On Fridays, a variety of delivery methods are utilized to reinforce key concepts in Internal Medicine and Quality Improvement.

Academic Half-Day

An Academic Half-Day is held weekly in both the Inpatient and Ambulatory settings. One half-day a week is reserved for lectures from various departments presenting board-relevant topics. Our resident physicians have protected time to attend these didactic lectures. Each month the focus of the lectures is dedicated to a specific subject of internal medicine (i.e. general internal medicine, cardiology, nephrology, etc.). Faculty from our Division of General Internal Medicine as well as our subspecialty divisions provide board-relevant and up to date lectures to supplement the education our residents receive in clinical practice.

Journal Club

As part of our Evidence-Based Medicine (EBM) curriculum, Journal Club is held once a month during the inpatient academic half-day and introduces critical appraisal concepts specific for each session. Senior residents and attending physicians facilitate small group discussions, where each resident engages actively in critical study appraisal.

Grand Rounds

Tuesday mornings are reserved for Department of Medicine Grand Rounds. Here, invited guest speakers and our own experts present new research developments, updates on best clinical practice and other topics of interest from the broad realm of internal medicine. In addition to expert panelists, residents have to opportunity to present research results or challenging case presentations during resident grand rounds.

Morbidity and Mortality Conference

This conference is a peer-protected conference to evaluate cases with unexpected complications, medical errors or mortality. Focusing on education, system based practice and multidisciplinary quality improvement the M and M conference provides a forum for residents, faculty, nursing and administrative staff to explore the details of cases with unexpected outcomes in a blame free environment. Most cases are identified by residents, presented by the chief residents and integrated directly into quality improvement projects. This conference has proved to be a great opportunity for residents to learn and get involved in quality improvement, often with an immediate positive impact on patient care and clinical practice.

To Apply

Applications are accepted through ERAS only.

Deadline for applications is Dec. 31, and interviews are by invitation only.

Application Requirements

We prioritize applications with a minimum USMLE score of 200, however we review the entire application and do not base our decision solely upon the USMLE scores. DO applicants may submit COMLEX scores in lieu of USMLE scores.

We require a Chair’s Letter plus two additional letters of recommendation to be attached to your ERAS application.

The institution sponsors only J-1 visas for international candidates.

Your year of graduation should be within five years of date of application.

The NRMP requires all interviewees to receive a copy of the Resident Agreement. The current resident agreement can be found here.

Preliminary Program Requirements

Applicants to other disciplines (i.e. anesthesia, dermatology, neurology, radiology) requiring a preliminary year must submit a separate ERAS application to our Internal Medicine Preliminary Program in addition to the specialty application. Efforts are made to coordinate interview dates with other subspecialty interviews at Penn State Health Milton S. Hershey Medical Center, but cannot be guaranteed. Separate interview dates may not be necessary depending on the specialty program.

For further information regarding our program and/or a preliminary program interview, please email Debbie Stevens.

Program Leadership

Current Residents

Internal Medicine residents are pictured in a group wearing white coats outside Penn State College of Medicine.

Past Residents

Graduate Placement

The NRMP Fellowship Match has proven very successful for our residents with an overall success rate of greater than 95 percent. Of those who have applied to fellowship over the past five years, the majority have placed in one of their top three program choices even in the most competitive specialties.

2016-2017

Allergy/Immunology

  • Penn State Health Milton S. Hershey Medical Center (2)

Cardiovascular Medicine

  • Penn State Health Milton S. Hershey Medical Center
  • The Ohio State University

Gastroenterology

  • Penn State Health Milton S. Hershey Medical Center

Hematology/Oncology

  • Brown University
  • Penn State Health Milton S. Hershey Medical Center
  • University of South Florida Morisani

Hospice and Palliative Medicine

  • Luke’s – Bethlehem
  • UPMC-Altoona

Infectious Diseases

  • Hofstra LIJ

Nephrology

  • University of Texas HSC-San Antonio

Pulmonary/Critical Care

  • Maine Medical Center
  • Penn State Health Milton S. Hershey Medical Center
  • University of Massachusetts

