IcahnSchool ofMedicine atInternalMedicineResidencyProgram atMount SinaiBeth Israel
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Table of ContentsMapIntroduction to our Programi3Why Choose Mount Sinai Beth IsraelEducation TracksOverview11Categorical Residency1213Our Valued Housestaff5Preliminary ResidencyA Tradition of Excellence5Our ResidentsLocation5Resident Life17Diversity of Experience5How to Apply19Our Faculty6Contact Information21Career Development8Unique Curriculum91
Introduction To Our Program2
Dear Senior Medical Student:The Internal Medicine Residency Program atMount Sinai Beth Israel provides outstandingclinical training, research opportunities andpreparation for a career in either academic orclinical medicine. These endeavors are carriedout in a humane, respectful and supportiveenvironment where the delivery of compassionate,high-quality care is the guiding principle.For us, excellence is not just a fancy buzzwordthrown around to inspire and motivate; it isa principle that we live by every day. Whetherit’s excellence in patient care, in educating ourtrainees, or in mentoring and nurturing buddingphysician-scientists, it imbues our missionand drives us to do better for ourselves andfor our patients.Ultimately, the goal of our program is to provideyou with solid clinical skills, and the abilityto adapt and function in the ever-changingenvironment of modern health care. We wantyou to graduate with the ability to pursue anyarea of academic medicine. Our residentsconsistently secure top fellowships around thecountry and thrive in academic medical centers.Our program supports resident scholarly activity,with many residents traveling each year topresent their research work at local, nationaland international meetings.The residency program places a great deal ofemphasis on and takes great pride in the diversityof trainees’ clinical experiences. The patient mix iswell-balanced and represents the cultural andsocioeconomic diversity of Mount Sinai Beth Israel’smetropolitan location. Residents are responsiblefor and play a major role in the care of all of thesepatients, including continuity of care betweeninpatient and ambulatory settings.As a member of the Mount Sinai Health System,our residents are in a unique position to leverage theexpertise and resources of the largest health careprovider in the New York City area. As part of theIcahn School of Medicine at Mount Sinai, ourresidents have access to world-class educationaland clinical resources, including clinical or researchelectives at hospitals across the system. Full-timefaculty members hold academic appointmentsat the Icahn School of Medicine at Mount Sinaiand are involved in training residents and medicalstudents on inpatient services, in the ambulatorysetting and on the subspecialty services within theDepartment of Medicine.The Mount Sinai Health System is in the midst of anover 500 million transformation of Mount Sinai BethIsrael, to create the new “Mount Sinai Downtown,” anexpanded and unified network of state-of-the-artfacilities stretching from the East River to the HudsonRiver below 34th Street. When this transition iscompleted in 2021, MSBI will host four independentresidency programs, including Internal Medicine.The Internal Medicine residency at MSBI will beredesigned to provide residents with world-classtraining and preparation for a career in either clinicalor academic medicine. Keeping pace with thenational trend to shift the delivery of care from thetraditional inpatient setting to the ambulatory one,residents in this program will spend one-third of theirtime in the traditional hospital setting and two-thirdsof their training time in ambulatory subspecialty andgeneral medicine venues.We recognize that the changes described aboveare significant. As you consider your next step inpost-graduate training, we want to affirm that theIcahn School of Medicine at Mount Sinai iswholeheartedly committed to ensuring that eachof our trainees receives the highest quality trainingexperience at all of our clinical training locations.So if you are interested in advancing your medicaltraining in a dynamic, urban environment thatpromises to provide unique opportunities forlearning and living, we urge you to consider joiningour mission.Daniel I. Steinberg, MDDirector, Internal Medicine Residency ProgramMount Sinai Beth IsraelHarry Fischer, MDInterim Site Chair, Department of MedicineMount Sinai Beth IsraelDavid C. Thomas, MD, MHPEVice Chair for Education, Department of MedicineMount Sinai Health SystemBarbara Murphy, MDChair, Department of MedicineMount Sinai Health System3
Why Choose Mount Sinai Beth Israel4
