Internal Medicine Residency
Tracks in Primary Care and Global Health
Excellent fellowship placement and ABIM exam pass rates
Clinical research opportunities
Team-based care, with inpatient geographic units and multidisciplinary rounds
Comprehensive bedside ultrasound curriculum
Innovative primary care models which address social determinants of health
Strong commitment to resident wellness
About Our Program
Exceptional clinical training, outstanding teaching, research opportunities, and a program with a mission to care for diverse and vulnerable populations
HCMC residents are the cornerstone of the institution. They have ownership over patient care decisions, lead ward and consult teams, run CODES, play key roles in quality improvement, and promote innovation in medical education and health care delivery. They foster a welcoming environment, first and foremost for our patients, but equally for co-residents, students, hospital and clinic staff. Resident play a central role in making HCMC the single-most requested teaching site for University of Minnesota medical students every year.
Hennepin’s teaching faculty are regionally and nationally-recognized, and hold academic appointments at the University of Minnesota. Our formal curriculum includes large and small-group teaching, bedside and procedural training, ultrasound training, simulation, on-line learning and procedural training. Education at HCMC is hands-on, challenging, interdisciplinary and meaningful, with excellent mentorship and support from peers, fellows, faculty, nurses, pharmacists, social workers and therapists. Graduates train in a collegial environment, are well-prepared to care for diverse populations, and have opportunities to develop valuable skills in quality improvement, bedside ultrasound, procedures, clinical research and global medicine.
As a Level I Trauma Center, and Minnesota’s only public teaching hospital, HCMC cares for a very unique urban patient base. We serve the largest Medicaid population by percentage in America, including numerous immigrant communities, and function as a referral center for rural Minnesotans with traumatic injuries and complex acute and chronic diseases. Residents provide extraordinary service to the community as they learn to manage a broad range of common and rare conditions, address social determinants of health, and advocate for vulnerable populations.
About Our Curriculum
ACGME Recognized for Innovation in Education
The three-year categorical Internal Medicine program delivers a comprehensive, hands-on education that enables our residents to take an early and active role in patient care while working side-by-side with experienced specialists. Every resident has a voice in the program, from providing day-to-day feedback to creating individualized career development plans with a faculty advisor.
We continually update and enhance our curriculum to provide the best possible training and patient outcomes. From 2005-2015, we participated as one of only 21 sites in the U.S. for the "Educational Innovations Project" sponsored by the Accreditation Council of Graduate Medical Education (ACGME). Under this project, our curriculum served as a model for other institutions, centered around three focus areas:
- Enabling residents to immerse themselves in a clinical setting by separating ambulatory clinic responsibilities from inpatient ward service rotations.
- Supporting residents in quality improvement projects based on their clinical experience.
- Encouraging residents to tailor their third year of training through an interactive evaluation and mentoring system.
Across our rotations and didactics, we maintain a well-earned reputation for our collegial atmosphere and supportive environment that fosters great patient care and learning.
Dedicated faculty, active learning, and a dynamic curriculum
The Internal Medicine residency offers numerous didactic opportunities, including traditional educational methods like morning report and noon conference coupled with small group case-based learning, simulation, and procedural training.
- Held daily, immediately before morning rounds.
- Coffee and light breakfast provided.
- Chief residents run an interactive, case-based learning session that attracts approximately 30 residents and medical students daily.
- Attended by Dr. Scott Davies, Chief of Medicine, and other key teaching faculty, and other key teaching faculty
- Cases focus on deductive reasoning in diagnosis, interpretation of physical exam and laboratory studies, and generation of a nuanced differential diagnosis.
- Daily, Monday through Friday.
- Also available online.
- Grand Rounds, teaching staff and visiting professors discuss areas of innovation and developing research.
- Core Curriculum Lectures - clinical updates on the management of common diseases
- Rotating Case-Based Subspecialty Discussions - Case-based conferences include Clinical Cardiology, Chest/ID conference, and a monthly Morbidity and Mortality conference highlighting a systems-based approach to reducing medical errors.
