Internal Medicine Residency Brochure

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Internal Medicine, Preliminary and Transitional Year

CHRISTIANA CARE

Residency Programs

What’s New at Christiana Care
Innovative Curriculum Expanded Fellowship Programs New Research and Leadership Tracks Christiana Care Health System Wins Best in the Business Honors

Scholarly Activities & Research Salary & Benefits

Branch Campus of the Jefferson Medical College of Thomas Jefferson University

Focus on Excellence
At Christiana Care our mission is to take care of our neighbors. With this noble purpose in mind, our

Mission Statement
The Christiana Care Health System is a not-for-profit, nonsectarian health care system located in northern Delaware. Our mission is dedicated to improving the health of all individuals in the communities we serve through health care services, education and research.

staff are constantly reminded to “Think of Yourself as a Patient”, always caring for a patient as they themselves would want to be cared for. If you take a close look at the Christiana Care diamond, you’ll find that the patient is at the center of everything we do. As part of our mission to care for our neighbors, Christiana Care Health System is dedicated to the pursuit and recognition of Service Excellence. With this in mind, Christiana Care is committed to being a worldclass health care provider and takes pride in having on our team, people who care about people and who are inspired in their work by a desire to help others.

At the heart of our program is Christiana Hospital, Delaware’s only tertiary care and Level-I trauma facility. In combination with Wilmington Hospital, Christiana Care hospitals comprise more than 1,100 beds with over 10,400 employees, 1,400 physicians and 230 residents. The institution is the 17th largest hospital system in the country based on annual admissions. We provide high-quality primary and referral care to patients from the urban, suburban and rural areas of Delaware, Maryland, Pennsylvania and New Jersey. This means that you’ll see a wide variety of patients from many different cultures, backgrounds and socioeconomic groups. In combination with the Helen F. Graham Cancer Center and Center for Heart & Vascular Health, our facilities offer some of the most advanced technology in the region and provide our residents unparalleled clinical experiences.

WHAT’S INSIDE
What’s New at Christiana Care . . . . . . . 4 Core Internal Medicine and Transitional Year Faculty . . . . . . . . . . . 17 Our Residents 2011-2012. . . . . . . . . . 21 Our Graduates . . . . . . . . . . . . . . . . . . 26 Research. . . . . . . . . . . . . . . . . . . . . . . 33 Salary and Benefits . . . . . . . . . . . . . . . 39 Delaware . . . . . . . . . . . . . . . . . . . . . . 40

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What’s New at Christiana Care
Innovative New Curriculum for Categorical Medicine

Christiana Care Expands Fellowship Programs
The Department of Medicine is the proud sponsor of cardiology and nephrology fellowship programs. On July 1, 2009 we expanded the size of the cardiology fellowship to four fellows per year and started a new invasive cardiology subspecialty fellowship training program. The fellowship is led by William S. Weintraub, M.D., FACC, John H. Ammon Chair of Cardiology, an internationally distinguished cardiologist and expert in outcomes research from Emory University. He, along with Associate Fellowship Director Ehansur Rahman, M.D. leads the rigorous fellowship which provides the fellows with outstanding clinical, research, and didactic experiences. The nephrology fellowship started in July 2009, and recently graduated its first fellow this past academic year. Led by Program Director, Prayus Tailor, M.D. and Associate Program Director, Robert Dressler, M.D., MBA, the program will soon expand to two fellows per year.

What if?

What if you had more time to dedicate to the rotation that you’re doing? What if you didn’t have to worry about leaving a floor rotation or an elective to get to clinic or an outpatient continuity practice? What if you never had to do two inpatient rotations back to back and had more time for rest and study? Two years ago the internal medicine residency program introduced an innovative curriculum design. Rather than typical half-day clinics added to all inpatient and outpatient rotations, the new curriculum splits the residents’ experiences into inpatient and outpatient blocks of time. Your clinical experience is a four week inpatient medicine rotation alternating with a two week ambulatory medicine experience. The new design allows residents to

completely focus on the rotation. So residents on an inpatient rotation, will not need to leave in the middle of the day to go to clinic. Similarly, when residents are in the outpatient setting, they will not need to run back to the hospital. “Creating block ambulatory time will become the trend at residency programs nationally,” comments Dr. Brian Aboff, Internal Medicine & Transitional Year Residency Program Director, “but right now we’re one of only a few programs who have adopted this innovative solution to residency training.” We’ve heard great feedback from the residents. In clinic, the residents are less stressed and more focused on caring for their patients and learning. On the inpatient rotations, residents have more time to take care of their patients, attend lectures and teaching rounds and do less cross coverage.

David Aljadir, M.D. Internal Medicine, Class of 2010 Hematology/Oncology Fellow

John Donnelly, M.D. Assistant Program Director, Director of Ambulatory Medicine "The new curriculum looks great because it separates the inpatient and outpatient obligations of the residents. When we decided to make this change, our primary obligation was making sure this was better for the residents’ education. I loved working on this project because I knew that it was a change that the residents wanted."

“Christiana has a large number of specialists on faculty, giving residents ample opportunities for exposure in specialty fields. In addition to that, many of our specialists come from programs across the country which gives residents at Christiana exposure to a wide variety of opinions and practices.”

Fellowship Placement
Our residents match with the nation’s most prestigious insititutions.
More than a third of our internal medicine residents pursue fellowships in subspecialties after graduation. This past year, seven of our residents matched in fellowships including cardiology, pulmonary/critical care medicine, rheumatology, and hematology/oncology. Six of the seven residents matched into one of their top two choices! In addition, the Christiana Care Health System offers fellowships in cardiology, interventional cardiology, nephrology and sports medicine.

Other 24% Fellowship 47% Hospitalist 29%
Out of the 19 graduating residents in 2011 (IM, Med-Peds, and EM/IM), the chart above shows where they went after residency.

Sample PGY – 1 Block Schedule
BLOCK BLOCK BLOCK BLOCK BLOCK BLOCK BLOCK BLOCK BLOCK BLOCK BLOCK BLOCK BLOCK 2 3 4 5 6 7 8 9 10 11 12 13 1 MICU AMB NF Elec AMB Floor AMB Elec AMB Floor AMB Floor AMB CICU AMB Elec AMB Floor

Here are some places our residents have gone for fellowship:
• Albany Medical Center (Cardiology) • Bridgeport/Yale (Cardiology) • Brown (Pulmonary/Critical Care) • Christiana Care (Cardiology, Nephrology) • Dartmouth (Nephrology) • Drexel (Hematology/Oncology, Nephrology) • George Washington (Endocrinology) • Georgetown (Pulmonary/Critical Care) • Hartford Hospital (Cardiology) • Johns Hopkins/Bayview (Geriatrics) • Lankenau (Cardiology) • Mass General (Pain & Palliative Care) • Medical College of Georgia (Pulmonary/Critical Care) • Medical College of Virginia (Cardiology)

Sample Ambulatory Schedule
Two days of the week are spent in Outpatient Continuity Practice. MONDAY Outpatient Continuity Practice TUESDAY Subspecialty Outpatient Rotation WEDNESDAY Outpatient Continuity Practice THURSDAY Subspecialty Outpatient Rotation FRIDAY Subspecialty Outpatient Rotation

• North Shore/LIJ (Cardiology, Hematology, Oncology) • Ohio State (Pulmonary/Critical Care) • Rhode Island (Hemotology, Oncology) • Rush (Infectious Disease) • Temple (Geriatrics) • Thomas Jefferson (Gastroenterology, Infectious Disease, Nephrology) • Tulane (Allergy/Immunology) • UCSD (Peds, Hemotology, Oncology) • UMDNJ (Gastroenterology) • University of Minnesota (Nephrology) • University of Pennsylvania (Gen. Internal Medicine, Nephrology) • University of Pittsburgh (Pulmonary/Critical Care) • University of Texas (Infectious Disease) • Wake Forest (Rheumatology) • Wayne State (Cardiology) 5

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Christiana Care Commits to New “Virtual” ICU Technology
Electronic ICU will leverage intensivists’ skills which are in high demand.
New technology provides electronic intensive care unit (eICU®) coverage for all of our ICU's. Through the eICU, Board Certified Intensivists monitor dozens of patients simultaneously at both hospital campuses. Remotely stationed intensivists use a multitude of medical monitoring devices, audiovisual equipment, and computer algorithms to care for more than 50 patients who occupy eICU beds. “Enhanced intensive care technology In addition to their own knowledge that operates 24/7 allows us to leverage the skills of our intensivists…” and skills, intensivists on duty in the remote monitoring room are “backed observes Dr. Marc T. Zubrow, up” by the new eICU eCareManager® Director of Critical Care Medicine and Medical Director of eCare. software, which causes a “smart alert” Management by intensivists has to be triggered when a patient needs been shown to attention, according “Enhanced intensive to Edward Ewen, reduce ICU mortality by up to 40 percent. care technology that M.D., director of It is listed by the Clinical Informatics. operates 24/7 allows “As an added safety Leapfrog Group— a nonprofit measure, decision us to leverage the coalition of support software skills of our runs continuously business and other groups in the background interventionists.” working to improve and monitors all the patient safety and quality of patients simultaneously,” Dr. Ewen health care—as a key quality says. “Rules and alerts built into this measures. EICU intensivists are system look at vital signs and other available to help residents with any clinical data to bring significant patient in either hospital, with any clinical changes or developing aspect of medicine, including x-ray problems directly to the intensivists’ interpretation. The eICU physicians attention, allowing them to more and residents work together as a proactively intervene in a setting team to provide the best patient where rapid response can determine care possible. the outcome.”

Christiana Hospital Among the Busiest on the East Coast
A 913-bed, 1.3-million-square-foot, modern facility in Newark, Delaware, Christiana Hospital provides a level of care only available in large-scale teaching hospitals. Christiana Hospital includes Delaware's only Level I trauma center (as verified by the American College of Surgeons), which is prepared to handle the most extreme medical emergencies. In fact, it is the only Level I trauma center on the East Coast corridor between Baltimore and Philadelphia. Christiana Hospital is also the only delivering hospital in Delaware with a Level 3 neonatal intensive-care unit, which is the highest level of capability. More than 6,500 babies are born at Christiana Hospital each year. More Christiana Hospital Campus

than 1,400 physicians and surgeons are active members of Christiana Care's Medical-Dental staff, and more than one in 10 of them have located at least part of their practices on the Christiana Hospital campus in two Medical Arts Pavilions adjoining the main hospital. The Center for Heart & Vascular Health in the Bank of America Pavilion at Christiana Hospital offers the latest “vascular surgery, cardiac rehabilitation and preventive medicine. Each year, the medical team at the Center for Heart & Vascular Health performs more than 800 open-heart surgical procedures, plus thousands of diagnostic and interventional procedures in our cardiac catheterization and electrophysiology labs. The recently added Gerret and Tatiana Copeland Arrhythmia Center is a fully capable electrophysiology suite that features advanced stereotaxis technology for the diagnosis and treatment of heart-rhythm disorders. Using the Stereotaxis Niobe Magnetic Navigation System, we are the only hospital in Delaware and among a select group of high-volume centers nationally with the capability to perform a new type of ablation—a corrective procedure—that cures atrial fibrillation in up to 80 percent of our patients. Adjacent to the Center for Heart & Vascular Health is the John H. Ammon Medical Education Center, which

houses 13 classrooms, a 300-seat auditorium equipped with audiovisual and video-conferencing technology and a 7,000-square-foot medical library. It also hosts a 9,000-square-foot high-tech physician Virtual Educaton and Simulation Training Center that allows doctors and residents to train in a realisic, simulated hospital setting. The center is equipped with a working laparoscopy station with simulated tissues, an endoscopy/ bronchoscopy simulator, 3D visualization software and display, and numerous task trainers. Located on the Christiana Hospital campus, the beautifully designed and landscaped, 200,000-square-foot Helen F. Graham Cancer Center is a state-of-the-art facility that serves a majority of the cancer patients residing in Delaware. This National Cancer Institute designated Community Cancer Center features advanced medical, surgical and radiation procedures and diagnostic services. The cancer research program includes the Center for Translational Research, a collaborative program with the University of Delaware. The Helen F. Graham Cancer Center also includes the Christiana Care Breast Center, an outpatient facility with the state's only dedicated breast MRI. 7

Matthew Stofferahn, M.D. PGY-5 EM/IM resident, EM/IM Chief Resident “As the only tertiary care hospital for the entire state of Delaware and much of the surrounding tri-state area, the diversity of patients and exposure to pathology is truly unmatched. The medicine service also has primary responsibility for many problems that would be delegated solely to specialists at university hospitals. As a result, there is scarcely a more clinically comprehensive internal medicine residency anywhere.”
ICU electronic medical record.