At first glance, it is often difficult to distinguishamong residency programs. All promise to provideexcellent medical training and to open doors forfuture careers. We believe that at Mount SinaiBeth Israel we can and do provide so muchmore, including an appreciation and value of ourhousestaff, a continued tradition of excellence, avaried and diverse experience, and an outstandingfaculty who are deeply involved in your training.foodie scene in New York with the famous UnionSquare Greenmarket and a cultural and shoppingmecca. Beyond Union Square is the FlatironDistrict and Chelsea—two other populous anddistinct areas with different health care needs.To our south is the Lower East Side and AlphabetCity, an economically and culturally diverse areawhere the population faces a variety of challengesaround health care.OUR VALUED HOUSESTAFFAt Mount Sinai Beth Israel, we are proud of ourreputation for running a respectful and humaneresidency program. We ask for and value regularfeedback from our housestaff about the program.We foster a warm and collegial atmosphere that isso appealing many residents choose to stay at orreturn to Mount Sinai Beth Israel after their training.DIVERSITY OF EXPERIENCEAs a resident at Beth Israel, you will care for andbe exposed to a large, varied patient populationand complex cases in both the inpatient andambulatory settings.A TRADITION OF EXCELLENCEFor more than a century, Beth Israel has beenserving the downtown New York community,providing excellent primary, secondary and tertiaryhealth care to a robust and diverse population.Today, as a member of the Mount Sinai HealthSystem, the physicians of the Department ofMedicine at Mount Sinai Beth Israel remaincommitted to giving their patients the very bestclinical care all while creating a rigorous andchallenging environment for our residents.LOCATIONLocated in the heart of lower Manhattan on theEast Side, our campus is conveniently locatedbetween two different and vibrant neighborhoods.To our west lies Union Square, a center of theInpatient care is delivered at the Milton andCarroll Petrie Division located at First Avenue and16th Street. The Petrie Campus is an acute careteaching hospital, which is the main site for trainingin Internal Medicine.The majority of our residents spend a significantperiod of time each year in the ambulatory setting,consistent with current ACGME requirements.As an “on the ground” institution dedicated toserving our communities, Mount Sinai Beth Israelis proud of its ambulatory care network, oneof the largest in New York City. Each ambulatorycontinuity training site is designated as Level 3Patient-Centered Medical Homes.General Medical Associates (GMA) is locatedsteps from one of the busiest subway stations inNew York City at Mount Sinai Downtown - UnionSquare. Its location results in a large and diversepatient population from all five boroughs. AtGMA, physicians provide comprehensive primarycare, with all medical, surgical and radiologysubspecialties located within the same building.Dedicated primary care faculty supervise residentsin a longitudinal fashion, providing exceptionalteaching and mentorship.The Ryan NENA Community Health CareCenter located on East 3rd Street in theLower East Side of Manhattan is a FederallyQualified Health Care Center that serves adiverse community. Ryan NENA offers residentsan outstanding precepting, learning andpractice experience.5
Our FacultyAs a medicine resident at Mount Sinai Beth Israel, you willhave the opportunity to work with and be mentored by agroup of physicians who are dedicated to your educationand training. The following is a sampling of our programand faculty leadership:Allergy & ImmunologyMary Lee Wong, MD, is AssistantProfessor of Allergy & Immunology. A wellknown clinician in New York City, shemaintains a very busy practice at the MountSinai Downtown Union Square. Dr. LeeWong mentors many residents in academicprojects and runs a very popular allergy elective.Asian ServicesWan Lam, MD, is the Medical Director ofthe Asian Inpatient Service, which providesculturally sensitive care to the Chinesepopulation of Lower Manhattan and otherboroughs in New York City. Dr. Lammanages patients across the hospital,allowing residents to interact with her and her patients.CardiologyJohn Fox, MD, is the Director of theInterventional Cardiology and CardiacCatheterization Lab at Mount Sinai BethIsrael and Associate Professor of Cardiology. He is a member of the CardiacSteering Committee, and Chairman of boththe Cath Lab Leadership Committee and the Cath LabQuality Improvement Committee.Endocrinology & DiabetesTerry Davies, MD, is the Chief of theDivision of Endocrinology and Diabetesand the Florence and Theodore BaumritterProfessor of Medicine. Dr. Davis is aninternationally known expert in thyroiddisease, and his lab is known for its work inautoimmune thyroid disease research.GastroenterologyIlan Weisberg, MD, MSc, is AssistantProfessor of Medicine (Gastroenterology)and the Director for the Gastroenterologyand Hepatology Fellowship Program. Hisclinical interests span the entire breadth of6gastroenterology and endoscopy, with a particularemphasis on the treatment of hepatitis, portal hypertension and other disorders of the liver.General Internal MedicineChristina M. Cruz, MD, is the AssociateProgram Director for Ambulatory Care,and