Texas Health Presbyterian Hospital Dallas is one of 17 acute-care hospitals in the Texas Health Resources hospital network, the largest healthcare system in North Texas. Texas Health Presbyterian Hospital Dallas is an 888-bed community hospital located in North Dallas. It is a Level I trauma center, comprehensive stroke center, and Joint Commission Certified in chest pain and heart failure. It is designated as a Magnet hospital by the American Nurses Credentialing Center, and honor that recognizes hospitals for excellence in nursing. It joins an elite group of just three percent of U.S. hospitals to have been honored with Magnet designation multiple times.
A large and diverse patient population provides the residents with ample exposure to rare as well as common diseases. Residents also gain exposure to a variety of health care delivery systems including Medicare, Medicaid, indigent care, managed care, and private payors. The diversity of patient population and health care delivery systems assures that residents have exposure to the full spectrum of medical problems. Residents provide increasingly independent patient care as they progress to the next postgraduate year level. At the completion of their Internal Medicine training, all residents are able to provide independent comprehensive medical care, even for patients with the most complicated and serious illnesses.
Residents receive admissions from the emergency room, private attending physicians, the ambulatory clinic patient population, and two hospitalist groups. Each ward team, which is on call every fifth night, consists of one resident and one or two interns. Each intern cares for a maximum of 10 patients at a time.
Interns are responsible for admitting/discharging patients, writing orders and daily progress notes, and following up on tests. The resident is encouraged to develop teaching skills and review medical literature in order to provide the interns with guidance to manage patients optimally. Each member of the ward team is scheduled five days off per month.
Formal teaching rounds are conducted three times a week by a faculty member or by a hospitalist based on call schedule. Pathophysiology, diagnosis and treatment plans for patients are discussed in detail.
The ICU rotation is an opportunity for residents to develop proficiency in the care and management of critically ill patients. ICU multidisciplinary rounds allow all team members to collaborate in order to determine the best course of treatment for patients, emphasizing quality care and patient safety. The team consists of intensivists, residents, nurses, respiratory therapists, pharmacists and social workers. Texas Health Dallas uses an "open" ICU system which facilitates continuity of care and communication between the ICU and primary team.
Categorical residents spend one half day per week in the Internal Medicine Clinic. Residents are assigned patients for whom they are responsible during the entire three-year training experience. This continuity of care model provides residents with exposure to a patient care setting similar to one many will enter upon completion of their training. An additional month, dedicated to ambulatory medicine, must also be completed in the second or third year of training.
The clinic staff consists of two faculty, registered nurses, medical assistants and a patient care representative. A multidisciplinary approach to patient care is practiced utilizing the services of nurses for patient education as well as a pharmacist.
In addition to providing primary care for hospitalized patients, residents at all levels perform subspecialty consultations. Each resident will have the opportunity to spend at least one month in each subspecialty of Internal Medicine. One-on-one teaching and mentoring from faculty provide an optimal subspecialty learning experience. Interns and residents have no scheduled night call responsibilities while on consultation services and generally do not work on weekends.
Private Practice Experience
Faculty members have very active private practices. The residents have the opportunity to work with these physicians in their offices. This experience provides exposure to both the medical as well as the business issues of private practice.
Texas Health Presbyterian Hospital Dallas offers six one-year preliminary internship positions for applicants planning on continuing with specialty training elsewhere. We engage all team members including those who are with the program for only one year. Our "prelims" experience the same challenges as the categorical interns with some exceptions. The preliminary interns do not work in the outpatient clinic but have the opportunity to work in many subspecialty outpatient clinics. They are offered the same elective opportunities and subspecialty experiences (except Nephrology) with a focus on their future specialty training. Texas Health Presbyterian Hospital Dallas continues to attract many talented preliminary applicants and sends them to their respective specialty training programs with the confidence and experiences that will help them succeed.