- Monthly academic half-day session for all residents.
- 2-3 hour teaching case focused on an area of medical knowledge
- Residents work in small groups to answer several questions on a topic such as dysnatremias or cardiac arrhythmias, using online access to evidence-based medical resources.
- Focuses on how to acquire, assess, and apply the best evidence to a specific case.
- Simulation training, code training, palliative care, and cost-conscious care topics addressed.
- Specialists discuss cases and review key learning points.
Evidence-Based Medicine Course
- One month course, meets two hours weekly.
- For residents in both the PGY-2 and PGY-3 years.
- Faculty provide training on study design, including how to assess and apply evidence to answer clinical questions.
Bedside Ultrasound Course
- One-on-one training sessions with HCMC’s echocardiogram technologists to develop bedside echocardiography skills.
- Led by the pulmonary critical care and cardiology divisions.
- Coursework includes assessment of global cardiac function, valvular function, pericardial abnormalities, and assessment of IVC/volume status.
- Hands-on training includes both models and critically ill patients in the MICU.
- Emphasis on practicality and utilizing bedside information to improve clinical decision-making.
Global Health Course
- Tropical and Travel Medicine course held annually at the University of Minnesota.
- Accredited by the American Society of Tropical and Travel Medicine.
- Open to all residents as an elective rotation.
- Features lectures from experts on infectious disease, public health officials, and leaders of major aid organizations.
- Includes applied lab work and information on setting up direct care and research initiatives abroad.
Simulation Center Activities
- Comprehensive simulation and procedure curriculum.
- Conducted in HCMC’s new state-of-the-art Interdisciplinary Simulation and Education Center.
- Focus areas include code response, cardiovascular emergencies, ambulatory scenarios, and central line teaching.
- Opportunities exist for residents to develop their teaching skills through curriculum design and execution of simulation scenarios.
- Weekly pre-clinic small group conference.
- These interactive, case-based teaching sessions focus on the evidence base for outpatient management of common diseases, and foster both collaborative learning and teaching skills in senior residents.
- In PGY-1, we pair each resident with a faculty advisor, who may also serve as a research advisor.
- Residents may apply up to one month per year of Electives toward research.
- Each PGY-2 resident completes a Quality Improvement Project using a systems-based practice and personal clinical experience.
- Additional opportunities exist for clinical outcomes-based or quality improvement research.
- Our residents routinely present at national specialty organizations.
- HCMC operates the Minneapolis Medical Research Foundation, a subsidiary of Hennepin Healthcare System, Inc., and operates as the research arm of Hennepin County Medical Center. MMRF is the third-largest nonprofit medical research organization in Minnesota and consistently ranks in the top ten percent of all institutions receiving research funding from the National Institutes of Health.
About Our Faculty
More than 160 faculty members comprise the Department of Medicine at HCMC, representing each subspecialty of internal medicine. These experienced physicians and teachers have been with us for many years, and their long-term commitment to education enables us to offer a consistently strong program.
Many faculty are nationally recognized as leaders in their fields, and all are active in research, teaching and patient care. All hold appointments at the University of Minnesota Medical School in addition to their practice at HCMC. In addition, five basic and clinical scientists also hold appointments.
- Dr. Rosemary Quirk, Program Director, Internal Medicine Residency at HCMC and Assistant Professor at the University of Minnesota
- Dr. Michael Lawson, Associate Program Director, Internal Medicine Residency at HCMC and Assistant Professor at the University of Minnesota
- Dr. Sam Ives, Associate Program Director, Internal Medicine Residency at HCMC and Assistant Professor at the University of Minnesota
- Dr. Wendy Miller, Associate Program Director, Internal Medicine Residency at HCMC and Assistant Professor at the University of Minnesota
Global Health / Primary Care Pathways
Intensive Training Opportunities in Primary Care and Global Health
Primary Care Pathway
Launched in 2010, the Primary Care Pathway provides targeted training and career development for those Internal Medicine residents interested in primary care. Our curriculum focuses on outpatient management in urban and underserved patient populations.
