Zucker School of Medicine at Hofstra/Northwell Internal Medicine Residency Program at Norwalk Hospital

Our 3-year categorical residency program has adopted the 4+2 curriculum model. Rotations are divided into 13 blocks consisting of 2 weeks each. Residents have separate blocks of inpatient and outpatient rotations, and alternate between 4- week rotations in the hospital and 2- week rotations in the outpatient continuity clinic or on elective. The benefits of the 4+2 model are enumerated below:

• Balanced scheduled allowing focus in each aspect of medicine without being pulled for other commitments
• Minimization of conflicts between inpatient and outpatient responsibilities
• Improved transitions of care and preservation of inpatient team structure
•  Protected weekly Academic Half days as well as protected administrative time during Ambulatory Block.
• Promotion of work-life balance

The chart below illustrates rotations by year of PGY training in weeks:

*For residents interested in Global Health, a 6-week international elective is available during the PGY-2 or PGY-3 year. Residents can currently choose from seven different countries for their Global Health elective. Residents also have the opportunity to rotate at Yale New Haven Hospital, Memorial Sloan Kettering Cancer Center, as well as at other hospitals affiliated with Northwell.*

Detailed View of Program Structure:

Opportunity
The goal of the Categorical Internal Medicine Residency is to train superior internists able to care for inpatients and outpatients across a wide disease spectrum. By graduation, all of our residents have participated in leadership and scholarly activities. Our program is the right size to provide breadth and depth of experience with personalized mentoring and feedback. The three major areas of clinical exposure are Team Care, Critical Care and Ambulatory Medicine at the Norwalk Community Health Center. We have a high Internal Medicine Board passage rate, with our residents pursuing excellent fellowship and practice opportunities upon graduation from our program.

Team Care
Team Care (general medical floors) is vital to our residents’ education program and the delivery of quality healthcare at Norwalk Hospital. There are seven teams participating in Team Care as well as a night float system.

The Team Care Service has full-time hospitalist clinician-educator faculty members and one Chief Resident responsible for much of the ongoing teaching, in addition to that provided by other members of the Department of Medicine. Our hospitalists are stellar teachers and clinicians who pride themselves on teaching patient-centered, evidence-based medicine. On Team Care, you are responsible for all patients admitted under your care under attending supervision and enter all orders. Team Care is an invaluable close-to-the-patient learning experience and includes daily resident reports, didactic and walk rounds, daily teaching conferences and journal club.

Critical Care
While on this rotation, our residents are closely involved with the care of patients in the Coronary Care Unit and Medical Intensive Care Unit. The house staff team has one PGY-3, two PGY-2s and four PGY-1s, as well as a daily 24 hour in-house critical care fellow and a full-time teaching attending.

Ambulatory Medicine

Ambulatory training in a variety of sites is critical to the development of outstanding clinicians. Participating in an academic practice model, residents follow their own group of culturally and socioeconomically diverse patients at an ambulatory care center located in Norwalk, CT. Special emphasis is placed on the development of patient-physician relationships, strong communication skills, preventative care, and chronic disease management. Dedicated ambulatory faculty members work closely with the house staff in this setting, allowing for close one-on-one supervision and mentoring. Additional patient care opportunities include exposure to internal medicine private practice offices, a variety of internal medicine subspecialty clinics and geriatric medicine.  In addition to patient care, residents participate in an intentional educational curriculum designed to expose residents to the broad field of outpatient internal medicine.

Subspecialty Rotations
While at Norwalk Hospital, each resident is able to choose from many subspecialties electives including Hospitalist Medicine, Cardiology, Endocrinology, Gastroenterology and Nutrition, Hematology-Oncology, Neurology, Pulmonary Medicine, Nephrology, Wound Care, Allergy and Immunology, and Rheumatology. Residents also take electives at Yale where they draw upon the knowledge and skills of physicians doing pioneering work in the practice of medicine and in research. Residents who are highly interested in Hematology-Oncology will also be able to do a one-month rotation at MSKCC in New York City.