Hospitalist Medicine (3)

Primary Care (1)

2015-2016 (100 percent match rate)

Cardiovascular Medicine

  • Penn State Health Milton S. Hershey Medical Center
  • University of Texas-Houston

Gastroenterology

  • Allegheny General (2)
  • Carilion Clinic-Virginia Tech Carilion SOM
  • Emory University
  • Penn State Health Milton S. Hershey Medical Center

Geriatrics

  • Johns Hopkins

Hematology/Oncology

  • Penn State Health Milton S. Hershey Medical Center (2)

Hospice and Palliative Medicine

  • University of Virginia

Nephrology

  • Yale-New Haven

Pulmonary/Critical Care

  • Penn State Health Milton S. Hershey Medical Center (2)

Hospitalist Medicine (5)

Primary Care (1)

2014-2015

Cardiovascular Medicine

  • Penn State Health Milton S. Hershey Medical Center (2)
  • Medical University of South Carolina

Endocrinology

  • Penn State Health Milton S. Hershey Medical Center

Geriatrics

  • NY Presbyterian Hospital, Weill Cornell Medical Center

General Internal Medicine

  • Penn State Health Milton S. Hershey Medical Center (Inaugural position)
  • University of Texas-Southwestern

Infectious Diseases

  • University of Maryland

Hospice and Palliative Medicine

  • Drexel University

Nephrology

  • University of Texas-Houston

Occupational Medicine Fellowship

  • University of Utah

Pulmonary/Critical Care

  • Penn State Health Milton S. Hershey Medical Center

Rheumatology

  • University of North Carolina

Hospitalist Medicine (5)

Primary Care (2)

2013-2014

Allergy/Immunology

  • North Shore-LIJ Health System, NIH Physician-Scientist Program T32

Cardiovascular Medicine

  • Penn State Health Milton S. Hershey Medical Center (2)
  • Thomas Jefferson University
  • University of Utah

Gastroenterology

  • Geisinger Health System
  • Penn State Health Milton S. Hershey Medical Center (2)

Hematology/Oncology

  • Penn State Health Milton S. Hershey Medical Center

Hospice and Palliative Medicine

  • Community Care of Lancaster

Rheumatology

  • Georgetown University

Hospitalist Medicine (7)

2012-2013

Allergy/Immunology

  • Penn State Health Milton S. Hershey Medical Center

Cardiovascular Medicine

  • Deborah Heart and Lung
  • Penn State Health Milton S. Hershey Medical Center (2)
  • St. Luke’s Hospital
  • Medical University of South Carolina

Critical Care Medicine

  • Cleveland Clinic

Gastroenterology

  • Penn State Health Milton S. Hershey Medical Center (3)
  • University of Minnesota

Hematology/Oncology

  • Mayo-Rochester

Pulmonary/Critical Care

  • Penn State Health Milton S. Hershey Medical Center (2)

Hospitalist Medicine (7)

2011-2012

Allergy/Immunology

  • Penn State Health Milton S. Hershey Medical Center

Cardiovascular Medicine

  • Emory University
  • Penn State Health Milton S. Hershey Medical Center (2)
  • University of Miami
  • University of Vermont-Fletcher Allen

Gastroenterology

  • West Virginia University

Hematology/Oncology

  • Penn State Health Milton S. Hershey Medical Center
  • SUNY, Stonybrook

Infectious Diseases

  • Penn State Health Milton S. Hershey Medical Center

Nephrology

  • Penn State Health Milton S. Hershey Medical Center

Rheumatology

  • University of Alabama

Hospitalist Medicine (9)

Contact Us

Mailing Address

Department of Medicine
Penn State Health Milton S. Hershey Medical Center
PO Box 850, Mail Code H039
500 University Dr.
Hershey PA 17033-0850

General Contact Information

Phone: 717-531-8903

Email: dstevens@pennstatehealth.psu.edu

Twitter: @PSU_IM_RES

Penn State College of Medicine is an equal-opportunity employer and accepts all qualified applications regardless of their gender, ethnic origin or religious background.