Assistant Professor of Medicine.She oversees the residency’s Ambulatoryand Wellness Curricula. Dr. Cruz regularlyreviews clinical vignettes and medicaleducation workshops for the Society of General InternalMedicine’s (SGIM) annual and regional conferences. Sheparticipates in medical education research around Endof Year Transfers of Care for high risk patients and morerecently a multi-center study of prevalence and potentialcontributors to burnout among resident physicians.Dr. Cruz’s primary area of interest is the intersectionbetween medical education and social accountability.Geriatric MedicineJoyce F. Fogel, MD, is AssociateProfessor and Chief of Geriatrics. Dr. Fogelhas developed a consolidated approach tocaring for the geriatric patient, whichincludes ambulatory, hospital and homebased care. Dr. Fogel oversees theresidency program’s geriatrics rotation, which has been apopular experience for our housestaff.Hematology and OncologyPeter Kozuch, MD, is Associate Professorof Medicine and the Associate ProgramDirector of the Icahn School of Medicineat Mount Sinai’s Hematology/OncologyFellowship. His clinical and researchinterests include malignancies of thepancreas and gastrointestinal tract.Hospital MedicineDahlia Rizk, DO, is Associate Professorand Chief of the Division of HospitalMedicine. Dr. Rizk has built the hospitalistprogram into one of the major inpatient clinical and teaching services in the hospital.She leads and is involved in numeroussystems-based initiatives for the Department of Medicineand throughout the institution.
Alfred Burger, MD, is AssociateProgram Director, Associate Professorof Medicine and Medical Education,and an attending in the Division ofHospital Medicine. Dr. Burger hasspecific interests in clinical reasoning ,quality improvement and in mentoring trainees in thedevelopment of clinical vignettes and case write-upsas early academic projects. Dr. Burger maintainsinvolvement in several national society workgroups,focusing on hospital medicine, hospital systems andquality improvement. He has taught numeroussessions and pre-courses on quality improvement atnational society meetings. He was a member of theSociety of General Internal Medicine’s ChoosingWisely Recommendations Work Group and isPresident-Elect of the New York State Chapter of theAssociation of Program Directors in Internal Medicine.Daniel I. Steinberg, MD, is ProgramDirector, Associate Professor ofMedicine, and Medical Education, andan attending in the Division of HospitalMedicine. Dr. Steinberg’s academicinterests include medical education,mentorship of trainees, faculty development andevidence-based medicine. He is actively involved inthe Society of Hospital Medicine (SHM), and the Association of Program Directors in Internal Medicine. He isa past President of the New York State Chapter of theAssociation of Program Directors in Internal Medicine.He presents regularly at national meetings and serveson multiple national society committees. He serveson the 2018 Annual Meeting Committee for SHMand is an Associate Editor of the American Collegeof Physician’s Journal Club which appears in theAnnals of Internal Medicine.Infectious DiseasesDavid Perlman, MD, is Professor andChief of the Infectious Diseases Division.He is an active investigator at the BaronEdmond de Rothschild ChemicalDependency Institution at MSBI andalso serves as the Director of theInfectious Diseases Core at the Center for Drug Useand HIV Research.Dana Mazo, MD, MSc, is AssistantProfessor of Medicine (InfectiousDiseases) and Interim HospitalEpidemiologist. Her interests includeinfection prevention and antimicrobialstewardship.NephrologyNikolas Harbord, MD, is AssistantProfessor of Medicine and Chief of theDivision of Nephrology. He is Director ofthe Nephrology Fellow’s AmbulatoryClinic as well as Director of the DiabeticNephropathy Clinic.Pulmonary, Critical Care and Sleep MedicineParu Patrawalla, MD, is AssistantProfessor of Medicine, ProgramDirector of the Pulmonary Critical Careand Sleep Medicine FellowshipTraining Program, and Director of theMount Sinai Beth Israel SimulationTraining Program.David Steiger, MD, is Professor ofMedicine and Chief of the Division ofPulmonary, Critical Care and SleepMedicine. He is an expert in interstitiallung disease, perioperative medicalmanagement, critical care medicine anda researcher in cognitive dysfunction in orthopaedicsurgical patients.Patricia Walker, MD, is AssociateProfessor of Medicine (Pulmonary,Critical Care and Sleep Medicine).She is an internationally knownspecialist in cystic fibrosis who runs theCF program at Mount Sinai Beth Israel.RheumatologyHarry D. Fischer, MD, is AssociateProfessor and Chief of the Division ofRheumatology and Interim Site Chair ofthe Department of Medicine. Dr. Fischerwas one of the first rheumatologists todescribe the rheumatic manifestationsof HIV infection. His additional clinical interests includesystemic lupus erythematosus, rheumatoid arthritis,vasculitis and Lyme disease.7
