Ability to Create Strong Career Pathways Is a Huge Draw for Internal Medicine Residents

Exceptional faculty depth, research opportunities, and clinical training based on some of the most challenging patient cases anywhere are among the reasons thousands of applicants compete each year for a small number of Internal Medicine residency openings at programs at The Mount Sinai Hospital, Mount Sinai Morningside/Mount Sinai West, and Mount Sinai South Nassau. But they’re also attracted by the opportunity to carve out career pathways in timely areas such as global health, genomic medicine, health care leadership, and medical education. Primary care residents can even structure their curricula with electives focused on treating geriatric, homeless, and imprisoned populations.

“Our residents have a multitude of choices when it comes to their training experience, based on inpatient clinical care, outpatient medicine, and research,” says Adrian Majid, MD, Director of the Internal Medicine Residency Program at The Mount Sinai Hospital, and Associate Professor of Medicine (Infectious Diseases), and Medical Education, at the Icahn School of Medicine at Mount Sinai. “After giving our residents subspecialty training in hepatology, hematology, oncology, cardiology, HIV medicine, and geriatrics, about 80 percent go on to some form of subspecialty fellowship.”

Just as importantly, they can choose among a host of electives that offer a good fit with their career goals, whether they’re in generalist or subspecialty medicine. The program also offers a unique mentorship opportunity called CHAMP (Career Hospitalist and Mentorship Program), geared to residents interested in careers in hospital medicine. CHAMP serves as a personalized resource for them right up to securing their first job.

When Dr. Majid asks his residents in casual discussions what brought them to Mount Sinai, many cite the institution’s vast research enterprise, whose faculty members are involved in so many forms of cutting-edge research that can draw on artificial intelligence, genetics/genomics, oncology, and much more. At least four incoming interns each year lean toward careers as physician-scientists as they match with the American Board of Internal Medicine (ABIM) Research Pathway. Others can explore physician-scientist careers during residency thanks to valuable research support from R38 National Institutes of Health grants. Approved last year, this funding allows these residents to spend an additional year on dedicated research projects in their third and fourth years of training.

Still other residents have their sights set on career paths in global health or hospital leadership, or as clinician-educators who will specialize in medical education. Mount Sinai has created comprehensive curricula around each of these tracks, which residents can apply for in their first year of residency.

Global Health is among the most distinctive. Residents are given the opportunity to hone their medical skills and knowledge at established partner sites such as AMPATH Kenya and AMPATH Nepal. AMPATH is a model for equitable collaborations among local academic health centers and a global network of universities and academic health institutions to tackle health disparities in underserved regions around the world while training future global health leaders. Discontinued during the pandemic, the Global Health initiative has been reactivated and Mount Sinai plans to grow the number of participants and allow them to begin the program’s longitudinal curriculum as early as their second year of residency.

Healthcare Leadership has proven to be a popular track among some Internal Medicine residents. “This curriculum appeals particularly to residents with an interest in quality improvement, patient safety, and efficient hospital administration,” explains Dr. Majid, an infectious disease and internal medicine specialist whose own practice is hospital-based alongside residents. “They’re given the chance to participate in hospital work groups and actually interface with leaders such as the vice chair of quality improvement and patient safety within the hospital.”

Some of the most intriguing clinical experiences are open to primary care residents in fields such as geriatric and community-based medicine. First-year residents selecting geriatrics, for example, become part of a continuity clinic that allows them to treat, manage, and form relationships with the same patients across their four years of residency and fellowship training. Other electives give them first-hand experience with health care delivery in HIV, drug and alcohol addiction, homelessness, and jail settings, working with community and state organizations as well as with Mount Sinai programs such as REACH, which provides primary care services to alcohol and drug users and people living with hepatitis C.

“Looking beyond our program’s varied tracks, its real focus is to train leaders in the latest academic medicine by giving them access to diverse patients and advanced research founded on innovation,” sums up Dr. Majid. “The curricula we’ve created for our residents fully support that mission and are the reason our program is considered among the most competitive in the country.”

Adds John Andrilli, MD, Director of the Internal Medicine Residency Program at Mount Sinai Morningside/Mount Sinai West: “We’re especially proud that 76 percent of graduates from our primary care track choose to stay in primary care, many of them within the Mount Sinai Health System. Also gratifying is the fact that 90 percent of our graduates continue working with historically under-resourced populations.”

Mount Sinai South Nassau enrolled its first class of 10 internal medicine residents in 2019, and in 2024 expanded to 13 trainees who do their required rotations at the 455-bed hospital in Oceanside, on Long Island, or at affiliated outpatient practices in the community. They also have the option of elective rotations at The Mount Sinai Hospital, Mount Sinai Morningside, and Mount Sinai West. According to Steven Weiss, MD, Director of the Mount Sinai South Nassau program, about half of the graduates go on to subspecialty fellowship training, while the remainder pursue careers in primary care or hospital medicine.