Dena Florczyk, M.D. Med-Peds Class of 2010 and Former Med-Peds Chief Resident "The new additions to Christiana Hospital have provided residents with state-of-the-art inpatient as well as educational facilities. These include patient care facilities, a medical education center, a simulation laboratory and employee wellness center. These visionary and technologically advanced additions have created intensive care units and library medical facilities that enhance resident education. In addition, the resources provided by the education center facilitate resident and physician success in patient care and professional advancement."

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Wilmington Campus $210 Million Transformation is Progressing
Plans include new 9-story tower, expanded emergency department, new medical office building, redesigned hospital entrance, surgical suites and more patient beds.
Christiana Care Health System has embarked on a five-year, $210 million expansion and renovation of Christiana Care’s Wilmington Campus, to transform the medical campus in the heart of downtown Wilmington by 2014. The upgraded hospital campus, with new, renovated and expanded facilities, will allow it to continue its tradition of service for many years to come. “For over a century, the nurses and physicians at Christiana Care’s Wilmington Campus and its Emergency Department have been serving the Wilmington community, meeting the community’s diverse medical needs and providing the safety net for the underserved,” says Dr. Robert Laskowski, Christiana Care’s President and CEO. “Expanding and renovating Christiana Care’s Wilmington Campus continues Christiana Care’s commitment to serve, to benefit our community and to ensure that our neighbors can access and receive the highest level of care and comfort.” The construction project adds 337,000 square feet to the hospital campus, bringing the campus’ total medical square footage to more than one million. All medical services will continue to be provided during construction. More than 62,000 square feet of existing hospital space will be renovated as part of this project. The plan includes: • A nine (9) story, 286,000 square foot tower that includes 13 new operating room suites, replacing the existing 10 operating rooms; 8 30 new patient beds and an Intensive Care Unit; and the capacity for up to 120 private patient rooms. • A new 61,000 square foot medical office building (10,000 square feet renovated plus approximately 51,000 square feet of new construction). • Doubling the physical size of the Emergency Department and its related services. of the Christiana Care’s Wilmington Campus transformation is the expansion and renovation of its emergency department. Christiana Care’s Wilmington Campus 31-room Emergency Department experiences patient volumes normally seen at large hospital emergency departments. Since 1998, the number of patients using the Christiana Care’s Wilmington Campus Emergency Department has increased by 9.5 percent, outpacing growth in most emergency departments nationally. Last year, 51,559 patients came to the Christiana Care’s Wilmington Campus Emergency Department for care. Straining to accommodate the growing demand for medical services, the number of patients walking through the doors of Christiana Care’s Wilmington Campus’ Emergency Department is twice that for which it was originally designed.

Christiana Care Health System Partnership with the University of Delaware Allows Residents to Obtain MBA
In cooperation with the University of Delaware, the Internal Medicine Residency program supports an optional four- year program that will allow residents to complete their internal medicine residency and earn an MBA, Masters of Health Science Administration, Masters in Management, or Masters of Organizational Development. The joint Internal Medicine residency-MBA program lasts four years. Residents complete their first year of residency and then start a modified schedule. In the remaining three years, residents spend approximately one third of their time each year attending classes at the nearby University of Delaware while being free of clinical duties. Residents continue to receive 70 percent of their base salary during the last three years of their residency, while attending full-time MBA course work. Even while attending classes, residents remain employees of the hospital so they continue to receive benefits. As an added benefit, for residents who live in Delaware, Christiana Care pays half of their in-state tuition costs. The first resident to earn the opportunity to participate in the program, Billy Chasanov, D.O. describes this opportunity as, “One I didn’t want to pass up.”

William Chasanov, II, D.O. Internal Medicine, Class of 2010, CCHS Nephrology Fellow “I earned an MBA at a reduced cost while still drawing a partial salary and benefits. Even when I was at the University of Delaware focusing on my MBA course work, I still kept my internal medicine skills up by moonlighting. I hope to use my MBA skills in hospital management or to branch into the pharmaceutical industry”

The facility’s new patient rooms are single rooms including space for families, and use as much natural lighting as possible throughout the campus. Additionally, the new patient rooms include flat-screen monitors to provide internet access and patient education videos (GetWell Network).

Expanding and renovating Christiana Care’s Wilmington Campus continues Christiana Care’s commitment to serve.

Simulation Lab Helps Residents Gain Experience
One of the valuable resources that the medicine residents utilize is the medical simulation lab which features technologically advanced mannequins for residency training and ongoing professional education. Some of the uses of the lab include central line training and rapid response team scenarios for the interns as they transition to becoming a senior resident. Code blue training using realistic scenarios is another tool used to teach the residents.

Christiana Care is embarking on this project to address demand for health care services that grew dramatically over the past decade. A key component

Christiana Care Simulation Lab

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Honors, Awards & Public Recognition
Dr. Laskowski, Christiana Care President and CEO Named Influential Person
Delaware Today features Robert J. Laskowski, M.D.
“Who has clout,” the publication asks? “There’s a new generation of movers and shakers emerging who are shaping policies and making things happen.” need to not only follow standards, but develop standards of excellence that set the tone for the entire region. Our aspirations are pretty bold. Given the resources and strengths of our community and my colleagues, we believe we can transform ourselves to the very best health care in the United States.” Those strides are being made. In March of 2009, Laskowski announced a partnership between Christiana, Nemours, Thomas Jefferson University and the University of Delaware collectively known as the Delaware Health Science Alliance. The healthcare super-group is pooling resources, contacts and assets to develop a campus for healthcare education, a cancer biology center,

Christiana Care Health System Wins National Award for Innovation
Christiana Care Health System has been named the 2010 Alliance Innovation Award winner from the Alliance of Independent Academic Medical Centers (AIAMC), a national organization made up of 69 major academic medical centers and health systems. The award recognizes Christiana Care for innovative approaches to medical education and research that result in better patient outcomes. Christiana Care received the award for developing and implementing an innovative graduate-level, 12-week course. The curriculum focuses on inter-professional learning through collaboration on quality improvement projects. The aim of the course is to produce measurable improvements in quality and patient safety. "We are honored to receive the Innovation Award," says Robert J. Laskowski, M.D., MBA, president and chief executive officer of Christiana Care. "It validates the dedication of so many of my colleagues at Christiana Care to provide quality education aimed at transforming the way we deliver care." "Christiana Care has been an active participant and leader in the AIAMC National Initiative: Improving Patient Care through Graduate Medical Education since 2007," says Kimberly Pierce-Boggs, AIAMC executive director. "Christiana Care serves as an excellent example of the successful integration of graduate medical education and quality. The AIAMC board of directors is delighted to present Christiana Care with this award."

Dr. Gardner and President Clinton Praise Report
Former president William J. Clinton and Timothy J. Gardner, M.D., former president of the American Heart Association and medical director of Christiana Care’s Center for Heart & Vascular Health, participated in a press conference in New York City applauding a new report showing that the beverage industry continues to reduce calories in schools.

Here’s what Delaware Today says about Dr. Robert J. Laskowski and Christiana Care:
“Under CEO Robert Laskowski, Christiana Care has emerged as an indomitable healthcare force on the East Coast.” “Between two acute-care hospitals staffed by some of the most talented physicians in the country, Laskowski is steering a very large ship—and the rest of the country is taking notice.” “The leadership here is viewed as a responsibility,” Laskowski says. “We

Robert J. Lasokowski, M.D.

and the Delaware Valley Institute for Clinical and Translational Science, a consortium they hope will lead to more grant money and fund even greater innovation. “That’s a multi-year effort that we think will be transformative in its own right,” Laskowski says.

Dr. Timothy J. Gardner, left, and Susan K. Neely, president and CEO of the American Beverage Association, right, at the press conference with former president William J. Clinton.

Christiana Care Named Top Workplace
For the eighth consecutive year, the News Journal, a state wide daily newspaper, has named Christiana Care a Top Workplace employer.
The newspaper bases the honor on employee surveys from 100 companies in the Delaware region. Only 50 companies made the best place to work list this year.

Dr. Laskowski Appears at National Press Club Event
Bob Laskowski, M.D., Christiana Care president and CEO, joined David Blumenthal, M.D., national coordinator for Health Information Technology, and other U.S. health care leaders on Thursday, Aug. 5 at the National Press Club in Washington, DC to promote use of electronic health records in physician practices. The event focused on the value of health information technology (HIT) and the federal government's efforts to bring about greater use of electronic health records. Dr. Laskowski outlined how Christiana Care will assist community physicians in the rapid adoption of electronic health records. Sponsors of the event were Health Affairs, a leading health policy publication, and Brandeis University's Health Industry Forum. 10

Christiana Care Health System Achieves Magnet® Recognition
Christiana Care Health System has achieved Magnet® recognition for excellence in nursing by the American Nurses Credentialing Center (ANCC). Only 6 percent of the nation's hospitals have earned this honor, the highest level of national recognition to health care organizations that demonstrate sustained excellence in nursing care. Christiana Care is the only hospital in Delaware to achieve Magnet status.

Here is what some of our employees say:
• I believe this organization is going in the right direction. • I have many opportunities to learn and grow at this organization. • I have the flexibility I need to balance my work and personal life.

Lionel Malebranche, M.D. Internal Medicine, Class of 2011, CCHS Cardiovascular Disease Fellow "The night float system provides a good balance between work, medical experience and much needed rest. The day team is guaranteed not to spend any overnight calls during the week days, which is great. The night team doesn't have to see patients in the morning before they leave. The clinical experience is so much better when you have enough rest time. It's really a win-win situation." 11

Grant Enhances Research Efforts
At Christiana Care Health System, reasearch into treatments for cancer and cardiovascular disease is expanding thanks to a five-year, $17.4 million federal grant. Christiana Care is a member of the Delaware IDeA Network of Biomedical Research (INBRE), a consortium of six Delaware institutions awarded the grant from the National Center for Research Resources at the National Institutes of Health. The grant is a federal award for the partnership, whose other members are the University of Delaware’s Delaware Biotechnology Institute, research in the area of cancer stem cells and biomarkers,” says Nicholas J. Petrelli, M.D., the Bank of America endowed medical director of the Helen F. Graham Cancer Center at Christiana Care, who will lead INBRE’s cancer-research program. William Weintraub, M.D., John H. Ammon Chair of Cardiology at Christiana Care’s Center for Heart & Vascular Health, says the INBRE award is “a major step in the development of cardiovascular research in the state of Delaware, with cardiovascular projects both at Christiana Care and at the University of Delaware.”