International Medicine/Global Health
In addition to exposure to general medicine as practiced in another setting, this 6-week elective offers a chance to experience another culture and broaden one’s perspective in a structured way through a partnership with the University Of Vermont School Of Medicine.

Didactic sessions are held daily and are designed to complement teaching rounds. Lectures are given during inpatient and outpatient blocks to provide a broad range of knowledge for future practice as competent physicians.

A comprehensive description of didactic sessions can be found below:

Grand Rounds

Grand Rounds occur every Thursday morning and are led by outside speakers or multidisciplinary team members. The sessions serve as a platform for topic review, clinical pathology review, ethics discussion, discussion of new developments and competency-based topic review.

Noon Conference

Noon conference is held daily for all residents in both inpatient and ambulatory rotations. Lectures are provided by our Norwalk faculty and also by renowned Yale University speakers to provide comprehensive knowledge in a wide breath of internal medicine topics. Additionally, noon conferences encompass lectures regarding billing and coding, job market and job search, internal systems education, teaching skills, patient perspectives, and Patient Safety and Quality Improvement lectures led by PGY-3 residents.

Patient Safety and Quality Improvement Conference

Patient Safety and Quality Improvement conferences are held once or twice each month to discuss a patient case wherein a safety event occurred or was narrowly missed requiring closer systems evaluation. PGY-3 residents prepare the presentation under the guidance of faculty and the inpatient Patient Safety team. This conference is intended to promote quality improvement by performing a root cause analysis and encouraging multidisciplinary discussions for each case.

Resident Report- Inpatient

Resident Report is held 4 days per week for PGY-2’s and PGY-3’s. Intern Report is held once weekly. Led by the Chief Resident, residents hold thought-provoking discussions regarding journal updates and participate in patient case presentations. A Journal Club is held each block during which time a recent journal article is dissected and reviewed for validity and application to our patient population. Internal Medicine Board Preparation occurs during Resident Report each block.

Morning Report- Ambulatory

Morning Report is held daily in the continuity clinic and is hosted by the Ambulatory Chief Resident and attendings. Residents hold vibrant discussion about journal articles and topics related to primary care to ensure practice of evidenced based medicine in the outpatient setting.

Academic Half Day

Academic Half Days occur during the outpatient blocks. One half day is dedicated to didactics. Residents learns about medications such as inhalers and insulin devices. Additionally, patient participate in lectures led by the Chief Resident and complete Ambulatory Medicine multiple choice questions through the Physician Education and Assessment Center.

Simulation Sessions

Our state-of-the-art Simulation Lab is available to all house staff. Sim sessions for Mock Code Training and rapid response scenarios occur weekly. Also, provided for our residents is Vascular Access Training, which is run by the Pulmonary Fellows. They hold regular sessions in the Simulation Center for procedural training, including peripheral IV line placement, central line placement, arterial line placement, paracentesis, thoracentesis and lumbar puncture.

Norwalk Hospital’s Internal Medicine Residency Program requires all residents to participate in scholarly activity. Opportunities are diverse and include clinical research, poster presentations, patient safety and quality improvement projects and population health initiatives at our Federally Qualified Health Center (FQHC).  Residents also have access to elective research rotations at Norwalk Hospital and our affiliated institutions, including Yale and Memorial Sloan-Kettering Cancer Center.   

Our goal is to ensure that each resident advances their knowledge in the principles of research and becomes competent in evidence-based medicine.  In collaboration with the Innovation and Research Department, our residents receive longitudinal instruction in clinical research principles through a lecture series focused on project development, study design and implementation.  In addition, a dedicated on-site research associate is available to guide residents through every stage of the research process, ensuring that all trainees have the support needed to transform their ideas into meaningful scholarly contributions. 

The Research Academy Program Trainee Track provides an exceptional opportunity for residents and fellows with limited or no prior research experience. This year-long program offers step-by-step mentorship in clinical research, allowing participants to learn research methodology, develop a study protocol, conduct a research project, and present their findings under the guidance of experienced investigators. The program is available to PGY-2 and PGY-3 residents in good standing with approval from the Program Director. 