CAREER DEVELOPMENTAt Beth Israel, our residency program is designed tocreate a well-rounded and rigorously trained houseofficer. What makes us proud is that so many of ourtrainees choose to remain as fellows or return asfaculty members. Regardless of your career plans,we provide thorough and thoughtful mentorship andprofessional development that best suits yourindividual trajectory and career plans.Faculty and Peer Mentoring: There are differenttypes of mentoring, and our system allows for eachtrainee to select which kind of mentoring worksbest for them. Every trainee is automatically part ofthe buddy program, described above. But supportfor residents doesn’t stop there. Many houseofficers naturally connect with subspecialty facultywho come to serve as mentors based on commoninterests, either professional or personal.The Buddy System: Upon entry into our trainingprogram, each house officer is paired up with both achief resident and a program director who serve asthe house officer’s “buddies.” The buddy systemallows for personalized, longitudinal mentoring. Chiefresidents provide one-on-one evaluation, counselingand advice to their house officer buddies.Peer-to-peer mentoring is another important waywe foster support and collaboration in the Department of Medicine. Our housestaff will often workwith a fellow who helps guide them in the development of a project. The high level of researchcollaboration attests to the close relationshipbetween these two groups of trainees.House officers meet formally twice per year withtheir program director buddy to review performance, discuss career plans or fellowship applications, and any other pertinent issues. In addition, allour program directors pride themselves on beingavailable to any resident for any issue wheneverthey should arise, and their doors are always opento housestaff and students.The Summer Research Presentation Series:Throughout July and August of each year, thesubspeciality divisions in the Department of Medicinepresent their ongoing research projects to the newresidents. This gives incoming housestaff an overviewof what is going on in each division, and helps themidentify faculty and fellows that they can contact forfurther guidance and research pursuits.8
UNIQUE CURRICULUMOur curriculum aims to develop and refine residents’clinical reasoning skills and their ability to practicehigh-quality, evidence-based medicine. Multiplevenues and opportunities ask residents to integratetheir knowledge of the basic and clinical sciencesinto real-life patient care and decision-making.A focus on critical appraisal and application of themost current literature to patient care is a themethroughout all teaching venues.6 2 Inpatient/Outpatient System: Our programwas an early adopter of this innovative schedulingsystem for our categorical program. Rather thanrunning to and from their ambulatory clinic oncea week during inpatient rotations, our residents nowrotate on inpatient services for six weeks at a timewithout ambulatory responsibilities. This allowsresidents and inpatient teams to be most efficientand provide uninterrupted care on the wards.Then two dedicated weeks are spent full-timein the ambulatory setting. Our residents experiencethe daily routine of an outpatient physician, andhave great opportunity and flexibility to providecontinuity of care. This scheduling providesfor a variety and change of pace to the usualinpatient environment.Academic Half-Day: One morning a week duringambulatory continuity rotations, residents from allthree outpatient sites come together to learn as agroup. Without the pressure of clinical responsibilitiesimmediately before and after, residents are able tolearn in a relaxed, stress-free environment. Topicsrange from clinical medicine to quality improvement tocultural competency and beyond. Multiple formats areused, including interactive small-group based workshops, interactive case conferences and traditionallectures. Our innovative ambulatory curriculum alsoincludes a Wellness Curriculum which consists of aseries of mindfulness sessions led by local mindfulnessexperts and guided debrief/reflection sessions led byour faculty. (A similar Wellness curriculum is in place forPreliminary residents.)The Alice and Richard Netter Simulation Center:With the days of “see one, do one, teach one” gone,simulation training has become an essential part of theresidency experience. Mount Sinai Beth Israel boasts astate-of-the-art simulation center. Under the guidanceof a chief medical resident and faculty, our housestaffundergo intense and wide-ranging training for managing a variety of emergent clinical situations. From behinda one-way mirror, dedicated Simulation Center staff andfaculty throw out scenarios for residents to workthrough as a team. Interns are taught proper airwaymanagement and chest compressions. Medicalresidents serve as Code Team and Rapid ResponseTeam leaders for all such calls throughout Mount SinaiBeth Israel, and receive intensive clinical and leadershiptraining in these areas. Communication and other toolsadapted from the aviation industry and the military aretaught and practiced. Residents also learn central lineinsertion and other procedures in the Simulation Center.This is widely viewed among the housestaff as a superblearning experience.9