Christiana Care Participates in Jefferson’s Delaware Branch Campus
Christiana Care has been approved as a participating hospital in Jefferson Medical College’s Delaware Branch Campus. This achievement underscores the transformative role Christiana Care plays in medical education. It specifically spotlights our core competency in providing clinical education to thirdand fourth-year medical students. Eleven students started their third year of medical education at Christiana Care at the beginning of July. They are our inaugural class, the class of 2013. Christiana Care has a long-standing relationship in providing first-rate medical education to students from Jefferson Medical College, one of the top-rated medical schools in the country. This new designation enables Christiana Care to provide better care to our neighbors by allowing these students to receive additional medical education opportunities on our campus. Also, receiving more of their clinical training at Christiana Care increases the likelihood that these students Science Award grant. It also better positions us to seek other grants. Designation as a Delaware Branch Campus benefits the Delaware Health Sciences Alliance, of which we are one of four member institutions. A key component of the Alliance is a future Jefferson facility at the University of Delaware to accommodate medical students in Delaware. Other Branch Campus partners are the DuPont Hospital for Children and the Wilmington Veterans Administration Hospital. Branch Campus approval comes from The Liaison Committee on Medical Education, the accrediting authority for medical education programs leading to the M.D. degree in U.S. and Canadian medical schools.

Leaders of the Delaware IDeA Network of Biomedical Research consortium gather to discuss the National Institutes of Health’s National Center for Research Resources grant.

Medical College
remain to practice in Delaware when they complete their residency training. This new partnership with one of the nation’s foremost medical research institutions, in collaboration with other Branch Campus partners, strengthens Christiana Care’s ability to pursue a Clinical Translational

into the effect of kidney function on the association between obesity and cardiovascular events.

“We are looking forward to expanding our collaborations in clinical research, especially to treat patients with common clinical problems more effectively.” Timothy J. Gardner, M.D.
Delaware State University, Wesley College, Delaware Technical and Community College and Nemours/Alfred I. duPont Hospital for Children. “The INBRE grant will help develop a broad range of translational research projects and make new ideas for improved diagnostics and therapy available to the state and nation,” says Dr. Weintraub, who also heads the Christiana Care Center for Cardiovascular Outcomes Research. The center serves as an analytic center for INBRE’s cardiovascular research effort. Funded projects under the grant include research by Claudine Jurkowitz, M.D., MPH, Director of Operations for the Center for Cardiovascular Outcomes Research,

One of several biomedical research projects
The Delaware IDeA Network for Biomedical Research Excellence, established in 2004, received a five-year, $16.7 million grant in 2004 from NIH’s National Center for Research Resources. Christiana Care was also part of the consortium’s forerunner, the Delaware Biomedical Research Infrastructure Network, started in 2001. Christiana Care is involved in a host of other clinical and biomedical research partnerships, including the Delaware Health Sciences Alliance in which it collaborates with the University of Delaware, Thomas Jefferson University and Nemours/Alfred I. duPont Hospital for Children onresearch into cancer, cardiovascular disease and rehabilitative medicine.

Cutting-edge cancer and cardiovascular research
The grant supports 15 research projects during its first year. The research includes Christiana Care’s work to develop cutting-edge medical treatments to improve the health of Delawareans. “The INBRE funding allows us to continue translational cancer

MICU Work Rounds with Michael Benninghoff, D.O. (Intensivist).

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U.S. News & World Report Ranks Christiana Care Among America’s “Best Hospitals”
For the fifth straight year, Christiana Care has been ranked one of the nation's best hospitals.
One of only 3 percent of US hospitals to make the list.
In its annual America’s Best Hospital edition, U.S. News & World Report places Christiana Care among the top 50 listings in two specialties – Diabetes & Endocrine Disorders and Digestive Disorders. Christiana Care is the only hospital in Delaware to make the list. Of more than 4,800 hospitals evaluated this year, only a select 174 – or 3 percent – are included. “Receiving national recognition in these specialties is a testimony to the exceptional care provided by our doctors, nurses and allied health professionals,” says Robert J. Laskowski, M.D., president and CEO of Christiana Care. “To be listed three years in a row underscores our regional and national reputation as a premier health care provider.” “Being named one of the top 50 hospitals in the US in diabetes and digestive disorders is a reflection of the hard work, dedication, teamwork and focus on excellence of all our caregivers and validates that we are truly transforming care for our patients," says Virginia E. Collier, M.D., FACP, Hugh R. Sharp, Jr. Chair of Medicine at Christiana Care. To receive this prestigious honor, the magazine uses a methodology that ranks hospitals on several metrics including mortality rates, reputation, number of patients cared for, quality of nursing care, use of advanced technology and a trauma center. A new metric added this year – patient safety – shows how well a hospital minimizes harm to patients.

Residents

reaching out

Volunteer Endeavors

Is there life after residency?
Our graduates definitely think so!
Our graduates choose from a variety of options after they leave residency. About 30 percent choose to be hospitalists. Several members of each graduating class stay at Christiana Care Health System to become hospitalists here. An equal number of residents choose traditional internal medicine practices, with a mixture of outpatient and inpatient care. Our graduates criss-cross the nation, some going as far as Wyoming or Hawaii. This past year about 47% have gone on to fellowships. In the past two years, we have seen residents successfully match in fellowships in Cardiology, Gastroenterology, Endocrinology, Infectious Diseases, HematologyOncology, Pulmonary/Critical Care and Rheumatology. Deborah Zarek, M.D., one of our graduates who remained in Wilmington, Del. to join an outpatient internal medicine practice, says, “Christiana Care is more than a hospital…it’s a community. After residency, I felt confident and well prepared to go into private practice, and had a family of support from the faculty and staff of the residency program at Christiana.”

Lionel Malebranche, M.D. Class of 2011, CCHS Cardiovascular Disease Fellow
"The residency program fully supported my endeavor to volunteer in Haiti after the earthquake. Although only a second-year resident, I had the opportunity to lead the medical staff and help strategize our action plan. My training from Christiana Care equipped me for the challenging cases I met and allowed me to make decisions that helped save lives. The experience was life-changing for me."

Ben Goodgame, M.D. EM/IM, Class of 2010
"In my fifth year, I had an amazing opportunity through an Internal Medicine scholarship program to spend one month in a rural hospital in Kenya. This was one of the most rewarding experiences of my residency. I was able to see an incredible patient pathology that I would have never experienced without the opportunity for an international rotation."

More Recognition of Excellence
• Christiana Care’s Center for Heart & Vascular Health was awarded three stars, the highest possible national ranking, from The Society of Thoracic Surgeons for our quality of cardiac surgery. • Christiana Care is the winner of the American Heart Association’s Gold Performance Achievement Awards for both heart attack and heart failure treatment. • Christiana Care is the recipient of the Gold Seal of Approval™ from the Joint Commission as a Certified rimary Stroke Center.
Jennifer Rowland, M.D. (Transitional Year PGY-1) and Poonam Maru, D.O. (PGY-1).

Elizabeth Kunkel, D.O. Internal Medicine, Class of 2011
"Christiana Care offered me a fantastic opportunity to live out my dream of practicing medicine in Papua New Guinea. When I was picking residency programs, I wanted a program that supported international medicine, not only did Christiana support it in theory, but through a Delaware ACP scholarship made it financially possible to go as well."

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Be in the

Know

You may be interested to know some of the things that Christiana Care offers you…
EDUCATION, NOT SERVICE
Christiana Care offers outstanding ancillary support 24 hours a day, 7 days a week so that you are not burdened with the traditional “scut” of residency. We strictly adhere to the ACGME work hour guidelines so that you are assured adequate rest.

Core Internal Medicine and Transitional Year Residency Faculty
Brian Aboff, M.D., FACP Cornell University Medical College, 1985 Residency, Vanderbilt University Chief Medical Resident, Vanderbilt University Program Director, Internal Medicine and Transitional Year Residency Programs Associate Chair for Education Clinical Associate Professor of Medicine, Jefferson Medical College Kunal P. Bhagat, M.D. University of Kansas School of Medicine, 1994 Residency, Christiana Care Health System Education Coordinator, Section of Hospitalist Medicine Matthew Burday, D.O., FACP University of Medicine & Dentistry of New Jersey, 1984 Residency, Christiana Care Health System Associate Program Director Director, Second and Third Year Student Programs Director, Medical Student Education Clinical Assistant Professor of Medicine, Jefferson Medical College Tabassum Salam, M.D. , FACP University of Pennsylvania, 1997 Residency, MCP Hahnemann Chief Medical Resident, MCP Hanhnemann Associate Program Director, Internal Medicine and Transitional Year Preceptor, Women’s Health Virginia U. Collier, M.D., FACP Johns Hopkins School of Medicine, 1976 Residency, Johns Hopkins Hospital Fellowship (Nephrology), Johns Hopkins Hospital Hugh R. Sharp Jr. Chair of Medicine Program Director, Internal Medicine & Transitional Year Residency Program, 1992-2005 Vice Chairman and Director of Education 1997-2006 Governor, DE Chapter, American College of Physicians, 2000-2004 Member, Board of Regents, ACP 2004 Chief, Section of General Internal Medicine 2005-2007 Chair, Public and Professional and Advocacy Committee, Medical Society of Delaware Professor of Medicine, Jefferson Medical College Robert M. Dressler, M.D. Sackler School of Medicine Residency, Montefiore Hospital & Medical Center Fellowship, Albert Einstein College Medicine Vice Chair, Dept. of Medicine Associate Program Director, Nephrology Fellowship John Donnelly, M.D. Michigan State University, 1997 Residency, Christiana Care Health System Chief Resident, Christiana Care Health System 2001-2002 Assistant Program Director Director, Ambulatory Medicine Preceptor, Adult Medicine Office Frank Beardell, M.D. Georgetown University School of Medicine Residency, Christiana Care Health System Fellowship (Hematology/Oncology), Jefferson Medical College Director, Bone Marrow and Stem Cell Transplant Program Education Coordinator, Section of Hematology Tony Bianchetta, M.D. Temple University School of Medicine, 1994 Med-Peds MCD/Christiana Care Health System 1994-98; Chief Medical Resident, Medical Center of Delaware 1998-99 Med-Peds Associate Residency Program Director Clinical Instructor, Internal Medicine David Biggs, M.D. University of Kansas School of Medicine, 1984 Residency, Medical College of Wisconsin Fellowship, University of Pennsylvania Hospital Chief, Section of Oncology Allison Buonocore, M.D. Jefferson Medical College, 2001 Residency, Christiana Care Health Services Internal Medicine/Pediatrics Faculty Member Jeff Cicone, M.D. Eastern Virginia Medical School, 1997 Residency, Christiana Care Health System Fellowship, Johns Hopkins University Chief Resident, Christiana Care Health System, 2000-2001 Education Coordinator, Section of Renal and Hypertensive Diseases Robert Cox, M.D. Jefferson Medical College, 1970 Residency, Christiana Care Health System Fellowship (Nephrology) Chief, Section of Renal and Hypertensive Diseases Tony Cucuzzella, M.D. New Jersey College of Medicine, 1962 Residency, Physical Medicine & Rehabilitation Hospital, University of Pennsylvania Chief, Section of Physical Medicine and Rehabilitation Patricia M. Curtin, M.D., FACP Jefferson Medical College, 1988 Residency, Christiana Care Health System Fellowship (Geriatrics), Jefferson Medical College Chief, Section of Geriatrics Clinical Assistant Professor, Jefferson Medical College

ELECTRONIC MEDICAL RECORDS
The institution has a fully incorporated EMR for both the inpatient and outpatient side of care, to allow physicians and other health care providers access to all dictations, pathology reports, laboratory data, radiologic studies, ER records and ECGs 24 hours a day, 7 days a week. Residents have the ability to access all of the Web-based technologies remotely from home as well. In the next year, the institution will be using computer order entry by the physicians.

EDUCATIONAL FUND
Each of the residents is allowed $1,000 from Academic Affairs for the purchase of educational materials and scientific meetings yearly.

MEDICAL LIBRARY
There are medical libraries at both the Christiana and Wilmington hospitals where residents have access 24 hours a day, 7 days a week. Many library services and references are available including medical librarians to perform literature searches for the residents.

