Frequently Asked Questions

 

Candidacy/Application Questions

1. What is your minimum score cut-off for USMLE Step 1?
2. Are applicants required to pass both USMLE Step 1 and Step 2 prior to applying?
3. How many letters of recommendation do you need? 
4. What is your deadline to apply?
5. When do you begin to download applications?
6. Do you accept international medical graduates?
7. Are there any additional requirements for international medical graduates?
8. Do you sponsor any visas?
9. ECFMG – when do you require certification? At the time of application or by the time the intern starts residency in July?
10. Do you accept Doctor of Osteopathic Medicine graduates?

Program Specific Questions

1. What is best about the program?
2. When do interns start?
3. How many patients do interns follow?
4. The program is so big. Is there any mentoring?
5. I've heard all about the amazing autonomy, but do you feel there is enough backup?
6. Are there any changes planned in the near future? And what are the most recent changes?
7. Are interns doing a preliminary year treated any differently than their categorical and primary care counterparts?
8. I knew nothing about the primary care program but it sounds really great. Is it too late to apply?
9. I might be doing general medicine, but I still might specialize. Does this mean I should not consider the Primary Care program?
10. Will I be able to do an international elective?
11. Do residents rotate through the NYU Heart Hospital?
12. Are housestaff required to do research?
13. How does the program comply with the duty hours regulations?
14. Are the house officers unionized? What are the benefits?
15. I heard that there are disparities in pay and insurance benefits between NYU and Bellevue?
16. Is there subsidized housing, and is there any help in finding housing?
17. What about food?
18. How much scut is there at Bellevue?
19. Does the program allow for Shabbat off for residents that observe Shabbat? 

Post-Residency Questions

1. What do residents do when they finish?
2. How will the program help me get the fellowship of my choice?
3. What is the pass rate for the IM boards?

Candidacy/Application Questions  

1. What is your minimum score cut-off for USMLE Step 1?

There is no minimum cut-off score for USMLE Step 1, as we carefully review all applications in their entirety.  The average score on the USMLE Step 1 among our current residents is 227. 

2. Are applicants required to pass both USMLE Step 1 and Step 2 prior to applying?

Applicants must pass Step 1 prior to applying. Applicants must pass Step 2 prior to graduating medical school.

3.  How many letters of recommendation do you need?

In addition to the Dean's letter, you need 3 letters of recommendation-one from the Chairman of the Department of Internal Medicine, and 2 from faculty members (these do not have to be IM faculty members). Additional letters are accepted.

4.  What is your deadline to apply?

December 1

5.  When do you begin to download applications?

September 15

6.  Do you accept international medical graduates?

Yes.  10 of our current residents (6%) are international medical graduates.

7.  Are there any additional requirements for international medical graduates?

IMGs must have had clinical experience in the United States in the form of direct patient care. Observerships do not qualify.

8.  Do you sponsor any visas?

Yes, we sponsor H1 and J1 visas. 

9. ECFMG – when do you require certification? At the time of application or by the time the intern starts residency in July?

We require ECFMG certification at the time of application.

10. Do you accept Doctor of Osteopathic Medicine graduates?

We are sorry, but we do not accept Doctor of Osteopathic Medicine graduates.

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Program Specific Questions

1. What is best about this program?

The camaraderie of the house staff is palpable. Not only are your fellow house officers your colleagues, they are also your friends for life. The diversity of patients and hospital systems is quite extraordinary- you won’t find anything like it anywhere else.

2. When do interns start?

July 1

3. How many patients do interns follow?

The program has gone to great lengths to adhere to the census and admission caps established by the ACGME. Interns follow a maximum of 10 patients but, depending on the service and the number of acting interns, typically follow closer to 7 or 8. Second year residents generally lead teams comprised of an intern and an acting intern and are capped at 14 patients. Third year residents generally lead teams comprised of two interns and are capped at 20 patients.

4. The program is so big.  Is there any mentoring?

The residency has an “Advisory Group" system, each of which is led by a Program Director and a Chief Resident.  These advisory groups were designed to create the feeling of small colleges within a larger university.  They serve as a mechanism for feedback and evaluation as well as social networking.  In addition, they serve to help each house staff officer identify at least one mentoring relationship by the end of the first year, and cultivate that relationship in the subsequent years.
Individual meetings between the house staff officer and their residency Advisor occur at least on a semi-annual basis, but are often more frequent.    

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5. I've heard all about the amazing autonomy, but do you feel there is enough backup?

The beauty of the NYU program is that it integrates autonomy with the right amount of support. There is no doubt that the patients perceive the house staff as their physicians, but the house staff know that they are not alone in decision-making.  Both Tisch and Bellevue have hospitalists who work during the days and overnight who are there to provide back-up and education.