Education Tracks10
OVERVIEWAs a resident at Mount Sinai Beth Israel, you will befully immersed in a program that teaches you theclinical skills, knowledge and leadership qualitiesof a twenty-first century physician.Formal instruction begins each morning with theresidents leading bedside teaching and work rounds.Team members review the progress of each patient,incorporating patient management, teaching anddiscussion of clinical decision-making. Residents andinterns regularly present and discuss patients duringrounds with the teaching faculty. Discussions rangefrom the bench to the bedside with a focus on clinicalreasoning, diagnostic skills and application of thelatest evidence to patient care.Conferences provide another method for teachingand training. But at Mount Sinai Beth Israel we do notbelieve in a one-way educational experience. Instead,in dynamic, interactive venues, housestaff meet withthe chief medical residents, the program directorsand the teaching faculty to present and discussinteresting and instructive cases. In a supportiveenvironment senior residents are asked to explaintheir medical reasoning, to justify their decisions withevidence and to consider the costs and risks of care.EDUCATIONAL CONFERENCESNoon Conference: Each day residents areprovided a noon conference that can take manyformats. Case presentations and lectures aredelivered in an interactive format, with audienceresponse technology used to enhance the learningexperience. Lunch is provided. The noon conferencecurriculum covers the range of clinical InternalMedicine and subspecialty topics, as well as topicssuch as ethics, cost-effectiveness, business aspectsof medicine and health care systems. On certaindays, interns learn together while senior residentsattend a separate resident report conference, andon other days, residents of all three levels are inconference together.Resident Grand Rounds (“Journal Club”):In the PGY2 year, residents present a clinical orresearch topic of their choosing to their housestaffpeers and selected faculty. A faculty member whois an expert in the field moderates the session.During the presentation, the resident presents ascholarly review of the topic, including basic sciencebackground, current trends, and future directions.In addition, residents critically appraise and presentan article from the recent literature that is relevantto the topic being given. Direct one-on-onementoring and assistance with preparation aregiven to each resident by a chief medical resident.Resident Report: Separate resident reportconferences exist for inpatient day and night floatteams. At night float report, overnight teams presentnewly admitted cases to the program directors,chief residents and other faculty. Teaching occursas the history, physical, radiology and lab results arereviewed and the overnight teams’ managementplans are discussed. At senior resident report,which occurs during the day, housestaff presentmultiple cases for higher-level discussion of clinicalreasoning, diagnosis and management. Residentsare asked to teach their peers by providing evidencebased answers to questions that came up at reportthe previous day.Department of Medicine Grand Rounds:Throughout the year, the Department of Medicinehosts nationally and internationally known speakerswho present on topics in the basic and clinicalsciences. Recent past speakers have includedNobel Laureates and other world-renownedluminaries in medicine.Subspecialty Conferences: Each division holdsweekly subspecialty conferences, frequentlyincluding prestigious outside speakers. Residentson elective participate in these conferences. Seniorresidents rotating in the CCU are required to presentformally to the faculty and fellows of the Departmentof Cardiology.11
CATEGORICAL RESIDENCYThe primary goal of Mount Sinai Beth Israel’sDepartment of Medicine categorical residencytraining program is to provide the trainee withadvanced medical knowledge, progressiveexperience in clinical decision-making and theopportunity to practice medicine in an environmentof academic excellence. Training occurs in anatmosphere of openness, where residents areencouraged to raise questions and contribute ideas.It is a point of pride that our hospital is considereda place that offers a cooperative and supportiveenvironment for both faculty and housestaff.All members of the health care team workclosely together. The hospital provides excellentancillary services, including transport staff,clerks, phlebotomists and IV teams to facilitatesafe and efficient patient care.PGY1: As a PGY1 you will further develop andmaster your organizational skills and ability to makeefficient, clinically sound decisions