PARKING
At both Christiana and Wilmington Hospital, parking is free for the residents.

DAY CARE
A full-service child day care and drop-in day care, Imaginations, is available on the Christiana Hospital campus. See page 32 for more detailed information about these services.

MEDICAL KNOWLEDGE SELF ASSESSMENT PROGRAM (MKSAP)
The MKSAP is one of the most comprehensive board review materials for the Internal Medicine certification exam. The Department of Medicine makes the MKSAP available to all residents during their residency.

The Bottom Dollar
Christiana Care is located in New Castle County, Delaware which is within driving distance from some of America's most exciting cities. Located 10 minutes from Wilmington (a city of approximately 73,000 people) Christiana Care residents have the opportunity to reside in the city or in a neighborhood in the suburbs. In fact, the cost of living in Wilmington is approximately 13 percent below the national average. Coupled with an intern salary of $51,900 and no sales tax, residents can buy or rent affordable housing.

“I have learned that Newark, Delaware is the best of both worlds it has that suburban architecture with a big city edge just minutes away. Either way on I95 you are bound to run into a big city to feed those social needs but when you just want some homemade ice cream and a nice peaceful walk along Main Street you can just come HOME to Newark. I must say this big-city girl has learned to love this little-city life.”

Brooke Mobley, D.O. Internal Medicine, Class of 2011, CCHS Nephrology Fellow

Attending Appreciation Breakfast: Allison Buonocore, M.D., Tony Bianchetta, M.D., Allen Friedland, M.D. (Medicine Pediatrics Program Director) and John Donnelly, M.D. (Internal Medicine Assistant Program Director).

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Our Faculty (continued)
Marci Drees, M.D. Pritzker School of Medicine, The University of Chicago, 1998 Residency, University of Colorado Health Sciences Center Fellowship (Infectious Disease), New England Medical Center Hospital Director of Resident Research Joseph Deutsch, M.D. Jefferson Medical College, 2006 Residency, Christiana Care Health System Internal Medicine Faculty Member Dan Elliott, M.D. Jefferson Medical College Residency, Christiana Care Health System Chief Resident, Christiana Care Health System, 2005-2006 Fellowship (General Internal Medicne), University of Pennsylvania Co-Director, Ambulatory Medicine Research and Outcomes Acting Associate Chair for Research Ed Ewen, M.D. University of Illinois Medical School, 1985 Residency, Northwestern University Director of Clinical Computing, Christiana Care Health System Clinical Assistant Professor of Medicine, Jefferson Medical College Marciana Filippone, M.D. Jefferson Medical College, 1978 Residency, Temple University Fellowship (Gastroenterology), Temple Chief, Section of Gastroenterology Allen Friedland, M.D., FACP, FAAP SUNY- Buffalo School of Medicine and Biomedical Sciences, 1993 Residency, Med-Peds, University of Cincinnati and Children's Hospital Medical Center Chief Medical Resident, University of Cincinnati Internal Medicine Med-Peds Residency Program Director Assistant Professor, Internal Medicine and Pediatrics, Jefferson Medical College Frederick A. Giberson, M.D., FACS University of Medicine and Dentistry of New Jersey - Robert Wood Johnson Medical School, 1991 Residency, Medical Center of Delaware Fellowship, (Trauma and Surgical Care), R. Adams Cowley Shock Trauma Center, Baltimore, MD Program Director, General Surgery Terry Horton, M.D. Jefferson Medical College, 1987 Residency, Beth Israel Medical Center Internal Medicine Faculty Member and Preceptor Ripu Hundal, M.D. Government Medical College, India 1987 Residency, Albert Einstein Medical College Fellowship (Endocrinology), Yale – New Haven Hospital Education Coordinator, Section of Endocrinology Neil Jasani, M.D., FACEP Georgetown University, Residency, Medical Center of Delaware Program Director, Emergency Medicine Co-Program Director, Emergency Medicine/ Family Medicine Residency Program Assistant Chair, Emergency Department John Kelly, III, M.D. Jefferson Medical College, 1984 Residency, University of Illinois – Chicago Fellowship (Cardiology), Texas Heart Institute Education Coordinator, Section of Cardiology Stephanie Lee, M.D. Jefferson Medical College Residency, Christiana Care Health System Chief Medical Resident, Christiana Care Health System, 2002-2003 Fellowship (Infectious Disease), University of Texas Education Coordinator, Section of Infectious Diseases James Lenhard, M.D. Albany Medical College, 1987 Residency, Miriam Hospital Fellowship (Endocrinology), Joslin/Harvard Director, Diabetes and Metabolic Disease Center, Christiana Care Health System Chief, Section of Endocrinology Clinical Assistant Professor of Medicine, Jefferson Medical College Vinay Maheshwari, M.D. Medical College of Virginia Residency, Medical College of Virginia Hospitals Fellowship, New England Medical Center Hospital Education Coordinator, Pulmonary Medicine Gregory V. Marcotte, M.D. New York University School of Medicine, 1992 Residency, University of Colorado Health Sciences Center Fellowship, John Hopkins University Chief, Section of Allergy Lisa Maxwell, M.D. UMDNJ-Robert Wood Johnson Medical School, 2002 Residency, Crozer Keystone Family Practice Residency Fellowship, Christiana Care Health Services Internal Medicine Faculty Member Neeta Milasincic, M.D. Baylor College of Medicine, 2000 Residency, Christiana Care Health Services Chief Resident, Christiana Care Health System, 2003-2004 4th Year Student Clerkship Director Internal Medicine Faculty Member Thomas Mueller, M.D. Thomas Jefferson University Hospital, 1986 Internship, UDMNJ/Cooper Medical Center Residency, Thomas Jefferson University Hospital Fellowship, Crozer-Chester Medical Center Chief, Section of Neurology

Our Faculty (continued)
Anand Panwalker, M.D. Christian Medical College, 1967 Residency, University of Illinois at Chicago College of Medicine Fellowship (Infectious Disease) University of Illinois at Chicago College of Medicine President-Elect, Christiana CareHealth System Medical/Dental Staff Badrish J. Patel, M.D. Virginia Commonwealth University, 2001 Residency, Virginia Commonwealth University Health System Fellowship, Temple University School of Medicine Medical Director, Medical Intensive Care Unit Education Coordinator, Section of Critical Care Medicine Amy M. Patrick, M.D. University of Pennsylvania School of Medicine, 1989 Residency, Graduate Hospital Fellowship, Graduate Hospital Education Coordinator, Section of Gastroenterology Stephen Pearlman, M.D. University of Rome, 1981 Residency, Long Island Jewish Childrens' Hospital Fellowship (Neonatal), Hershey Medical Center Associate Director, Department of Neonatology Medical Director of Pediatrics Clinical Assistant Professor of Medicine, Jefferson Medical College Shakaib Qureshi, M.D. King Edward Medical College, 1994 Residency, UPMC – McKeesport (IM) Residency, UMDNJ – Robert Wood Johnson(Occupational Medicine) Fellowship (Rheumatology), University of Oklahoma Education Coordinator, Section of Rheumatology Charles L. Reese, IV, M.D., FACEP Jefferson Medical College, 1978 Residency, Internal Medicine, Medical Center of Delaware Chairman, Department of Emergency Medicine Program Director, Combined Emergency Medicine/Internal Medicine Residency Program Clinical Assistant Professor of Surgery (Emergency Medicine), Jefferson Medical College

Dr. Tabassum Salam (Associate Program Director), Dr. John Donnelly (Assistant Program Director), Dr. Brian Aboff (Program Director), Dr. Matthew Burday (Associate Program Director). Albert A. Rizzo, M.D. Thomas Jefferson University Hospital, 1978 Residency, Thomas Jefferson University Hospital Section Chief, Pulmonary James E. Ruether, M.D. University of Toronto, 1993 Residency, Christiana Care Health System Medical Director, Unit Based Internal Medicine Faculty Member Sarah Schenck, M.D. Jefferson Medical College, 2000 Residency, Medical College of Virginia Hospitals Director, Adult Medicine Office Anthony Sciscione, D.O. University of New England, 1987 Residency, Christiana Care Health System Fellowship, Maternal-Fetal Medicine Program Director, OB-GYN Associate Professor, Drexel Medical College Jason M. Silversteen, D.O. Lake Erie College of Osteopathic Medicine, 2005 Internship, Graduate Hospital Residency, Drexel College of Medicine Fellowship, University of Texas Southwestern Medical Center Education Coordinator, Section of Neurology Julie Silverstein, M.D., FACP NYU School of Medicine, 1985 Residency, Cambridge Hospital Chief Medical Resident, Cambridge Hospital Director, Patient Safety and Performance Improvement, Department of Medicine Chief, Section General Internal Medicine Associate Chair for Ambulatory Medicine Clinical Associate Professor of Medicine, Jefferson Medical College Pamela Simpson, M.D. Jefferson Medical College, 2001 Residency, Christiana Care Health Services Fellowship, MCP-Hahnemann University Education Coordinator, Section of Oncology Shveta Singh, D.O. Arizona College of Osteopathic Medicine, 2003 Residency, Christiana Care Health Services Internal Medicine Faculty Member R. Bradley Slease, M.D. University of Kansas, 1972 Internship, National Naval Medical Center, Bethesda Fellowship (Hematology/Oncology) National Navy Medical Center Chief, Section of Hematology Michael Sneider, M.D. Wayne State, 1988 Residency, Oakwood Hospital & Medical Center Fellowship, University of Michigan Program Director, Diagnostic Radiology Residency Chief, Cardiothoracic Radiology Cem H. Soykan, M.D. University of Virginia School of Medicine, 2002 Residency, Children's National Medical Center Internal Medicine Faculty Member Maurice Thew, M.D. University of Leeds, 1964 Residency, University of Pennsylvania School of Medicine Chief, Section of Dermatology Marc T. Zubrow, M.D. Jefferson Medical College, 1977 Residency, Lankenau Hospital Fellowship (Pulmonary and Critical Care), University of Pittsburgh Director of Critical Care, Christiana Care Health System Medical Director, eCare Clinical Assistant Professor of Medicine, Jefferson Medical College

Neeta Milasincic, M.D., FACP Alumna, previous Chief Resident, 4th Year Student Clerkship Director “At Christiana Care Health System, tremendous diversity of disease, excellent teaching and mentorship, and vast research support create the ideal learning environment for trainees at all a levels. With these opportunities, our residents and students succeed at building the best foundation vital for the rest of their careers as physicians"

Anthony Munson, M.D. University of Virginia, School of Medicine, 2000 Residency (Neurology), University of Maryland Health System Medical Director, Stroke Unit Education Coordinator, Section of Neurology Jason Nace, M.D. Medical College of Virginia, 1997 Residency, Christiana Care Heath System Director, Clinical Decision Unit Internal Medicine Faculty Member

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By the Numbers
More than 10,000 employees
Christiana Care is the largest private employer in Delaware and the 10th largest employer in the Philadelphia region.