- Block rotation: Participants spend four months of each year on a Primary Care Block rotation, which provides more experience in their own Continuity Clinic practices and time for sub-specialty ambulatory sessions. These include rotations in the following:
- Health Care For the Homeless
- Home Visits for their own primary care and geriatric patients
- Medicine sub-specialty clinics such as Cardiology, Gastroenterology, Hematology/Oncology, Renal
- Breast Cancer clinic surgery clinic
- Additional primary care training at community clinic sites
- Specialized primary care clinics focused on disease panel management (eg: Diabetes clinic, Asthma clinic)
- Forum: Dedicated, weekly half-day didactic session during the PCP block with primary care focused journal club and collaborative teaching from physician faculty, nurses, pharmacists, and physical therapists about topics such as chronic care management, ambulatory procedures, and practice management.
- Other experience: Primary Care Pathways participants also participate in a breakfast book club with guided discussions about the chosen book. Previous books have ranged from Being Mortal by Atul Guande, to American Pain by John Temple.
The Primary Care Pathway program accepts 2-3 residents per class. Applications are accepted after the match and participants are selected based on demonstrating a strong interest in primary care for the urban underserved. There are limited opportunities to join the pathway in the G2/G3 year as scheduling permits.
Global Health Pathway
After match, Internal Medicine residents seeking further experience with international health may apply for the Global Health Pathway program. The Global Health Pathway provides a rigorous and structured education in global health, focused on delivery of care in developing countries, and to immigrant and refugee populations. Program participants benefit from collaboration and learning at international sites, additional mentoring and guidance about careers in international medicine, and priority scheduling for international rotations.
- Structured curriculum based on ACGME core competencies. A framework based on the ACGME core competencies of medical knowledge, patient care, communication, professionalism, and system-based practice guides the Global Health Pathway program. The program helps participants increase their awareness of health disparities and the many factors that influence health and disease; promotes cross-cultural sensitivity during clinical experiences; and fosters greater dialogue and professional development among residents, HCMC faculty, and other healthcare professionals.
- Collaboration with University of Minnesota. Since 2006, HCMC and the University of Minnesota Medical School have combined resources to sponsor the Global Health Pathway. Participants attend the Global Health Course and Tropical and Travel Medicine lecture series held at the University of Minnesota, and have access to numerous international clinical sites who partner with the University.
- Faculty mentoring in global health careers. Additional training in international health opens the door to many career opportunities. Global Health Pathway participants meet twice annually with a designated faculty mentor for one-on-one guidance about their personal career interests.
- Dedicated partner institutions. PGY-3 participants spend a one-month elective working at a healthcare facility outside the U.S. HCMC maintains established facilities at a number of sites around the world. Residents may also access the University of Minnesota’s international sites, work overseas with HCMC faculty, and in special circumstances, design their own elective experience.
- Priority for international rotation opportunities. PGY-2 participants must use their elective to attend the Global Health Course held at the University of Minnesota, which then guarantees first priority in choosing an international rotation during PGY-3. Past Global Health Pathway locations include Cameroon, Costa Rica, El Salvador, Kenya, Madagascar, Nepal, Pakistan, Peru, South Africa, and Tanzania. (Residents are not limited to these locations.)
International Rotation Sites
Through HCMC’s partnership with the University of Minnesota, program participants can access a variety of partner institutions, including:
- UCIMED in Costa Rica: A medical school with associated hospitals and clinics. Rotations include inpatient rotations on general ward services, consult services such as ICU and tropical medicine, research, and outpatient work. Conversational Spanish is required.
- St. John’s Medical College in Bangalore, India: A medical school with a large hospital and multiple outpatient clinics on site. Rotations include research, especially in nutrition and infectious disease, ICU, public health, and general medical wards. English is spoken.
