The purpose of morning report is to teach residents how to think. This includes an emphasis on clinical reasoning, test characteristics, and cognitive bias. Some reports focus on diagnostic challenges, others focus on management decisions. Morning Report is run by the Chief Residents and attended by the Program Director, Mark Siegel, as well as a few core faculty members or invited consultants. Interns and residents volunteer to present a recent or current patient from their service. The presenter is expected to share the history, physical exam, and primary data including labs and imaging for the patient. We emphasize personal review of primary data (including chest X-rays, CT scans, ultrasound, and EKGs) to enhance housestaff interpretive skills. Then, as a group, we focus on summarizing the case into a succinct syndrome around which we build our differential diagnosis. Residents are expected to share their opinion about the "most likely" diagnosis and their estimation of pre-test probability of that diagnosis. The conversation is resident-run, with faculty interjecting only when they feel they have a pearl or tip to add. At the end, the presenter shares the hospital course of the patient and takes an active role in discussion some teaching points related to the case.
Medical Grand Rounds:
The Department of Medicine at Yale prides itself in the quality of its Medical Grand Rounds. The following are broad categories of subjects generally selected:
- Patients whose problems lend themselves to discussions by clinical faculty, chief residents, or clinician scientists of:
- Dilemmas in diagnosis or management
- Science underlying the disease (often discussed by faculty whose scientific work is in that area)
- Ethical issues
- Issues related to access to health care in the U.S.
- Faculty experiences with clinical work or research in low-resource areas
- Faculty experiences in disaster areas
- Medical errors and quality improvement
- Medical humanities
- Other Annual Named Lectures:
- Paul Beeson Visiting Lectureship
- Samuel Their visiting Lectureship
- John Peters Lecture: given by an eminent visiting endocrinologist or nephrologists in alternate years
- Massimo Calabresi Lecture given each year by an eminent visiting cardiologist
- Paul Calabresi Lecture in Medical Oncology given by an eminent visiting endocrinologist
- Gerald Klatskin Lecture given each year by an eminent hepatologist
- Samuel Kushlan Lecture given each year by an eminent gastroenterologist
- Ralph Horwitz Lecture given each year by a young clinical investigator
Noon conferences are lectures from faculty and chief residents on various topics. During the summer, noon conferences focus on high-yield topics in inpatient medicine to help interns triage the most common issues that arise in the hospital. They are open to all housestaff but are specifically focused on the needs of new interns. They are held at Yale and at the V.A. and posted online for review afterwards.
Ambulatory Medicine Didactics
Outpatient didactics include outpatient report, case discussions from the Yale Office-Based Medicine Curriculum, and educational half-days. Outpatient report occurs once per week during lunch at the Yale Primary Care Center and the VA. Report is led by a PGY3 who discusses a diagnostic or therapeutic challenge involving a patient from their continuity panel. It is an informal discussion among interns and residents with additional guidance provided by chief residents or faculty. In addition, residents get protected time to discuss cases from the Yale Office-Based Medicine Curriculum, which cover all topics in ambulatory medicine over the course of 3 years. Lastly, every Friday morning during clinic blocks is dedicated to educational half-days, in which focus on building skills and knowledge base. Themes for these half-days change every year and have included: health policy, women's health, musculoskeletal exams, pain management, geriatrics and palliative care in the outpatient setting, and mental health.