Our Residents 2011–2012
Internal Medicine
PGY 1

913
number of beds at Christiana Hospital

Enoch Arhinful, M.D. Saba University Muhammad Baig, D.O. Lake Erie College of Osteopathic Medicine Lauren Douglas, M.D. Jefferson Medical College Foyin Fasanmi, M.D. University of Maryland School of Medicine Christopher George, M.D. Temple University

Claudia Dal Molin, D.O. Edward Via Virginia Jennifer Juice, D.O. University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine Ruhong Ma , D.O. Edward Via Virginia Amratash Malodiya, MBBS Kastarba Medical College Kathy McGill, D.O. Philadelphia College of Osteopathic Medicine Adaorah Okafor, D.O. New York College of Osteopathic Medicine Donald Slack, M.D. University of Maryland Aubre Weber, D.O. Philadelphia College of Osteopathic Medicine Chia-Shing Yang, M.D. Eastern Virginia Medical School

New York College of Osteopathic Medicine Jennifer Brettler, D.O. University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine Bobby Gulab, M.D. Ross University Jennifer Hurd, M.D. Jefferson Medical College Narrani Kanapathippillai, M.D. Saint George's University Jason Magargle, D.O. University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine Heather Ragozine-Bush, M.D. Jefferson Medical College Lauren Salmon, D.O. Edward Via Virginia Sandra Schwarcz, D.O. Philadelphia College of Osteopathic Medicine Anna Taran, D.O. Lake Erie College of Osteopathic Medicine

$210 million
Wilmington campus undergoing transformation

$51,900
Salary of a PGY 1 medicine resident

Wide Variety of Content and Formats for Internal Medicine Residents’ Conferences
Internal Medicine residents need to acquire a vast spectrum of knowledge and skills during their training. Hence, we use a variety of formats and settings to deliver this to our residents. Every day at noon, there is a didactic session – many take the form of lectures, but, several are presented as workshops. Procedural skills, including office based procedures such as joint injections and skin biopsies are taught in workshops. Residents experience simulated cases lifted from potentially high-stress situations, such as Code Blues, in a simulation lab. Residents attend regular EKG reading sessions. An exciting addition to the lecture experience for our residents has been the use of an electronic Audience Response System, which allows the residents to interact with presenters. Apart from core medical knowledge, residents also have the opportunity to develop leadership skills and learn the business of medicine.

Delaware experienced the most rapid decline in cancer mortality in the United States from 1990-2005, at a time when cancer deaths were increasing nationwide.

Michael Gross, M.D. University of Medicine and Dentistry of New Jersey Ali Hamid, MBBS Dow Medical College JJ Hernandez, D.O. University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine Adrian Hurst, D.O. Philadelphia College of Osteopathic Medicine Adam Lammly, D.O. Philadelphia College of Osteopathic Medicine Poonam Maru, D.O. Western University of Health Sciences Tresa Mascarenhas, MBBS Madurai Medical College - India Calvin Williams, M.D., Ph.D. University of Maryland School of Maryland

Christiana Care’s Ranking
by Volume Compared to Other U.S. Hospitals U.S. RANK
17 th in Admissions 26 th in Births 20 th in Emergency Visits 23rd in Total Surgeries

PGY 3
Courtney Ackerman, M.D. Saint George's University Roi Altit, M.D. Jefferson Medical College David Armstrong, D.O.

EAST COAST RANK
10 th in Admissions 12 th in Births 10 th in Emergency Visits 11th in Total Surgeries
*Source: American Hospital Association Annual Survey Database of 6,280 U.S.Hospitals. Copyright Health Forum, LLC

PGY 2
Peter Burke, D.O. Philadelphia College of Osteopathic Medicine
Intern Welcome Celebration: Lauren Salmon, D.O. (PGY-3) and Anna Taran, D.O. (PGY-3).

Justin Morea, D.O. (Internal Medicine, Class of 2011) presenting at Medicine Grand Rounds

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Internal Medicine Residents (continued)

Medicine Pediatrics
PGY 1
David Chen, M.D., MPH University of Medicine and Dentistry of New Jersey Himani Divatia, D.O. Philadelphia College of Osteopathic Medicine Stephanie Guarino, M.D. Baylor College of Medicine Vishal Patel, M.D. Albany Medical College Giovanna Uzelac, M.D. Jefferson Medical College Narrani Kanapathippillai, M.D. PGY-3 IM Resident Jennifer Gauntt, M.D. Georgetown University Christopher Prater, M.D. Michigan State University Christopher Prendergast, M.D. Brown University

Preliminary Medicine
PGY 1
Matthew Butler, M.D. University of Medicine and Dentistry of New Jersey Nirav Das, M.D. University of Texas Southern Medical Center Assaf Graif, M.D. Technion Sameul Hanif, M.D. George Washington University Sergey Kochkine, M.D. SUNY Stony Brook Christopher O'Neill, M.D. Columbia University Samir Thaker, M.D. Case Western Reserve University School of Medicine

PGY 4
Raymond Carter, M.D. New York College of Medicine Samantha DeCouto, D.O. Philadelphia College of Osteopathic Medicine Andrea Read, D.O. Philadelphia College of Osteopathic Medicine Karla Testa, M.D. Georgetown University

PGY 3
Kelly Billig-Figura, M.D. State University of New York Candace Sprott, M.D. Wake Forest University Mark Troiano, D.O. Philadelphia College of Osteopathic Medicine

Transitional Year
PGY 1
Megan Dowling, M.D. Eastern VA Medical School Nathan Finch, M.D. Eastern Virginia Medical School Daniel Fistere, M.D. Virginia Commonwealth School of Osteopathic Medicine Chad Hummel, M.D. Jefferson Medical College Roshan Modi, M.D. Drexel University Matthew Moon, M.D. Mount Sinai School of Medicine Tim Niesen, M.D. Drexel University Jennifer Rowland, M.D. University of Pennsylvania Vivek Sahani, D.O., University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine

PGY 2
Sneha Daya, M.D. Albany Medical College

“Everyone from the office staff to my attendings have been nothing but helpful and encouraging. Christiana Care is a great nest for residents to grow in and learn to fly.”

Emergency Medicine/Internal Medicine
PGY 1
Stephen Boone, M.D. University of Texas Tam Dang, M.D. Creighton University Andrew Deitchman, M.D. Temple University

PGY 3
Mary-Stewart Grote, M.D. University of Kansas Daniel Hess, M.D. University of Maryland Vikram Marocha, M.D. Baylor College of Medicine Wahida Azimi, D.O. Internal Medicine, Class of 2010 "I loved the wonderful camaraderie and social network at CCHS!" Hana Choy, M.D. Case Western University Elizabeth Lee, M.D. University of Maryland Matthew Stofferahn, M.D. Johns Hopkins University

PGY 2
Nour Rifai, MBChB Royal College of Surgeons in Ireland Brian Robertson, M.D. Virginia Commonwealth University School of Medicine
Physical Diagnosis Charades, Intern Orientation: Tresa Mascarenhas, MBBS (PGY-1), Muhammad Baig, D.O. (PGY-1), Roy Kao, M.D. (Chief Resident), Amratash Malodiya, MBBS (PGY-1).

PGY 4
Edgardo Ordonez, M.D. University of Medicine and Dentistry of New Jersey Alon Payenson, M.D. Drexel University Margaux Snider, M.D. Oregon Health Science University School of Medicine

Joseph Romano, M.D. Virginia Commonwealth University School of Medicine

PGY 5

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Teaching Skills Course
The Active Learning Credo
(from Silberman, 1996 Active Learning 101 Strategies) What I hear, I forget. What I hear and see, I remember a little. What I hear, see, and ask questions about or discuss with someone else, I begin to understand. What I hear, see, and do, I acquire as knowledge and skill. What I teach to another, I master. three enjoyable off-site retreats that you’ll experience over the course of the residency program. For those individuals who are interested in pursuing additional teaching skills education, our program offers a yearly ten week course held every Fall. Topics covered in the course include: • Adult learning theory and learning preferences • The One Minute Teacher • Using the Data Gatherer-Reporter-Interpreter-Educator (D-RIME) model for teaching • Oral presentations and documentation • Teaching medical decision making and strategies to avoid cognitive bias – Donnelly • Teaching during bedside rounds – Deutsch • Teaching the physical exam – Burday • Teaching in a lecture format – Schenck • Conflict resolution • Effective evaluation • Feedback skills • Preparing abstracts and presentations

New Leadership Track for Residents
Good leaders are made not born. If you have the desire and willpower, you can become an effective leader. Good leaders develop through a never ending process of self-study, education, training, and experience (Jago, 1982).
Residency training is first and foremost about learning to take safe and effective care of our patients. However, 21st century demands the high quality that comes from effective teamwork with other doctors and the healthcare team. Physicians are the natural leaders of these teams. To that end, our residency program is excited to announce the start of a new optional leadership track. Built into the curriculum so that your clinical experiences are undisturbed, residents who participate in this three year track will acquire the knowledge and skills to be a highly effective leader. In the first year of the program, you’ll participate in the Achieving Competence Today course. A twelve week, nationally acclaimed curriculum developed by the leadership at Christiana Care, residents learn in multidisciplinary groups about patient safety, change theory, health care financing, and quality improvement. In the second and third years of training, residents will learn the skills of negotiation and conflict resolution, effective communication and learning styles, business fundamentals, organizational development, managing people, and mastering the physician leader role. Residents who successfully complete the program will be given an additional certificate of completion at graduation. The knowledge and skills developed through this program will provide our residents with a competitive advantage for getting jobs, fellowships, and help launch their leadership career.

Did you know that the word doctor in Latin means teacher? Becoming an effective teacher is an important component of a physician’s growth. As an intern, you’ll be teaching 3rd and 4th year medical students. As a PGY-2 and more senior resident, you’ll have the exciting opportunity to lead and teach teams. Our program helps you become an excellent teacher through a series of

PGY2 Retreat 2011: Nour Rifai, MBChB (EMIM PGY-2), Ruhong Ma, D.O. (PGY-2), Kathy McGill (PGY-2), John Donnelly, M.D. (Assistant Program Director), Brian Robertson, M.D. (EMIM PGY-2), Sarah McTighe (2010-2011 Chief Resident).

Basic Research Opportunities at the University of Delaware
For residents with an interest in basic research, Christiana Care is sponsoring residents to perform basic and translational research full time at the Delaware Biotechnology Institute and University of Delaware.
With the approval of the program director, residents can spend one to two years in the lab participating in programs at these research centers. While doing research, residents would remain employees of the hospital with full benefits and salaries. The institute’s current emphasis is in the fields of oncology and sophisticated imaging technologies.

The Christiana Care Diamond

PGY2 Retreat 2011

TO BECOME OUR FAN ON FACEBOOK
http://www.facebook.com/home.php?#!/pages/Newark-DE/Christiana-Care-Internal-Medicine-Residency/ 168912839788310 • http://www.twitter.com/cchsimresidency • http://cchsimresidency.wordpress.com 24 25

Recent Graduates
Internal Medicine Graduates
RESIDENT
2010–2011
Matthew Barrett, D.O. (EMIM) William Chasanov, D.O., MBA Matthew Dunn, M.D. (Med-Peds) Yugenia Hong, M.D. (Med-Peds) Roy Kao, M.D. (Med-Peds) Elizabeth Kunkel, D.O. Lionel Malebranche, M.D. Brooke Mobley, D.O. John Mohline, D.O. (EMIM) Justin Morea, D.O. Sajid Noor, D.O. James Perkins, M.D. Briana Sanders, M.D. Jenny Taylor, D.O. (Med-Peds) Jessica White, M.D. De Winter, M.D. (EMIM) University of Maryland Christiana Care Practice (AZ) Hospitalist Infectious Disease Washington Hospital Center (DC) Pediatric Hematology/Oncology UCLA Practice (WA) Hospitalist Cardiology Christiana Care Nephrology Christiana Care Practice (DE) Medical Informatics Regenstrief Institute Indiana University Practice (DE) Hospitalist Cancer Research (PA) Practice (MD) Hospitalist Practice (DE) Hospitalist Quality and Patient Safety Christiana Care Emergency Medicine Pracice (NC) Pulmonary Critical Care Nephrology Fellowship

Internal Medicine Graduates (continued) RESIDENT
2009–2010 (continued)

FELLOWSHIP

PROGRAM
Practice - Medicine Pediatrics (NH) Practice - Medicine Pediatrics (DE) Radiology Oncology Residency, Georgetown Practice- Emergency Medicine (MD) Practice (CA) Hospitalist

FELLOWSHIP

PROGRAM

Jennifer Packard, M.D. (Med-Peds) Adam Rudnick, M.D. (Med-Peds) Stephen Walsh, M.D. Erin Watson, M.D. (EM/IM) Esther Wong, M.D.