6.  Are there any changes planned in the near future?

The program prides itself on adapting in order to address national changes in internal medicine. In addition, we encourage house staff to voice their ideas and engage in ways to improve on what currently exists. We have monthly town halls at each site. The program director meets with the house staff as a large group once a month. The house staff representative group is active in task forces for improvement.

Perhaps the biggest change has been the complete restructuring and organization of Tisch Hospital, the private hospital inpatient medicine services. In response to concerns about the balance of service and education, two of the four teams there are run by hospitalists. All private physicians admitting patients to this service relinquish the care of the patients to a single hospitalist. The other two teams are staffed by single private teaching attendings who are empowered to run rounds daily and make basic care decisions. A new Step Down Unit was created at Tisch to unburden the ward teams with sicker patients and thus make it possible for them to comply with census and admission caps, as well as work hour regulations. A new Hematology service was also created at Tisch. Thus far, the changes have resulted in markedly improved experiences for the house staff. Other changes have included the creation of a fully geographic teaching service at Bellevue hospital. This change has resulted in cohesive multi-disciplinary relationships as well as strict adherence to census caps. In addition, full coverage of pagers is provided in noon conference at Bellevue for all house staff, allowing for uninterrupted and protected learning time.

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7. Are interns doing a preliminary year treated any differently than their categorical and primary care counterparts?

Absolutely not!  Most attendings don’t even know who the preliminary interns are because they are so well integrated and so outstanding.  The only difference is that prelims have 2 months of protected elective time and no clinic.

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8. I knew nothing about the Primary Care program but it sounds really great.  Is it too late to apply? 

It is not too late.  Just let the Recruitment Coordinator know and she will facilitate contact with our leadership to arrange an interview.

9. I might be doing general medicine, but I still might specialize. Does this mean I should not consider the Primary Care program?

The Primary Care program is designed for people interested in general medicine. That being said, occasionally graduates of the PC program do end up sub-specializing, and they match in competitive fellowships. The program believes that the training is an asset to any individual and supports each individual’s decision. That being said, if you are contemplating a fellowship in Cardiology, Pulmonary/Critical Care or Gastroenterology, you should probably stick with the categorical program. If you are on the fence, please inquire!

10. Will I be able to do an international elective?

No formal program for international experiences exists at present, though interns in internal medicine are spearheading the effort to create one!  At present, about one house staff officer per year is able to go abroad.  International electives require submission of a proposal four months in advance, approval by the institution, and outside funding for travel/expenses and salary.  Hopefully, by the time you are senior residents, a stream-lined and well-funded program will be in place.  Until then, remember that the world really does come to you when you work at Bellevue Hospital.

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11. Do residents rotate through the NYU Heart Hospital?

While housestaff officers of all levels rotate through the CCUs at Bellevue and the VA, the NYU Heart Hospital is staffed by second year residents only. In addition to the residents, there is a dedicated teaching attending as well as a fellow who round daily with the team to provide education and assistance in management. For those interested in a career in cardiology, this is a great resource to really consolidate your knowledge as well as to see cutting edge cardiology in practice.

12. Are housestaff required to do research?

House staff officers are not required, but are encouraged to do research, and the majority does.  The program has designed a system that encourages house staff to identify their research interests early in their intern year, and helps facilitate house staff connection to principal investigators.  Opportunities to conduct clinical and bench research are plentiful.  House staff involvement ranges from short 2-4 week elective experiences doing research to ongoing continuity research over 3 years (this obviously is more of an investment but can be accomplished).  Most house staff applying in the competitive subspecialties have published an abstract or a manuscript by the time they apply.
In addition, there are several opportunities for residents who want to dedicate more time to research:
1. Interns can apply half-way through their internship to consolidate their elective time in their pgy2-3 years into 2-4 full month blocks at the beginning of their second year.  Thus far, roughly 6-8 residents have opted for this consolidated research track, involving both clinical and basic science projects, and have been enormously productive.
2. Residents interested in taking a year off to do research can now apply for funding through the Physician Scientist Training Program- a program which matches funds from the department with funds from the medical school.
3. Residents who are destined to become physician scientists can apply through the research track to be a part of the ABIM research pathway.  In this pathway, clinical training is shortened to 2 years and research in the applicant’s specialty of interest is started and combined with fellowship training (exact requirements vary by specialty and can be found on the ABIM website).  In our research pathway, residents are expected to complete their fellowship training at NYU.
The residency program is committed to being flexible in order to accommodate research interests.  Please contact us for more information.

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13.  How does the program comply with the duty hours regulations?