Residents are encouraged to showcase their scholarly work at regional and national meetings, including the annual Connecticut Chapter of the American College of Physicians Scientific Meeting and the Joseph L. Belsky Research Day. These venues provide valuable opportunities to present research, network with colleagues, and engage with the broader academic community. Many of our residents also present original work at regional and national conferences, supported by an educational stipend for scholarly activities.

Board Preparation: 

At Norwalk Hospital we are proud to share our program’s consistently exceptional board passage rate. Board review is incorporated into resident report regularly and often takes the form of “Medical Jeopardy” which is very popular amongst the residents. Additionally, our program provides each resident with a subscription to AMBOSS as the medical knowledge digital platform. 

Mentorship Program: 

Our program is committed to supporting a smooth transition into residency while fostering each trainee’s personal and professional growth. Following their first three months of training, interns are paired with a dedicated faculty mentor who provides individualized guidance throughout residency. Formal mentorship meetings occur quarterly during the intern year, with additional meetings tailored to each resident’s evolving goals, interests, and needs. Mentors help residents navigate the challenges of residency, identify opportunities for scholarship, research, leadership, and professional development, and explore career pathways. For residents pursuing fellowship training, faculty mentors may help connect mentees with subspecialty-specific mentors who can provide additional career guidance and support. During the PGY-2 year, residents meet with their mentors semiannually, while mentorship in the PGY-3 year becomes increasingly flexible and individualized, reflecting each resident’s unique career trajectory and professional goals. 

Simulation & Objective Structured Clinical Examinations (OSCEs):   

Simulation and encounters with standardized patients are a great way to build confidence and clinical competence in a low-stakes, controlled and supportive learning environment.  Sessions take place in our state-of-the-art simulation lab in the McGraw Advanced Learning Center.  The carefully crafted curriculum includes mock codes and rapid response scenarios with the goal of mastery as well as graduated difficulty to keep learners engaged, building on previously learned skills. Other important elements such as teamwork, closed-loop communication, lab, imaging and telemetry interpretation are also a focus of attention during simulation education.  

Residents also participate in communication OSCEs annually.  In these sessions, residents learn to navigate challenging and sensitive conversations.  Topics include establishing rapport, medication counseling, breaking bad news, and medical mistake disclosure. 

Point-of-Care Ultrasound (POCUS): 

Norwalk Hospital was one of the first in the network to develop and implement a POCUS program specifically for the internal medicine residency program. This program was designed to provide internal medicine residents with a thorough understanding and hands-on skills in bedside ultrasonography. 

Residents have access to online POCUS modules, in addition to simulators in the form of POCUS-enabled mannequins.  Small-group bedside POCUS rounds are conducted with one of our pulmonary/ICU faculty members on a bi-weekly basis. 

Patricia A. Tietjen, MD Teaching Academy (PATMDTA) – Trainee Track  

In 2023, PATMDTA launched its first cohort of the Trainee Track exclusively for PGY-2 and PGY-3 residents and fellows who were interested in a career in medical education.  The year-long curriculum is organized as a series of curated learned experiences designed to strengthen pedagogical skills and inspire a professional path in clinical education.  Learning sessions are a blend of virtual and in-person sessions.  Each scholar develops educational content in the form of an infographic which s/he presents at the PATMDTA Annual Academic Symposium in June.  This infographic is published in the institutional Just in Time Teaching (JiTT) app and counts toward scholarly activity. 

The Global Health Academy 

The Global Health Academy offers residents and fellows at Norwalk Hospital the opportunity to participate in a truly immersive global health experience.  Trainees are supported through a six-week elective with careful consideration given to clinical teachings, global health issues, social and political situations, ethical dilemmas and cultural competency.  PGY-2s and PGY-3s in good standing may apply for the elective after approval from the Program Director.  Find more information at:  www.theglobalhealthacademy.org 

We accept all Applications through the ERAS only and participate annually in the NRMP Match Program.