2008–2009
Kevin Copeland, D.O. Joseph Deutsch, M.D. Jamie Fountain, M.D. (Med-Peds) Cherilyn Hall, M.D. (Med-Peds) Tamar Jackson, M.D. Lisa Jones, D.O. Matthew Judd, D.O. (EM/IM) Jonathan Kaufmann, D.O. Jeffrey Mindel, M.D. Michael Perraut, M.D. (EM/IM) Lisa Preston, D.O. (EM/IM) Marina Pulini-Franks, M.D. Niksad Puthiya Purayil, M.D. Mina Rim, M.D. (Med-Peds) Tequa Salehi-Rad, D.O. (Med-Peds) Chief Resident Practice (DE) Hospitalist Practice Practice (MD) Practice (DE) Hospitalist EM Administrative Endocrinology Christiana Care, Private Practice (PA) Practice (HI) Hospitalist George Washington University Practice Private Practice (CT) Medical University of South Carolina Christiana Care Practice (DE) Hospitalist Cooper University

2009–2010
Dave Aljadir, M.D. Wahida Azimi, D.O. Brad Bley, D.O. (Med-Peds) Chris Coletti, M.D. (EM/IM) Jennifer Cooke, D.O. Nancy Fleurancois, M.D. (Med-Peds) Dena Florczyk, M.D. (Med-Peds) Ralph Gonzalez, M.D. Ben Goodgame, M.D. (EM/IM) Lalitha Gudipaty, M.D. Aman Jalali, M.D. Jennifer LeComte, D.O. (Med-Peds) Sarah McTighe, D.O. Phyllis Owusu-Griffin, M.D. Hematology/Oncology Sports Medicine Emergency Administration Roger Williams Practice (HI) Hospitalist University of Massachusetts Christiana Care Private Practice (FL) Practice (DE) Hospitalist UCLA Practice (DE) Hospitalist Cooper University Hospital University of Pennsylvania Practice Hospitalist Peds Chief AI duPont Hospital for Children (DE) Chief Resident Practice (MA) Hospitalist

Rheumatology Cardiology Infectious Disease

2007–2008
Abimbola Olowo, M.D. Armin Marefat, D.O. Caroline Weston, M.D. (Med-Peds) Christine Manley, M.D. (Med-Peds) Greg Beato, D.O. Hayley Rintel-Queller, M.D. (Med-Peds) Jason Nomura, M.D. (EM/IM) Jennifer Genuardi, M.D. (Med-Peds) Jonna Gies, M.D. (EM/IM) Matthew Grove, D.O. Michael Silverberg, M.D. Thinesh Dahanayake, M.D. (EM/IM) Gastroenterology Gastroenterology Sports Medicine Sports Medicine EM Ultrasound Practice UMDNJ Practice (NJ) Hospitalist Jefferson Medical College Virginia Tech Christiana Care Christiana Care Chief Resident Practice (WY) Christiana Care Drexel University Rochester

Sports Medicine Critical Care Endocrine Research

Cardiology Emergency Medicine Critical Care

Christopher Rogan, M.D. (EM PGY-3), Vikram Marocha, M.D. (EM/IM PGY-3), Justin Morea, D.O. (Internal Medicine, Class of 2011), Chaney Stewman, M.D. (Preliminary, Class of 2010), Lionel Malebranche, M.D. (IM, Class of 2011), Anna Taran, D.O. (PGY-2).

"My experience of residency training at CCHS has prepared me better than I could ever have imagined for my job. The diversity of the cases I saw, the volume of patients, the innovativeness of the residency program and outpatient experiences, the nurturing atmosphere, and the technology at Christiana has allowed for this easy transition into a busy inner city clinic. My colleagues come to me with questions about managing all of the challenging patients, look to me as a leader on improvement projects and problem-solving, and count on me to be a teacher for the mid-level providers."

Jennifer Genuardi, M.D. Alumna and previous Chief Resident 26 27

Intern Retreat, Rehoboth Beach: Dan Hess, M.D. (EM/IM PGY-3), David Armstrong, D.O. (PGY-3), Jason Magargle, D.O. (PGY-3), Stephen Walsh, M.D. (Alumnus)

Gregory Beato, D.O. Alumnus

"I always knew my training at Christiana was excellent, but I didn't fully appreciate the diverse exposure and attention to teaching we have until experiencing other graduate medical education programs and community hospitals. Being able to consult with any number of well trained and approachable specialists and internists assisted my training exponentially. Christiana Care Health System and the graduate medical education program were thorough and detailed in preparing me for becoming an attending. The exposure to pathology and excellent teaching made the transition to fellowship smooth. Going from CCHS Internal Medicine residency to a Sports Medicine fellowship was smooth because I felt prepared on the medicine topics so that I could focus on learning my specialty information. I believe even after being away from internal medicine on a day to day basis for one year, my training at CCHS has allowed me to pick up right where I left off now as a primary care physician and hospitalist."

Internal Medicine Graduates (continued) RESIDENT
2007–2008 (continued)
Tina Mirza, M.D. Uzoma Kalu, M.D. Vivek Reddy, M.D. Zeshan Rana, M.D. Private Practice (PA) Private Practice (OH) Practice (DE) Hospitalist Cardiology

Internal Medicine Graduates (continued) PROGRAM RESIDENT
2005–2006 (continued)
David Rosenstein, M.D. (Med-Peds) Mike Schiano, M.D. Andy So, D.O. Jason Sperberg, D.O. Alex Straight, M.D. (EM/IM) Seth Torregiani, D.O. (Med-Peds) Chris Valle, M.D. (EM/IM) Cardiology Nephrology Practice (TX) Practice (NY) Hospitalist Lankenau Hospital Practice (CO) Hospitalist University of Minnesota Practice (DE) Practice (FL)

FELLOWSHIP

FELLOWSHIP

PROGRAM

2006–2007
Eric Adkins, M.D. (EM/IM) Ankush Bansal, M.D. Rani Beharry, M.D. Doreen Bett, M.D. Yolanda Domond, M.D. (Med-Peds) Richa Gopal, M.D. Lacy Hobgood, M.D. (Med-Peds) Matt Jacobson, M.D. Nana Kutateladze, M.D. Brian McGillen, M.D. Alexia Moutsatsos, M.D. Rob Myers, M.D. Jean Rim, M.D. (Med-Peds) Charles Roche, M.D. Rani Singh, D.O. Sue Thompson, D.O. (EM/IM) Dennis Trigueros, M.D. (EM/IM) ED Critical Care Geriatrics Nephrology Ohio State Practice (DE) Hospitalist Temple Dartmouth Practice (OR) Practice (DE) Hospitalist Practice (NC) Practice (DE) Practice (DE) Chief Resident Practice (DE) Christiana Care Rush Practice (HI) Hospitalist Practice (DE) Practice (DE) UC - Irvine

2004–2005
Stephen Chrzanowski, M.D. Amy Collis-Cowitch, M.D. Jasdeep Dalawari, M.D. (EM/IM) Kerri Donahue, M.D. Aaisha Haque, M.D. Vinay Hosmane, M.D. Qing Liu, M.D. Cybele Mathai, M.D. Parag Patel, M.D. (Med-Peds) Rebecca Resnik, M.D. Cardiology Cardiology Pulmonary/CC Cardiology Hartford Hospital Practice (PA) Hospitalist Medical College of Virginia Medical College of Georgia Practice (DE) Hospitalist Christiana Care Practice (DE) Hospitalist Practice (AZ) Hospitalist Baylor Mass General Hospital

Cardiology Infectious Disease

Atherosclerosis Pain/Palliative Care

Ultrasound

2005–2006
Rigoberto Acosta, M.D. Scott Dyer, D.O. Dan Gilday, D.O. (EM/IM) John Granger, M.D. Binu Jacob, M.D. Michelle Jordan, D.O. Colin Kane, M.D. (Med-Peds) Karen Kinkel, M.D. Thomas Mathew, M.D. Collette Mehring, D.O. Kendall Ritz, M.D. (Med-Peds) 28 Allergy Infectious Disease Practice (DE) Tulane Practice (WA) UT Practice (DE) Hospitalist Chief Resident Emory University Practice (DE) Practice (DE) Hospitalist Thomas Jefferson Practice (DE)

Physical Diagnosis Charades, Intern Orientation: Lauren Douglas, M.D. (PGY-1), Jennifer Rowland, M.D. (Transitional Year PGY-1), Poonam Maru, D.O. (PGY-1).

Peds Cardiology

Nephrology

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Team building exercise at the PGY2 Retreat 2011.

“My favorite, most rewarding part of residency training was having my own outpatient practice in a residents' clinic. As the medical director of the Adult Medicine Office at Christiana Care, I strive to impart that enthusiasm and passion for outpatient medicine to our residents. Residents are privileged to take care of their own panel of patients with the support of an expert faculty, dedicated staff and a sophisticated electronic medical record. Through the development of the doctor-patient relationship over the course of their residency, residents learn the art and science of outpatient medicine.”

Transitional Year Graduates
RESIDENT
2010–2011
Yousaf Awan, M.D. Adam Fang, M.D. Shoheb Farooqui, M.D. Judith Gadde, D.O., MBA Mamta Gupta, M.D. Amr Kouchouk, M.D. Heather Mosca, D.O. Hemesh Rama, M.D. Dillenia Reyes, M.D. Radiology Radiology Radiology Radiology Radiology Ophthalmology Radiology Radiology Radiology Univeristy of Maryland University of Rochester Christiana Care Christiana Care MCV/VCU George Washington University Christiana Care Beth Israel Medical Center Temple University

Sarah Schenck, M.D., FACP Medical Director, Adult Medicine Office

RESIDENCY

PROGRAM

Transitional Year Graduates (continued) RESIDENT
2007–2008 (continued)
Shivam Patel, M.D. Daymen Tuscano, M.D. Michael Spina, M.D. Jesus Velez, M.D. Radiology Radiology Radiology Radiology Temple University Emery University Christiana Care Health System Christiana Care Health System

RESIDENCY

PROGRAM

2006–2007
Rachel Brock, M.D. Kevin Bowman, M.D. Gabriel Chong, M.D. F. Char DeCroos, M.D. Radiology Joanna Galati, M.D. Andrew Gargiulo, M.D. John Scheel, M.D. Radiology Radiology Ophthalmology Ophthalmology Jefferson Medical College Psychiatry Radiology Radiology Christiana Care Health System Jefferson Medical College Duke University Duke UniversityAnton Delport, M.D. Johns Hopkins University Temple University University of Virginia

2009–2010
Kazal Bahl, M.D. Belal Bakir, M.D. Joanna Busquets, M.D. Rebekah Clarke, M.D. Andrew Gunn, M.D. Sonia Gupta, M.D. Soham Mahadevia, M.D. David Raj, M.D. Elana Smith, M.D. Radiology Opthamology Dermatology Diagnostic Radiology Radiology Radiology Radiology Radiology Diagnostc Radiology Christiana Care University of Texas Thomas Jefferson University Baylor University Mass General Hospital Christiana Care Emory University Christiana Care Morristown Memorial Hospital

2005–2006
Paul Cedeno, M.D. Lawrence Cheung, M.D. Matthew Keller, M.D. Samri Kodsi, M.D. Karyn Leniek, M.D. John Moore, M.D. Jocelyn Park, M.D. Katie Rossy, M.D. Kamyar Sartip, M.D. Radiology Radiology Dermatology Radiology Preventive Medicine Ophthalmology Radiology Dermatology Radiology Christiana Care Health System Stanford Jefferson Medical College Tufts New England Medical Center University of North Carolina Johns Hopkins Beth Israel Hospital Metropolitan Hospital Christiana Care Health System

