Newton-Wellesley Hospital (NWH) is a 200-bed community hospital that is part of the Partners Healthcare System. Partners’ hospitals include Massachusetts General Hospital (MGH), Brigham and Women’s Hospital (BWH), Spaulding Rehabilitation Hospital, and Faulkner Hospital. NWH is located in the suburb of Newton about 8 miles west of Boston and it is a quick drive from downtown via the Mass Pike or an easy subway ride on the MBTA (Green “D” line at Woodland Station). NWH offers most specialties on site but there are occasionally some patients we refer downtown to MGH for services such as urgent cardiac catheterization or transplant surgery

NWH has over 400 residents who spend some part of their residency if not all of their internship at NWH. We have our own Transitional Year internship program as well as other internship programs associated with NWH. MGH Categorical Anesthesia residents spend their internship at NWH before going on to their 2nd year at MGH. MGH/McLean psychiatry interns spend 6 months of their internship doing medicine at NWH. In addition, residents from the MGH in medicine, surgery, and pediatrics spend 1-2 months per year at NWH to gain some exposure to a community hospital. Tufts/NEMC orthopedic residents and Cambridge Health Alliance podiatry residents also rotate at NWH. Finally, Tufts 3rd and 4th year medical students rotate at NWH for clerkships, electives and sub-internships.

Our transitional year program typically matches 5-7 interns per year. This number is flexible based on the number of MGH Categorical Residents that match. The number of interns from the two programs totals eleven per year. There are ten MGH/McLean psychiatry interns that spend 6 months of their internship at NWH, thus there are 5 at NWH at any given time. So, despite NWH’s transitional year program being small, the addition of the other programs gives NWH 16 interns here at a given time. This helps make it more interesting given the different backgrounds and interests the mix of interns brings to NWH. The three different interns are hence referred to as NWH-based interns.

We do not have fellows at NWH, so contact is directly between attendings and residents. Given we are a small community hospital, the environment at NWH is welcoming and quite collegial. We have the distinction of being just outside Boston and affiliated with the larger academic centers in downtown Boston, allowing NWH to have an academic feel. NWH based interns are held to the same standards that the rotating residents from MGH are, so our interns work hard along side their MGH colleagues. Most people would agree that NWH is a unique hospital given the high academic expectations yet it operates at a community pace.

The typical transitional year intern schedule is divided into 13 four week blocks:

Service	Proposed Number of Blocks
Medicine Ward Service	3
Surgery Service	3
ICU	1-2
Dayfloat (medicine)	1-2
Ambulatory Care	1
Emergency Medicine	1
Elective	2-3

Each intern is able to take up to 3 weeks paid vacation per year. We offer free parking or a paid monthly subway pass. There is a gym on site as well as a daycare center. Noon lectures are held on weekdays and free lunch is provided at those conferences. Meal cards to be used at one of our 3 onsite restaurants are given to you for breakfast and dinner for your overnight call shifts.

Medicine Service

With the IOM work hour recommendations and the change in requirements for internal medicine programs to include more ambulatory experiences, our medicine rotation will likely need to be revised for 2010-11.

However, currently there are 4 medicine teams (regionalized to 2 different floors of the hospital) that comprise our medical teaching service. The teams are comprised of:

- MGH senior or junior medicine resident
- MGH medicine intern
- NWH-based intern
- Tufts MSIII
- NWH Dayfloat intern (1 intern per 2 teams)

Each intern on a team follows a 4-day admitting cycle: long call, post call, short call and pre-call. Long call starts at 12pm and the intern admits overnight with signout occurring at 12:30 the next post-call day. On a long call day the intern will admit up to 5 new patients and he/she cross covers the patients in their “region” overnight. The long call intern patient list is covered by a dayfloat intern until they come in at noon at which time the dayfloat intern passes back the patient list to the long call intern. And the following afternoon they sign out at 12:30 to that same dayfloat intern. So the dayfloat intern covers the long call intern list in the morning and the post-call intern list in the afternoon. Short call days have the intern pick up any nightfloat admissions (a MGH junior resident supervises the long call interns overnight and admits any overflow patients), and admits up to 2 new patients until 3pm. On pre-call days, the interns just cover their patient list and do not admit any new patients.

