Chief Resident's Message
Caroline Cubbison, MD
Chief Medical Resident
Welcome to the Salem Hospital Internal Medicine residency program. Thank you for your interest in our program. I hope the following information gives you a sense of what makes our hospital a truly exceptional place to pursue your residency training. The residency program is committed to outstanding resident training, while fostering a supportive and collaborative environment with emphasis on continuous improvement. Our graduates go on to develop successful careers in primary care, hospital medicine and various subspecialties around the country. More uniquely, several of our residents enjoy staying in or returning to Salem Hospital for their clinical practice.
Residents care for a diverse patient population on the medical floor and the ICU through a multi-disciplinary team consisting of attending physicians, senior residents, interns, nurses, pharmacists, case managers and social workers. We also work very closely with Physical Therapy, Occupational Therapy, Speech Therapy and Nutrition Services teams. This allows for a well-rounded learning experience and seamless patient care for our inpatients.
Over the 3 years of training, all residents rotate through multiple specialties including: general internal medicine, critical care, cardiology, emergency medicine and urgent care, neurology, geriatrics and other subspecialties. Our neurology and medicine consults rotations are done at Massachusetts General Hospital in Boston. This combination of rotations comprises a well-rounded and hands-on clinical experience to help develop a strong foundation in internal medicine.
New for 2021-2022, we are implementing a structured Addiction Medicine Curriculum to augment our resident’s knowledge about Addiction and the various treatments and harm reduction strategies we can employ to better serve our patients.
Starting in June 2020 we shifted to an “X+Y” schedule format. This means that for 4 weeks (the “X”), residents will work on inpatient care (ICU/ Wards) or rotate on elective rotations which could be ambulatory or inpatient as well (e.g. Gastroenterology, Infectious Diseases, Pulmonology, Palliative Care, etc.). On week 5 (the “Y”), our residents experience a rich mixed week as shown below:
- Continuity Clinic (Categorical Residents):
Our outpatient continuity clinic experience is fantastic and was improved after switching to our X+Y format. Every fifth week of the year categorical residents will attend their continuity clinics and build their patient panels under the guidance of faculty at a North Shore Physicians Group outpatient site. Being a stone’s throw away from several of the country’s most robust medical centers means residents care for patients with both common and rare conditions and gain excellent exposure to management for a multitude of illnesses. Clinic sites are within a 10-15-minute drive from our main hospital.
- Urgent Care Exposure (Preliminary Year Residents):
Cognizant that ambulatory medicine exposure may be limited for Preliminary Year residents, one day of their Y week is spent working at the outpatient Urgent Care at North Shore Physicians Group in hopes of expanding their exposure to outpatient internal medicine.
- Interdisciplinary Exposure Day:
Residents are encouraged to work alongside another department or specialty (such as Hospice, Echocardiography, Pulmonary Function Testing Lab, IV Therapy, etc.) to better understand how the medical system functions and expand their knowledge of adjunctive department roles and procedures. Categorical residents spend one day with another discipline during their Y week, while Preliminary year residents spend two days.
To increase resident satisfaction and afford an opportunity for residents to accomplish personal appointments or responsibilities, categorical residents have a dedicated Wellness ½ day during their Y week that may be used as pleased. Preliminary year residents have an entire day of Wellness for the same purposes.
- Quality Improvement training through the Clinical Process Improvement Program (CPIP):
In line with a culture of constant growth, there is a dedicated half day session for our quality improvement (QI) curriculum. This focuses on enhancing skills in improving the practice of medicine and health care design. Our projects are sponsored by the Albright Read Institute for Quality Improvement. Residents are encouraged to initiate their own projects which are carried out longitudinally throughout the year and may be expanded to span all three years of training. Past projects have decreased the use of unnecessary telemetry monitoring; improved central line access placement; and advanced code status and goals of care documentation for inpatients, to name a few. Resident-initiated QI projects have recently been accepted for presentation at national society meetings such as the Society of Hospital Medicine.
- Academic Half Day:
Residents are afforded dedicated time to complete training in different areas such as CITI Certification and Suboxone waiver training. Dedicated time for preparation of presentations such as Journal Clubs, Morbidity and Mortality Reports, and Peer Reviews is also given during this time.
Well established didactics are integrated all throughout the three years of training at Salem Hospital. Learning occurs in various forms including:
- Daily morning reports presented by residents under the supervision of attendings from either hospital medicine or subspecialties
- Noon conferences with topics selected based on residents’ request and presented by subspecialists both from Salem Hospital as well as Massachusetts General Hospital and Dana Farber Cancer Institute.
- Department of Medicine Grand Rounds on Friday mornings
- Bimonthly Simulation Lab where residents practice and hone their abilities to stabilize patients with direct observed feedback
- Monthly Journal Club
- Monthly Morbidity and Mortality Conference where multidisciplinary specialties are invited to discuss options to treat, prevent and improve medical care.
As residents of Salem Hospital, we pride ourselves in working well together both inside and outside the hospital. During residency, we have developed very close friendships with each other and we truly consider the people at Salem our family away from home. Additionally, we also make the most of numerous hiking trails, parks, marinas, ski resorts and museums in the neighboring towns. The hospital’s proximity to Boston affords the residents the opportunity to enjoy some of the best food, culture, sporting events and night life in New England.
Thank you again for considering Salem Hospital Internal Medicine residency program in your search for a training program. Personally, I cannot be happier to have spent three years as a resident here and I am honored and excited to be here for my Chief Year.
Please do not hesitate to contact me with any additional questions.
Caroline Cubbison, MD
Chief Medical Resident