as you rotatethrough various experiences. We expect our PGY1housestaff to begin to think independently and tovoice their opinion on diagnosis and treatment plans.PGY1s participate in our “Residents As Teachers andLeaders” seminar in the spring to help prepare themfor their PGY2 year.A sample PGY1 schedule is as follows:PGY1MonthsInpatient Medical Wards3.5-4.5Ambulatory ContinuityPractice3 (spread over 6recurring 2wk blocks)Night Float1-1.5Elective TimeSee below underElective TimeCCU1MICU1Rapid Evaluation andTreatment Unit0.5Vacation1PGY2: As a PGY2, your responsibilities grow.You will lead and teach teams of interns and medicalstudents on the inpatient wards and perform medical12consultations to other services. In the ambulatorysetting, you will enjoy an ever-increasing sense ofcontinuity as your personal patient panel grows.PGY2s use their elective time to explore careerinterests or conduct research. Increased academicexpectations include regular presentations atresident report and other conferences.A sample PGY2 schedule is as follows:PGY2MonthsInpatient Medical Wards2-4Ambulatory ContinuityPractice3 (spread over 6recurring 2 week blocks)MICU0-1ED1Night Float1ElectiveSee below underElective TimeMedical AdmittingResident0-1Rapid Evaluation andTreatment Unit0-0.5Vacation1
PGY3: Our PGY3s assume major clinical leadershiproles on the medical service. Advanced rotationsinclude the CCU, the telemetry unit, and serving asthe Code and Rapid Response Team leader for theinstitution. We expect our PGY3s to role modelprofessionalism and outstanding clinical care to theirjunior peers. The transition to fellowship or clinicalpractice moves into high gear at the beginning of thisyear with ongoing individual mentoring by theprogram directors and faculty.than just a stop along the way towards an advancedresidency. Our program is challenging, but is widelyviewed as a tremendous developmental experience.The clinical and educational activities and the workschedule for preliminary housestaff are the same asfor categorical housestaff. The exception to this isthat preliminary housestaff do not attend ambulatorycontinuity clinic or ambulatory-related activities. Inrecognition of the fact that our preliminary interns domore inpatient ward rotations than our categoricalinterns, they get significantly more elective time.A sample PGY3 schedule is as follows:For anesthesia preliminary residents, in order tosatisfy your advanced program’s requirement forEmergency Department rotation, we require that twoor four weeks of your elective time will be used.The exact amount will vary depending o
Internal Medicine Residency Program Baird Hall 350 East 17th Street, 20th Floor New York, NY 10003 Tel: (212) 420-3363 Email: intmed@mountsinai.org Internal Medicine Residency Program at Mount Sinai Beth Israel Icahn School of Medicine at. 1st A ve. 2nd A ve. East 17th St. 3rd A ve. 5th A ve. 4th A ve. 6th A ve. 7th A ve. 8th A ve.
Internal Medicine Residency Training Program Curriculum P. BouKhalil, S. Abi Doumeth, A. Berjawi, J. Mhanna. 2019 Page 2 Internal Medicine Residency Training Program Curriculum I. Mission Statement II. Overview A. ACGME-I Core Competencies B. Internal Medicine Residency Program Overview 1. Categorical Program 2. Preliminary Program
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Internal Medicine Residency Program Housestaff Manual Revised May 08, 2017 The Housestaff Manual is a guideline for the rules and regulation of the Internal Medicine Residency Program. The Manual will be updated on a periodic basis as the program continues to evolve. Residents
de Guadalajara in 1995, his residency in Internal Medicine at Texas Tech University Health Sciences Center in 2000, and his fellowship in Nephrology at the University of New Mexico in 2002. From 2009 to 2015, Dr. Blandon worked as the Program Director of the Internal Medicine Residency Program at Paul L. Foster School
Our faculty Jen Tieman MD, Program Director BA biology 1993, North Central College MD 1998, University of Chicago Pritzer School of Medicine Fellow 1997-1998, Maclean Center for Clinical Medical Ethics at University of Chicago Residency 1998-2001, Mount Sinai Family Practice Residency of Chicago Anne Sly MD University of Missouri-Kansas City Undergraduate
teaching residents and had been teaching with our residency since 2018. He became Program Director in 2019 and has great vision for the direction of the program Timothy Kamerzell MD, PhD Associate Program Director Dr. Kamerzell is a board certified internal medicine. He joined our residency as Associate Program Director in 2019.
The grid, one of the oldest architectural design tools, is a useful device for controlling the position of building elements. Grids have been and continue to be used in all manner of layout tasks from urban design to building construction (see figure 1) . A grid can help a designer control the positions of built and space elements, making the layout task more systematic. By determining .