All applications to the Norwalk Hospital Internal Medicine Residency Program, which is fully ACGME accredited, will only be accepted through the Electronic Residency Application Services (ERAS). The ERAS website can be located at http://www.aamc.org/students and we participate annually in the NRMP Match Program. We thank you for your interest in applying to our program!

Requirements for Application: The following items must all be submitted through the ERAS application website:

• Current Curriculum Vitae
• Dean’s Letter/MSPE
• 3 Letters of Recommendation
• Personal Statement
• Medical School Transcripts
• USMLE Step 1 CK or COMLEX Level 1 Score
• USMLE Step 2 CK or COMLEX Level 2 CE Score

Additional Requirements for International Medical Graduates:

• All of the above requirements
• US. citizen or permanent residency preferred
• J-1 Visa’s and H1-B Visa’s will be considered
• ECFMG Certificate
• Recent US clinical experience is preferred

All applications must be submitted and completed by October 31, 2026 in order to be considered for review. Early applications are strongly encouraged.

• We holistically review our applications, starting with people who signaled our program
• We will interview approximately 200 candidates for 15 positions from October 29^th through December 12^th
• We look at preference signaling only in the review/selection for interview process, not for matching
• We have a rolling invitation process; first invites will be sent early October
• We do not offer more invitations than there are spots but we expect a response (accept/decline) within 48 hours in order to allow for other applicants to be invited
• All interviews will be held virtually
• Post-interview communication does not impact ranking

Our frequently asked questions page is the place to find the answers to your common questions regarding the Norwalk Hospital Internal Medicine Residency and Fellowship Programs affiliated with the Yale University School of Medicine.

What are the special aspects of the Norwalk Hospital Internal Medicine Residency?

How do you prepare residents for the Internal Medicine Boards?

Does Norwalk Hospital have a night float system?

Vacation!!! Vacation!!! Vacation!!! How much?

What is the conference schedule like for the medical residents?

How often am I on-call overnight?

Do I have to work every day during certain rotations?

Where have your recent graduates gone? Can I get a prestigious fellowship after completing this residency?

What is the role of residents in residency program decision-making?

Is there special attention to transitions from one year to the next?

When do residents rotate to Yale?

Is it possible to do outside electives at any other location than Yale?

What kind of research opportunities are available at Norwalk Hospital?

Q: What are the special aspects of the Norwalk Hospital Internal Medicine Residency?

A: Our faculty and residents have:

• All the benefits of an individualized and personalized educational experience that comes from being in a community hospital setting, and the world-class opportunities that come from our affiliation with Yale.
• Participated in the creation of the Norwalk Community Health Center, a Federally Qualified Health Center committed to medical education
• Monthly resident-faculty meetings which facilitate increased resident participation in residency program development
• Created and sustained multiple research projects on topics such as hypertension, diabetes, pulmonary embolism, syncope, viral hepatitis and anesthesia use for gastrointestinal procedures
• Won awards for presentations at the regional and national American College of Physicians Annual Meeting as well as at other regional and national specialty meetings
• Career mentoring including a structured mentorship program
• An annual Leadership Skills Retreat for rising PGY-2 residents
• Implemented multidisciplinary rounds on the medical inpatient service to facilitate medical care and residents’ systems-based learning
• Involvement in community activities and health fairs to promote health education and wellness

Q: How to you prepare residents for the Internal Medicine Boards?

A: Our educational and clinical experience prepares residents well for the Internal Medicine Boards. The core conference schedule focuses each month on specific organ systems delivered by full-time faculty and speakers from Yale. The annual in-service exams are reviewed with the Program Director to aid studying. There are weekly board review sessions provided by attending physicians and chief residents.

Q: Does Norwalk Hospital have a night float system?