The program must answer to New York state (405) as well as national (ACGME/RRC) regulations.  Duty hours are monitored on a monthly basis to make certain our house staff are in compliance and to identify problems.  Adjustments are made in the schedule or the staffing structure when persistent problems are identified. 
Our program has had a night float system in place for the ward services since the 1980s, and thus the new 16-hour limit for interns will impact only the ICU rotations.  Plans are already underway to accommodate this requirement in the ICU and this rule will be strictly enforced.
1. 80 hour work week: each admitting cycle at each hospital has been structured to allow for better work hours.  Improvements in ancillary services and expansion of non-teaching services have had major impact on the ability of our house staff to adhere.
2. 24 hrs off in 7 days: All ward interns are off either Saturday or Sunday.  The interns on call on Saturday are off on Sunday (the resident rounds with the hospitalist).  The resident on call on Saturday is off on the Friday before (the interns round with the hospitalist or with a chief resident that day).  In the ICUs, the resident and intern on call on Saturday have either Friday or Monday off.
3. 10 hours off between shifts:  Night float starts admitting patients at 6pm at all 3 hospitals to enable the long call team to leave the hospital by 9pm.  Back-up mechanisms are in place to handle high volume admission days.
4. 24 hours plus 3 hours/4 hours for residents: If a resident has been on call for 24 hours, they are forced to leave after 27 hours in Bellevue and Tisch (NY state rules) and after 28 hours at the VA (federal rules).
5. 16 hours for interns: While the exact structure of the 16 hour shift in the ICU has not been determined, rest assured it will be strictly enforced.

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14. Are the house officers unionized? What are the benefits?

Yes. The housestaff are part of the Committee of Interns and Residents (CIR). Benefits include (but are not limited to) the following: dental, eyeglasses, disability insurance, life insurance, over $600 per year in educational expenses, legal services, psychiatric services, and well-baby care.

15. I heard that there are disparities in pay and insurance benefits between NYU and Bellevue?

The unionization of housestaff working at Health and Hospitals Corporation (of which Bellevue is a part) has prevented the creation of a single paymaster.  Thus, housestaff are paid on separate paylines which rotate every year.  While there are subtle differences in benefits, the institution has worked extremely hard and has been successful in achieving parity.  In addition, we make every effort to accommodate housestaff requests to be on a certain payline, and there are equal numbers of requests to be on Bellevue or on a NYU payline.

16. Is there subsidized housing, and is there any help in finding housing?

OCHAP (Off Campus Housing Assistance Program ) is a medical center resource specifically created to assist in navigating the New York City apartment market. The office is staffed by professionals who provide assistance and information on neighborhoods, transportation options, and other issues related to living in New York City.  A small number of subsidized on campus apartments are made available, with priority given to house staff moving from out of state.  Most housestaff who live locally find affordable housing through other means with ease.

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17. What about food?

Lunch is provided 4 times weekly.  Food services are readily available at each institution.  Plus you can get whatever cuisine you want delivered to you at any time of day or night (it is New York City after all)!!!

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18. How much scut is there at Bellevue?

At NYU, the VA and at Bellevue, specifically, the housestaff administration has been working closely with the hospital administration to minimize any unnecessary ancillary work. 
At Bellevue we now have greater than 95% completion rate of morning phlebotomy. 
Phlebotomy, I.V. services, blood culture teams and transport are available 24 hours/day, 7 days/week.
Nurses accompany unstable patients to radiology
There is a functional pneumatic tube system to send specimens to the lab
Nurses (LPNs) are trained to place PICC lines at the bedside
PACS are in place for radiology retrieval at all 3 hospitals.
Each hospital has its own Electronic Medical Record.
Dual headset interpreter phones are available at each patient’s bedside and in every clinic room.
At Bellevue and Tisch, nonteaching services staffed by physician assistants continue to expand

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19. Does the program allow for Shabbat off for residents that observe Shabbat?

No. We are sorry, but we cannot accommodate this situation.

Post-Residency Questions

1. What do residents do when they finish?


Essentially, whatever they choose. Residents leave the NYU program with the most sought-after fellowships and with their choice of internal medicine jobs.  About 80% of our house staff end up in fellowships and we have over a 98% match rate.  The other 20% become general internists.  Many who go into medicine take hospitalist positions in either academic or community institutions.  We pride ourselves on the fact that our housestaff are exceptionally well prepared for any field they choose.

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2. How will the program help me get the fellowship of my choice?


The program prides itself in the successful placement of all of its house staff applying for fellowship, with over a 98% first time match rate.  Residents who are applying are mentored by the Program Director in their specialty of choice as well as one of the Internal Medicine program directors.  In addition, upperclassmen who completed the process the year before volunteer as “fellowship buddies,” to serve as an informal guide.   Career nights are hosted by each subspecialty and mock interviews are made available.  Frequent communication occurs between the core Program Director and the subspecialty Program Directors on the status of interviews and rank lists. Finally, the Program Director and Department Chair frequently make phone calls at the end of the interview season to advocate for house staff at their favorite programs. 

3.  What is the pass rate for the IM boards?

Greater than 95% for each of the past 10 years.


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Updated as of September 29, 2011