We have an extensive hospitalist service and a few private physicians who admit to the medicine teaching service. The communities where a majority of our patients come from are quite affluent. Our patient population is weighted heavily to patients who are elderly, educated, and compliant with medications and follow-up. There are certainly many exceptions to this and we do admit patients with de novo presentations of common and less common diseases. Patients will come in with a variety of illnesses including coronary artery disease, cardiac arrhythmias, congestive heart failure, valvular heart disease, chronic obstructive pulmonary disease, asthma, diabetes and its complications, renal failure, stroke, seizure disorders, a variety of neoplastic diseases including lymphoma and multiple myeloma, gastrointestinal bleeding, pancreatitis, pneumonia, pyelonephritis, and bacterial endocarditis.

There are many didactic sessions scheduled on the medicine service. Resident report, visit attending rounds and noon lectures with lunch served are scheduled daily. On a weekly basis, journal club, intern report and grand rounds are scheduled.

Surgery Service

There is one large surgery team that includes:

- MGH senior level surgery resident
- MGH junior level surgery resident
- MGH intern surgery resident
- NWH-based interns (3)
- Tufts MSIII students (4-5)

Given the team has few senior members; interns are often first assist in one of our many operating rooms. So if you like the operating room, you will have plenty of time to hone your skills in laparoscopic and open cholecystectomy, large and small bowel resections, hernia repairs, vascular bypass and endarterectomy, breast biopsy, breast lumpectomy and modified radical mastectomy. Call is overnight and is on average q4. We have the largest gastric bypass department in the state and there will often be patients on the surgery service status post gastric bypass. There are weekly didactic lectures by the Chair of Surgery.

Intensive Care Unit (ICU)

The ICU is a closed unit of 12 beds comprised of surgical, cardiac and medical patients. The surgery service above covers the surgery patients in the ICU. The cardiac and medical patients are covered by the ICU resident team, which is comprised of:

- MGH senior medical resident
- MGH junior resident (2)
- NWH based interns (2)

Call is overnight every fourth night. The ICU is staffed by critical care attending physicians during the day and moonlighter attending level physicians at night. Patients suffer from a variety of syndromes requiring intensive care unit treatment including sepsis, respiratory failure, toxic overdoses, acute myocardial infarction, unstable angina, congestive heart failure, and gastrointestinal bleeding. There are daily teaching sessions and the ICU is a most enjoyed rotation due to the team structure and excellent teaching.

Emergency Medicine

Each NWH intern will spend 4 weeks rotating in our new Emergency Department. We are not a trauma center but do see a variety of emergency situations such as myocardial infarction and drug overdoses. The interns have first contact with a variety of patients and can often do procedures such as suturing and intubation if desired. The nine hours shifts are scheduled Monday – Friday and include an hour for the daily noon lecture with lunch.

Ambulatory Care

The transitional year review committee requires a minimum of 140 hours be spent in an ambulatory setting. The rotation includes some time in an offsite local Urgent Care center and some time in a primary care practice at NWH. The interns have first contact with patients and work along side 1-2 attendings so teaching is a daily occurrence.

Electives

There are a variety of elective choices at NWH. We are very flexible on what electives interns choose and support research opportunities if appropriate.

Additional Information

Over the past 5+ years, our matched applicants have graduated from US medical schools within the past 2 years and go on to finish residencies in anesthesia, radiology, ophthalmology, and other various programs.

For additional information on our trainee contract, benefits, and other policies please refer to: http://www.partners.org/research/gme/research_gme_trainee.html

If you have any questions or are interested in our program, please contact us.

Janet "Jodi" C. Larson, MD, Program Director

Marie Williams, Graduate Medical Education Coordinator 
Email
Phone: 617-243-6467