2008–2009
Patrick Chan, M.D. Janine Collinge, M.D. Bryan Franck, M.D. Kathryn Grandfield, M.D. Eric Ko, M.D. James Lee, M.D. Joseph Le, M.D. Thomas Reilly, M.D. Clint Wrigley, M.D. Opthamology Opthamology Radiology Radiology Radiology Oncology Radiology Radiation Oncology Radiology Radiology Columbia University Washington National Eye Center Christiana Care Brown University Mt. Sinai Medical Center Christiana Care Washington University Albert Einstein Medical Center Christiana Care

2004–2005
Julie Bykowski, M.D. Andrew Chen, M.D. Kheng Lim, M.D. Kristen Lott, M.D. Ankit Patel, M.D. Aron Rosenthal, M.D. Jessica Wei, M.D. Greg Wilde, M.D. Radiology Radiology Radiology Radiology Physical Medicine & Rehabilitation Radiology Radiology Radiology University of California San Diego University of Massachusetts Christiana Care Health System University of Pennsylvania Hospital Baylor Medical Center University of California San Diego Pennsylvania Hospital Christiana Care 31

2007–2008
Gregory Chandler, M.D. Kriti Gwal, M.D. Aaron Parnes, M.D. Keyur Patel, M.D. Radiology Radiology Radiology Radiology Temple University Pennsylvania Hospital University of Maryland UMDNJ- Robert Wood Johnson

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Imaginations
— Child Care —
Tuition Rates
(effective July, 2011) Visit our web site www.brighthorizons.com Full Time Rates (40 Working Hours)
Infant Program (Babyland, Creepers) Toddler Program (Toddlers) Twos Program (Rompers, Explorers) Preschool Program (Preschool, Pre K) $250 Per Week $230 Per Week $222 Per Week $211 Per Week 5-9 Hours $56 $53 $51 $49 5 Hours or Less $44 $41 $39 $37

CHRISTIANA CARE named a “Thomson 100 Top Hospitals Performance Improvement Leader”

Department of Medicine
Scholarly Activities and Original Research
All categorical internal medicine, medicine/pediatrics, and emergency medicine/internal medicine residents are required to complete at least one scholarly activity during their residency, although many residents complete more than one. These scholarly activities are intended, given that residency is a unique time in one’s training with an extremely high learning curve, to encourage residents to satisfy their intellectual curiosity and place the clinical information they’ve acquired into the context of population health and the overall health system. In addition, residents will gain writing and presentation skills, work closely with one or more faculty mentors, improve their abilities to search and understand the medical literature, and potentially gain skills in performance improvement and evaluation. Residents who complete one or more scholarly activities are generally considered more competitive candidates for fellowship and other career opportunities. The types of activities that qualify to complete the scholarly activity requirement include: • Writing and presenting an abstract to a regional or national conference. • Presenting research findings at a regional or national meeting. • Peer-reviewed publications. residents, and will pay for travel to national meetings if residents’ work is selected for presentation. In recent years, DOM residents have also presented their work at such national meetings as the American College of Cardiology, Infectious Diseases Society of America, American College of Emergency Physicians, American Heart Association, and others. Peer-reviewed publications can occasionally arise from these abstracts, and are expected to result from original research projects. The Delaware Medical Journal is a peer-reviewed publication that is a particularly good opportunity for residents to publish their work. Please see the attached list of publications for other examples. Residents can also participate by working with a faculty member who is asked to write a review article or book chapter. The Clinicopathological Conference (CPC) is an opportunity for residents (typically PGY-III or higher) to work with a faculty mentor to investigate an interesting, unknown case and to present the case, their differential diagnosis, and their diagnostic approach at a session of Medical Grand Rounds. These sessions are generally greatly enjoyed by both the presenting resident and the audience.

Drop-In Rates (Daily)
Infant Program Toddler Program Twos Program Preschool Program Registration Fees: $100 Registration Fee 2nd Child: $50

For the second consecutive year, Christiana Care is a Thomson Reuters 100 Top Hospital Performance Improvement Leader. Formerly Solucient, Thomson Reuters is a nationally known provider of health care information. This prestigious award places Christiana Care among the top 100 U.S. hospitals—and among the top 15 major teaching hospitals— for the fastest, most consistent performance improvement over five consecutive years.

• Book chapters, review articles or similar non-peer-reviewed publication. • Presenting a Clinicopathological Conference (CPC) at Medical Grand Rounds. • Original research. • Other special projects may be approved by the Program Director on a case-by-case basis (e.g. new curricula, performance improvement projects that are published) Abstracts are frequently case reports of interesting or unusual clinical cases but can also be descriptions of original research projects. The Department of Medicine (DOM) submits multiple resident and medical student abstracts to the Delaware American College of Physicians (ACP) meeting, which occurs annually in February. Several residents are also selected to present their work at the national ACP meeting in April. CCHS will print resident posters at no cost for the

NOTES: • Please see the Center Director for part time options • For two (2) or more children, a 10% discount will be given on tuition for the oldest child. • Payments are made two (2) weeks in advance and will be made through payroll deduct. • Rates are subject to change. • Tuition is reflective of staff-child ratios in assigned classrooms.

Intern Welcome Event, Neeta Milasincic, M.D., Lionel Malebranche, M.D. (Class of 2011), Enoch Arhinful, M.D. (PGY-1).

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Program Announces New Optional Research Track
Beginning in the 2011-2012 academic year, the Department of Medicine (DOM) added an optional “Research Track” for those residents who know early in their residency that they are interested in pursuing a research project. The goal of the Research Track is to provide interested and motivated residents with the infrastructure and support to successfully complete and present and/or publish an independent research project. Please note that residents who do not enroll in the Research Track up front are not precluded from conducting research at a later date. Advantages of the Research Track will include more structured research mentoring, education in research methodology, administrative support, and higher priority in accessing information technology (IT) and statistical support. Residents will enroll in the Research Track early in their intern year, and over the first year will identify a faculty mentor and develop their research question and protocol. Early in their second year of residency, they will submit their project through the Christiana Center for Outcomes Research (CCOR, see below) for study design and statistical evaluation, then the DOM Clinical Research Committee and the Institutional Review Board (IRB) for approval. Once these steps have occurred, the resident will conduct their research during their second year, with the goal to finish the data collection and analysis by the beginning of the third year, which will then be spent writing up, presenting and publishing their work. This time line will be stretched out slightly for residents in combined programs.

is the research nurse supervisor assigned to the DOM to assist with resident research projects. She and her staff of 5 additional research nurses will help with IRB applications, obtaining funding if necessary, chart abstraction, subject enrollment and other research activities.

Roy Kao, M.D. (Med Peds, (Class of 2011, Chief Resident 2011-2012) demonstrating on the Sim Lab mannequin at Medical Grand Rounds.

Types of Resident Research Projects
Heather Ragozine-Bush, M.D. PGY-3 Internal Medicine resident Chief Resident 2012-2013 “Christiana allows you the autonomy to grow and develop into an individual physician while offering an infinite amount of teaching, both didactic and Socratic, to help guide you along the way. Nowhere is this more true than in the MICU, where attendings, physician assistants, nurses, residents, and medical students work together to form plans using evidence-based medicine while emphasizing the need to practice cost-effective medicine. Opportunities to preform supervised procedures, such as central line placement and paracentesis, are abundant. These procedures are taught and perfected in a simulation lab to develop our technique prior to patient contact.” For the most part, due to residents’ clinical responsibilities and other time constraints, most resident projects involve retrospective review of existing medical records via chart review and/or database analysis. CCHS’ patient volume and excellent medical informatics provide an extremely rich source of data for a wide variety of research questions. However, some residents have successfully managed to conduct prospective studies, such as surveying health care workers before and after an intervention, or screening a specified patient population for a given condition, or even randomized controlled trials. Many residents also become involved in both informal and formal performance improvement projects, many of which result in publishable results.

Steps to Successfully Completing an Original Research Project
Successfully completing an original research project is time-consuming, and always requires a team effort. CCHS and the DOM are dedicated to providing as much oversight and support as residents need to initiate and complete their projects. Such support includes: 1) Institutional Review Board (IRB) Human Subjects Protection Training and IRB approval. IRB training is an online course available via the

Research Support
Marci Drees, MD, MS, and Daniel Elliott, MD, MSCE, serve as the Co-directors of Resident Research for the DOM and help to coordinate resident research efforts. Dr. Drees periodically distributes research ideas and opportunities for residents, and can help to find a research mentor for residents who are interested in working in a particular subject area (such as in preparation for fellowship application). Patty McGraw, RN, MSN,

CCHS intranet. All EM/IM residents are required to complete this course as part of their residency training; all other residents who have even the slightest interest in conducting a research or PI project are strongly encouraged to complete this training as early as possible. Dedicated time will be allotted to complete these modules during the Evidence-based Medicine elective or other time allowable by the Program Director. Incoming residents who have documentation of completion of similar training during medical school may be exempted from this requirement. All research projects must be approved by the IRB prior to commencement; while PI projects may be considered exempt from IRB approval, they must still be approved prior to any publication or presentation of results outside of CCHS. 2) Literature review. The Lewis B. Flinn Medical Library, located in the John H. Ammon Medical Educational Center, has a wide variety of print and electronic articles available, which can be printed or copied for no cost. Articles from journals for which CCHS does not

hold a subscription can be ordered individually through the librarians at no cost to residents. In addition, the medical librarians will gladly assist with performing an effective literature search on the topic of interest. 3) Finding a Research Mentor. The Co-directors of Resident Research, Dr. Drees and Dr. Elliott, are the primary contact persons within the DOM for residents interested in research. Dr. Drees will distribute potential opportunities (faculty members who have an ongoing project or an idea for a project, who are willing to mentor residents interested in participating), try to identify research mentors for residents interested in a particular subject matter, and will meet with residents individually as needed to discuss the Scholarly Activity Requirement and original research. In addition, Dr. Drees and Dr. Elliott both have masters-level training in clinical research and epidemiology, and can assist as secondary mentors for those faculty-resident teams who need additional assistance with clarifying the research question, study design and analysis.

4) Statistical Analysis and Information Technology (IT) support. Established in 2005, the Christiana Care Center for Outcomes Research (CCOR) not only conducts a number of clinical research projects, but has a fundamental goal to assist faculty and residents across CCHS to successfully complete clinical research projects. Residents who require IT and/or statistical support can submit a brief request to the IT/Statistics Planning Committee, which meets monthly and will review the study design, data elements needed, planned measurable outcomes and statistical analysis. Members include faculty from the DOM, biostatisticians (PhD and Masters’ level), epidemiologists, and IT specialists. After review, the committee will determine a plan and time line for data extraction and statistical analysis. 5) Writing, Publication & Presentation Support. Dr. Drees and Dr. Elliott are also available to edit and review abstracts, Powerpoint presentations, posters, and all other publications submitted by residents. The Medical Imaging Department will print posters at no cost for residents.

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6) Funding. Most resident research projects do not require any external funding. However, some projects may require supplies, computer software, additional laboratory testing, etc. Proposals can be submitted to the Clinical Research Committee, a multidisciplinary group from the DOM who will review the protocol and determine if funding is appropriate. The Committee has access to more than $50,000 in funding for resident research projects per fiscal year. Each resident through the Department of Academic Affairs may be awarded and additional $800 per year for costs associated with their proposals. 7) Other Educational Opportunities. The Center for Outcomes Research holds the biweekly Epidemiology Luncheon Lecture Series, a noon conference where CCHS and outside speakers will discuss their ongoing research projects. All CCHS staff and residents are welcome to attend (lunch is provided). As part of the Resident core lecture series, several didactic lectures annually are

devoted to research-related topics, such as study design and biostatistics. In addition, both basic and advanced biostatistical seminars are regularly offered through CCOR.