Global Health Pathway participants can also take advantage of institutional relationships held by the University of Minnesota, which include: Selian Lutheran Hospital in Arusha, Tanzania; Chiang Mai University in Chiang Mai, Thailand; and Makerere University in Kampala, Uganda.
Other possible sites include: the University of San Antonio in Cuzco, Peru and the University of the West Indies, in Jamaica.
The Global Health Pathway program accepts two residents per class. Applicants should demonstrate a strong interest in a career overseas or in working with refugee and immigrant populations in the U.S. or a foreign country. International rotations are open to all Internal Medicine residents, however, preference is given to Global Health Pathway participants, followed by PGY-3 residents, then PGY-2 residents. Traveling residents are selected by formal application beginning in September of each year.
- July: Informational overview of Global Health Pathway program
- September 1: Application opens
- October 1: Application deadline
- November 1: Participants selected
- April: Applications due for international rotations
Applications Due November 15
- Medical school transcripts
- Dean's letter
- Three letters of recommendation from faculty supervising inpatient rotations
- USMLE and/or COMLEX scores
- Personal statement
Non-resident applicants are welcome to apply. HCMC sponsors the J1 visa only. International graduates must meet the following requirements with no exceptions:
- Have at least twelve weeks U.S. inpatient experience at a U.S. academic teaching hospital (observerships considered)
- Achieve a score of 220 or higher with a first-time pass on USMLE steps 1, 2, and CS
- Apply within five years of medical school graduation
We consider applications and extend interviews on a rolling basis, beginning October 1.
- Submission: Submit your application through the Electronic Resident Application System (ERAS). Contact your medical school’s student affairs or dean’s office for instructions. We do not accept applications through the mail. HCMC participates in the National Resident Match Program (NRMP).
- Scoring: Each applicant will be scored based on these criteria.
- Board scores
- Medical school transcripts
- Honors and accomplishments
- Dean’s letter
- Letters of recommendation
- Personal statement
- Demonstrated commitment to serving a safety net population
- Interviews: Selected applicants will be invited for interviews. We hold interviews beginning October 15.
What Sets Us Apart?
HCMC serves patients who speak dozens of languages and are supported by one of the largest hospital interpreter programs in the nation. The Global Health curriculum and Global Health electives enable residents to learn more about international healthcare delivery and travel to places as diverse as Nepal, Papua New Guinea, Thailand, Peru, Laos, Cameroon, Pakistan and South Africa.
Our residents work within existing clinical trials, publish articles in top journals, and present scholarly work at regional and national meetings. Residents obtain statistical support, faculty expertise and other scholarly resources to accommodate every interest and experience level.
Simulation, Bedside Ultrasound and Procedural Training.
We have a state-of-the-art Simulation Center with task trainers for a wide variety of procedures, as well as online and in-person resources for learning and mastering bedside ultrasound and developing competency in central and A-line placement, paracentesis, thoracentesis and other procedures.
Employment and Fellowship Opportunities.
Roughly half of our graduates go on to fellowships, and place in competitive programs across the country. Our primary care and hospitalist graduates are in high demand for challenging clinical positions.
Focus on Wellness.
Residents in our program have very high rates of wellness, peer support, job satisfaction and appreciation, which we’ve been measuring annually since 2014.
Primary Care Track.
Our Primary Care pathway allows residents to rotate at additional outpatient sites, further develop ambulatory procedural skills, and receive focused education in chronic disease and practice management.
Educational Innovations Project.
Our program was chosen to be part of an ACGME collaborative focused on curriculum innovation in continuity clinic.
About Our Facility
HCMC is a Level 1 Adult and Pediatric Trauma Center, with a campus spanning five city blocks in downtown Minneapolis. We have the busiest Emergency Department in the region, as well as a brand new ambulatory building for all outpatient surgeries and procedures. In the past ten years, the MICU, SICU, Burn Unit, dialysis unit, Rapid Treatment Unit for observation patients and Simulation Center were either rebuilt or renovated.