Internal Medicine

A letter from the Program Director, Dr. Bernard McGuire

As you begin your fourth year in medical school, you may have the opportunity to consider electives or free time blocks at institutions other than your University. Furthermore, as the year progresses you will begin to contemplate postgraduate training in the discipline of your choice. Thus, I am writing to inform you of undergraduate and graduate medical education opportunities, which are available at St. John's Mercy Medical Center in west St. Louis County, Missouri. My specific purpose is to introduce you to the opportunities in the Department of Internal Medicine, but this Web site describes several other training programs that exist here.

St. John's Mercy Medical Center, an 979-bed, modern, well-equipped hospital is a member of the Council of Teaching Hospitals. The Department of Medicine has 35 geographic full-time teaching staff in the various divisions of the Department. Also, several general internists and subspecialists serve as volunteers in the teaching programs.

Undergraduate electives available

The undergraduate electives available for junior or senior medical students include a sub-internship on general medicine, cardiology (coronary care unit and/or consult service), endocrinology, gastroenterology, infectious diseases, neurology, nephrology, pulmonary diseases, hematology/oncology, allergy/immunology and rheumatology. Many students from regional medical schools have spent elective months in the Department. While here, students are provided free parking, a meal ticket and access to the Wellness Center. I hope that you will consider spending an elective or free time month at this excellent Medical Center. Please click here to print an application. Any inquiries about the existing requirements, months that are available, structure of the elective, and other issues, may be obtained by calling the Chief Medical Resident at (314) 251-6960.

Emphasis on teaching

The Graduate Training Program in Internal Medicine is fully approved by the Residency Review Committee of the Accreditation Council of Graduate Medical Education and fully compliant with the ACGME work hour guidelines. We place a strong emphasis on teaching, which is accomplished through a variety of mechanisms.

Teaching attending rounds occur 4 days a week, 90 minutes per session, with a significant bedside component. These rounds are conducted by members of the staff who are skillful and enthusiastic teachers. The faculty has teaching as their only responsibility during these rounds. Similar teaching rounds occur in the Coronary Care Unit and the Intensive Care Unit.

Formal teaching conferences are held five days a week and are rotated among the medical subspecialties, discharge conference, patient management conference, chief resident's rounds, and the Morbidity & Mortality Conference.

Medical Grand Rounds is held weekly with speakers from our teaching staff, faculty of the Department of Medicine at the University of Missouri-Columbia with which we are affiliated, and Visiting Professors from throughout the United States.

Interns have night call every 4th to 5th night during the months on inpatient services. The only night call that is scheduled for interns during the months of elective and Ambulatory Care Clinic is one evening of "short call" from 5 p.m. until 9 p.m. for the purpose of answering cross-coverage inquiries. When averaged over four weeks, our residents spend no more than 80 hours per week on patient care duties while on inpatient rotations. Furthermore, our residents average at least one full day out of seven free of patient care responsibilities while on inpatient rotations.

A Variety of Ambulatory Care Experiences

Ambulatory Care training occurs in two settings: Our hospital John F. Kennedy (JFK) Clinic and also in private general internal medicine clinics.

Each incoming house officer is assigned to a continuing care clinic in JFK every other week for 3 years and sees 5 to 9 patients per session. These sessions provide the house officer with exposure to the types of problems he or she would encounter in office practice and promote familiarity with the ancillary services used there. The resident cares for patients during an extended period and develops an appreciation for the social and psychological aspects of patient care.

During the second year, two months are devoted to Ambulatory Care. Each resident obtains experience vital in the preparation for transition into private practice by working in a private ambulatory care setting one half day per week. This allows residents to obtain real life experience with patients in the community that participate in a variety of managed care and private insurance plans.

During each of the three years each resident spends one month entirely in the JFK Ambulatory Care Clinic. This rotation allows them to increase their patient population and enhance overall experience in the outpatient setting. Each resident is assigned a group of patients for whom he or she is the primary care physician. When a patient from the JFK Clinic is hospitalized, the resident who has been caring for him or her as an outpatient continues to work with the hospitalist team in delivery of care.

Visit our Training Experiences page for more detailed information about ambulatory care training.

Excellent Medical Library

Our medical library contains approximately 9,000 bound volumes and 350 professional journals, including 100 electronic journals, that are available to house officers 24 hours a day. Books or journals not stocked on site are available within 24 hours through interlibrary loan. In addition, personal computers in the Medicine Department office are available at all times to provide residents unlimited access to Internet sites including MD Consult, Up-To-Date, and numerous online databases and textbooks available under the OVID umbrella.

Fellowship & Career Opportunities Abound

Residents who complete our program have many opportunities to practice general internal medicine in the St. Louis metropolitan area or elsewhere. A program exists within the institution for assisting residents in identifying and starting a practice.

Since the year 2000, our program has graduated 53 internists. Twenty-six of them (49%) have entered the primary practice of internal medicine. Four of them (8%) have chosen careers as hospitalists. Twenty-three of them (43%) have placed in fellowships of their choice. This includes four in cardiology, four in hematology/oncology, four in critical care, three in rhematology, three in endocrinology, two in geriatrics, and one each in gastroenterology, pulmonary, and allergy/immunology.

Our residents have performed well on the ABIM Certifying Exam. During the past three years, 95% of our residents passed the ABIM certifying exam the first time they sat for it. See our residents' recent career destinations.

Beginning in August of 1998 we began participating in the Association of American Medical Colleges' Electronic Residency Application Service (ERAS). We will only be accepting applications for the match in internal medicine through this service.

I hope this information is helpful in your deliberations about applying for training with us. We realize that this Web site covers only a portion of what you may want to know about our program. We look forward to hearing from you by phone, mail or in person to further discuss the excellent opportunities that St. John's Mercy Medical Center has to offer.

Sincerely,
Bernard J. McGuire, MD, FACP
Director, Residency Training Program
Department of Medicine

Inquiries can be made to:
Cam Aulgur
Office of Resident Coordinator
621 S. New Ballas Road, Suite 3019
St. Louis, MO. 63141
314/251-6595
aulgca@stlo.mercy.net