Examples of Recent Resident Research Projects & Abstracts in the Past Three Years
• Using a Report Card to Improve the Quality of Care for Patients with Diabetes. Presented at the Society of General Internal Medicine, 2011 – Dr. Prater • Increased Utilization of Ultrasound Guidance for Central Venous Catheters by Non-Emergency Medicine Residents Due to Emergency Medicine Related Programs. Presented at the Society for Academic Emergency Medicine, 2010 – Dr. Winter • RITE -->O: Residents Improving Transitions of Care; ED to Outpatient. Presented at the Alliance of Independent Academic Medical Centers National Meeting, 2011 – Dr. Stofferahn (EM/IM), Dr. DeCouto (Med-Peds), Dr. Read (Med-Peds) and Dr. Kunkel • Resident Knowledge of Resuscitation Medication Availability. Presented at the Society of Academic Emergency Medicine, 2011 – Dr. Hess • Acceptance of Novel H1N1 Vaccination During Pregnancy. Presented at the Infectious Diseases Society of America (IDSA) meeting, 2010 – Dr. Wong • Survival and Neurologic Recovery in Patients with ST-Elevation After Resuscitation from Cardiac Arrest Found to have Non-obstructive Disease on Angiography. Presented at the American Heart Association, 2010 – Dr. Malebranche • In Setting of Normal White Blood Cell (WBC) Counts, Elevated Bands Predict Infection and Death. Presented at the Infectious Diseases Society of America (IDSA) meeting, 2010 – Dr. Kanapathippillai • Long Term Morbidity and Healthcare Utilization among

Research Awards
There are a number of opportunities for residents to be recognized for their research and other scholarly activities. The DE ACP will nominate one resident with an outstanding abstract to present at the national ACP meeting. The CCHS Department of Academic Affairs conducts Education Week festivities annually in March, and provides a number of awards for resident research, including best case report, best abstract, best clinical discussion, best original research project, and awards in specialized topics such a family medicine and medical imaging. Cash prizes are provided. In addition, there is annual Focus on Excellence awards to recognize PI-related projects. One session of Medical Grand Rounds (held annually in June) is devoted to recognizing resident research, and residents are invited for both oral and poster presentations.

Jason Sperberg, D.O. Alumnus “I would never change my residency training for anything else. Christiana Care was terrific in so many ways. Spending time working alongside the specialists (pulmonary, cardiology, GI, renal) was important. I think the structure set up there for managing interns and residents as you mature through the program builds a tremendous amount of organization and management skills. The intense time in the medical and cardiac ICUs improved my skills in critical care patient management and procedures – which I use every day now. The best experience came from my time at Wilmington hospital where we were independent and the internist faculty there encouraged extreme independence. This is where I became confident and efficient. I was well prepared for my career as a hospitalist and had no problem stepping comfortably into my role managing internal medicine patients on the floor, in the ICU, or in consultation with surgical specialties. In fact, I quickly became one of the most effective and respected physicians at my hospital, in large part because of the training at Christiana.”

PGY2 Retreat 2011

Uninfected Children with Perinatal HIV Exposure. Presented at the Eastern Pediatric Research Society Meeting and the Pediatric Academic Society National Meeting, 2009 – Dr. Salehi-Rad • Zinc Intake and Biochemical Markers of Bone Turnover in Type 1 Diabetes. Published in Diabetes Care, 2008 – Dr. Owusu-Griffin • Resident Perceptions of an Integrated Remote ICU Monitoring System. Presented at the Society of Critical Care Medicine, 2009

• Fanconi Syndrome Induced by Tenofovir. Presented at the DE ACP, 2011 – Dr. Chasanov • Purpura Fulminans: a Severe Microvascular Complication of Pneumococcal Sepsis. Presented at the DE ACP, 2011 – Dr. Read • Aggressive Pancreatic Adenocarcinoma after Kidney Transplantation. Presented at the DE ACP, 2011 – Dr. Reyes • CNS Deficits in Multiple Myeloma with Primary Amyloidosis. Presented at DE ACP and National ACP meetings, 2010 – Dr. Taran • Paraganglioma Precipitating Reversed Takotsubo Cardiomyopathy. Presented at DE ACP and National ACP meetings, 2010 – Dr. Gonzalez • Relapsed Disseminated Cutaneous MALT Lymphoma. Presented at DE ACP, 2010 – Drs. Goodgame & Coletti • A Large Bleed From Ockham’s Razor. Presented at DE ACP, 2010 – Dr. Brettler (IM) • Spontaneous factor XI inhibitor presenting as bilateral subdural hematomas in a 67 year-old male. Presented at DE ACP, 2010 – Dr. Packard

Examples of Recent Resident Case Report Abstracts & Publications
• Palms that Unraveled an Occult Carcinoma. Presented at Delaware ACP and National ACP meetings, 2011 – Dr. Malodiya • Suspected Levamisole Contaminated Cocaine Induced Vasculitis. Presented at Delaware ACP and National ACP meetings, 2011 – Dr. Billig-Figura (Med-Peds), Dr. Burke (IM), and Dr. Ragozine-Bush • Diagnosis and management of auto-immune mediated myocarditis. Presented at the DE ACP, 2011 – Dr. Burke

Post Match Event: Muhammad Baig, D.O. (PGY-1), JJ Hernandez, D.O. (PGY-1), Vivek Sahani, D.O. (Transitional Year PGY-1), Jennifer Rowland, D.O. (Transitional Year PGY-1), Foyin Fasanmi, M.D. (PGY-1), Tresa Mascarenhas, MBBS (PGY-1), Tim Neisen, M.D. (Transitional Year PGY-1), Kathryn Bowser, M.D. (Surgery PGY-1).

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Salary and Benefits
Intern Welcome Event: Tresa Masacarenhas, MBBS (PGY-1), Lauren Douglas, M.D. (PGY-1), Jennifer Hurd, M.D. (PGY-3), Heather Ragozine-Bush, M.D. (PGY-3, 2012-2013 Chief Resident), Foyin Fasanmi, M.D. (PGY-1), Joe Deutsch, M.D.

Department of Medicine 2011-2012
SALARY
PGY 1 PGY 2 PGY 3 $51,900 $53,434 $55,921 Computers: Compaq computers are available for use by all medicine residents in the Medical Resident's Library providing: • Free internet access. • Computerized medical literature searching over the internet with OVID which allows for full text reprints. • Networked access to various Microsoft Office applications with free training available. • Networked access to Micromedex, Cerner Power Chart (clinical repository for lab and x-ray reports, discharge summaries, path reports, etc) and Logician (electronic medical record for adult medicine office patients). In addition, all residents have remote access to the Christiana Care Health System network via the Internet. Communication services: All incoming interns are provided with reimbursement for cell phones. Extracurricular activities: Tickets to many of Wilmington’s subscription series (theater, opera) and professional athletic events in the Philadelphia Baltimore - Washington area are offered through the Department of Medicine. These tickets are available to medical residents on a rotating basis.

BENEFITS
Vacation: Three weeks paid vacation for all house staff plus one week off for educational conference. • Segmental Arterial Mediolysis: First Case Reported of a Patient Presenting with Abdominal Pain and Biliary Obstruction. Presented at DE ACP and National ACP meetings, 2009 – Dr. Malebranche • Occam’s Razor Not Always Right, In AIDS Keep Hickam’s Dictum In Sight. Presented at DE ACP 2009 – Dr. Gulab & Dr. Salehi-Rad • Adult Onset Acute Epiglottitis. Presented at DE ACP 2009 – Dr. Payenson (EM/IM) • Primary CNS Lymphoma, a Challenging Diagnosis. Presented at DE ACP 2009 – Dr. Kao • Signet Ring Cell Adenocarcinoma Presenting as an Aggressive Hypercoagulable State. Presented at DE ACP 2009 – Dr. Mindel • Primum Non Nocere: Bisphosphonate-Induced Hypocalcemia in a Patient with Severe Occult Vitamin D Deficiency. Presented at DE ACP 2009 – Dr. Rim • Acute Tongue Swelling in a Patient Taking Lisinopril: Not Always Angioedema Presented at DE ACP 2009 – Dr. Stofferahn • Risk of Rapid Response Team (RRT) Activation within 4 hours of Admission. Retrospective casecontrol study – Dr. Malodiya • RITE -->O: Residents Improving Transitions of Care; ED to Outpatient. Prospective study – Dr. Stofferahn, Dr. DeCouto, Dr. Read and Dr. Kunkel • New Patient Engagement Program (N.P.E.P.). Prospective PI project. Drs. Chasanov and Lee • In Setting of Normal White Blood Cell (WBC) Counts, Elevated Bands Predict Infection and Death. Retrospective cohort study – Dr. Kanapathippillai • Frequency of severe valve disease associated with mediastinal XRT. Retrospective case-control study – Dr. Copeland • Standardized H+P's for Admitted Ward Patients from the ED. Prospective study – Dr. Lee Education allowance: $1,300 Allowance to be applied toward the cost of an educational conference and/or purchase of medical textbooks or related items such as Palm Pilots. Insurance (disability, life, medical, dental): see Residency Program catalogue.

Examples of Current/ Ongoing Resident Research Projects
• Factors influencing survival rates and neurological outcomes in patients who undergo hypothermia protocol after a cardiac arrest. Retrospective cohort study – Dr. Ma (IM)

Combined Programs Journal Club: Kelly Billig-Figura, M.D. (Med-Peds PGY-3), William Chasanov, II, D.O. (IM, Class of 2011).

Brandywine Park in Delaware

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Delaware
Despite its small size, Delaware is blessed with natural beauty, cultural diversity, rich local history, and warm friendly people.
Traveling from the rolling hills of Northern Delaware to the more than 20 miles of coastal beaches is a mere two hour drive through the green farmlands of central and southern Delaware and along the haunting marshes of the Delaware River and Bay. Delaware’s location affords easy access to the major metropolitan areas of the northeast, with both New York City and Washington, DC just two hours away. The state has three counties: New Castle, Kent and Sussex, with more than 875,000 people calling the First State their home. Delaware’s high quality of life is not accompanied by a high price tag. Cost of living comparisons conducted by recognized experts indicate that the costs associated with living and doing business in Delaware are far below those experienced in the neighboring states of New Jersey, Pennsylvania and Maryland.
continued on the next page

Cost of Living Comparisons
Below is the Delaware median household income according to American Community Survey (based on 2010 data) compared to other cities in America.

INDEX OF LIVING COSTS
Yearly Family Income City Wilmington Baltimore State DE MD 1.00 1.13 1.20 1.19 1.26 1.33 2.05
University of Delaware, Newark, Delaware

$53,774

Philadelphia PA Princeton Boston Washington New York NJ MA DC NY

The Christina Riverfront in Wilmington.

Outdoor and Cultural Life
• Five state parks within 15 minutes. • 150 miles of mountain biking, hiking and equestrian trails. • University of Delaware sports, minor-league baseball. • Close to beaches and Chesapeake Bay. • Longwood Gardens, Winterthur. • Delaware Symphony, Opera Delaware, Delaware Art Museum.

Grand Opera House on Market Street Mall in the city of Wilmington.

Rehoboth Beach, Delaware

A great place to work. A great place to live.
Centrally located between New York and Washington, D.C.
Destination Drive time Philadelphia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 minutes Baltimore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5 hours Washington, D.C. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 hours New York . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 hours Pocono (PA) mountains . . . . . . . . . . . . . . . . . . . . . 2.5 hours Delaware beaches . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5 hours
One of the beautiful scenes in Delaware. Wilmington Hospital

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Notes

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Christiana Care is a private, not-for-profit regional health care system and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission.

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