A: Yes. Norwalk Hospital’s Internal Medicine Residency has night float systems in place for the general inpatient service and in the ICU for interns. For Team Care (general medical floor), there is a night float intern handling cross coverage seven days a week for all teams from 7:30 p.m. to 7:30 a.m. Each intern has 1-2, two-week blocks on this rotation. A senior medical admitting resident night float has been in place for many years with the on-call Team Care resident returning home to sleep every night.

Q: Vacation!!! Vacation!!! Vacation!!! How much?

A: House staff get four weeks of vacation per year. Maternity and paternity leave are also available.

Q: What is the conference schedule like for the medical residents?

A: There are many different conferences each week for the residents to attend. Core conferences are attended on all rotations, and there are specific additional teaching conferences during Team Care and Ambulatory rotations. There are weekly Grand Rounds and four lunchtime resident-oriented conferences per week. Core conferences are teleconferenced between the hospital and NCHC with participation of residents and faculty at both sites at lunchtime with food provided. There are also subspecialty conferences.

On Team Care, resident report is an integral part of inpatient medical education. The first-year residents on Team Care attend a special intern report once a week. Second- and third-year residents attend resident report four times a week. Furthermore, on Team Care, there are daily Attending Rounds, except for Thursdays. In the Critical Care Facility, there are daily ICU and CCU rounds with the Team, which consists of four first-year residents, two second-year residents, one third-year resident, a Pulmonary/Critical Care fellow and an attending from Pulmonary/Critical Care Medicine or Cardiology.

Ambulatory conferences, as well as special courses on physical diagnosis skills, patient interviewing, quality improvement and evidence-based medicine are provided during the ambulatory block rotation.

Q: How often are you on-call overnight? 

A: On-call varies by residency year and the service that you are on. Our on-call schedule varies by rotation.

• First Year: No overnight call on the general medical service. On average, interns do four weeks of night float on the general medical wards. While in the ICU, interns do 2-4 weeks of nights over the course of intern year.
• Second Year: No overnight call on the general medical service. While in the ICU, overnight call is every third night.
• Third Year: No overnight call on the general medical service. While in the ICU, overnight call is every third night.

Q: Do I have to work every day during certain rotations?

A: No. Even during the busiest rotations, you will get on average of at least one day off every week.

Q: Where have your recent graduates gone? Can we get a prestigious fellowship after completing this residency?

A: For the past several years, many of our graduates have entered fellowship programs, with other graduates entering practice or research positions at major institutions. Our track record for fellowship placement is outstanding.

Graduation Success Stories

Q: What is the role of residents in residency program decision-making?

A: There is a longstanding monthly interactive Resident-Faculty Meeting, which provides a forum for input and review of changes planned for the residency.

Q: Is there special attention to transitions from one year to the next?

A: The Department of Medicine faculty and staff are devoted to the promotion and well-being of our residents. Besides mentoring, we have formalized a retreat for interns becoming PGY-2 residents and meetings for residents in each year to enhance leadership and cohesiveness.

Q: When do residents rotate to Yale?

A: PGY-2s and PGY-3s rotate to Yale for electives. Usually this includes a month at the PGY-2 level and up to three months at the PGY-3 level.

Q: Is it possible to do outside electives at any other location than Yale?

A: Sometimes PGY-2 or PGY-3 residents make special arrangements to do electives in a different part of the country where they are planning to move for fellowship or private practice. In addition, residents who are interested in hematology-oncology may apply to do a month long rotation on the leukemia service at MSKCC in New York City.

Q: What kinds of research opportunities are available at Norwalk Hospital?

A: As outlined in the previous section, Norwalk Hospital has a strong commitment to scholarly activity. Residents are currently active in studying the diagnosis and treatment of hypertension, diabetes, anemia evaluation, pneumonia, syncope and others. Many opportunities exist to join projects underway; however, there is more than enough help here at Norwalk to start your own!

For those interested in “bench” research, there are also numerous opportunities at Yale to work with cutting-edge physicians nationally known for their subspecialty work. Special research blocks are given to interested residents who wish to pursue these opportunities.