The division of general internal medicine was established in April 2006 to follow the policy from Ministry of Health and Welfare and to cooperate with Taiwan Association of Medical Education. We turned Ward 16C into a teaching ward for the implementation of the “general internal medicine training and demonstration center” and chose some attending physicians good at teaching to become clinical teachers. We aim to accomplish the goal of “meeting the social requirements of modern medical education, cultivating well-rounded knowledge, improving medical quality and enhancing the continuation and completeness of medical training to achieve holistic medical care.” Since 2009, following the policy from Ministry of Health and Welfare, we have been promoting the program of teacher education for general medicine training. Moreover, we are training clinical teachers in general medicine practicing six core competencies that are defined by ACGME (Accreditation Council for Graduate Medical Education) in order to prepare qualified clinical teachers for future “2-year PGY training program for general medicine” in 2019. After 7-year implementation of the program, “general internal medicine training and demonstration center,” all the clinical teachers and trainees agree that the purpose, concept and content of this program are matched with the training courses for general internal medicine. More than 95% of students, both residents and interns, are satisfied with the training. Since 2010, to cooperate with Ministry of Health and Welfare and Taiwan Association of Medical Education, we have been designing the methods for clinical skills evaluation, implementing the program of teacher education for general medicine training and establishing clinical skills center and objective structured clinical examination (OSCE) exam rooms. We are now still promoting the courses for clinical teacher education required by“1-year PGY training program for general medicine” and cultivating clinical teachers in general medicine practicing six core competencies that were defined by ACGME.

We believe in the concept of problem-based learning and practical application. We encourage physicians to engage in lifelong learning and enhance critical thinking and problem-solving ability. Thus, we can constantly improve our medical services.

1. Training Ward
   Our teaching ward for the implementation of the “general internal medicine training and demonstration center” (Ward 16C in CMUH) features 50 beds and five medical teams (attending physicians, resident physicians and interns). A physician takes care of, on average, 8-12 patients. The five medical teams have exccellent clinical teachers specializing in cardiology, chest medicine, gastroenterology, nephrology and geriatric medicine. The teaching ward has meeting rooms, duty rooms and teacher’s office, equipped with HarBoard teaching software, computers, picture archiving and communication system (PACS), general medicine books and teaching aids. All our clinical services, teaching aids and clinical decision support system are better than other wards.
    
2. Outpatient facilities
   There are teaching clinics providing healthcare 6 times per week. A teaching clinic provides comfortable environment and well-rounded services to serve the dual purpose of treatment and education. In addition, the image monitoring systme is installed to help trainees learn how to offer medical services and correct their mistakes.
    
3. Libraries and information appliances
   We have rich collection of books and information appliances. Our library is equipped with audiovisual equipments, teaching videos and multimedia learning resources. In addition, there are many general medicine books (supplemented and revised every year) for clinical teachers and trainees to look over. Moreover, the teaching aids are also provided for clinical teaching.
    
4. Other teaching resources
   Our teaching ward is equipped with the simple examination room providing ultrasound scanner so as to implement non-invasive ultrasound examination. We have clinical skills center and OSCE exam rooms equipped with simulation training system (acute & critical care medicine and surgery), patient simulators and heart & breath sounds simulators. In addition, there is a set of 3G advanced patient simulator helping trainees learn teamwork from a simulated situation. General internal medicine trainees should take training courses for related skills. We also invited professional clinical teachers to supervise trainees complete skills enhancement and auxiliary training.

The division of general internal medicine, cooperating with Ministry of Health and Welfare, has implemented the program of teacher education for general medicine training for 7 years. We have completed all integrated general medicine training and increased the number of qualified clinical teachers in order to enhance the training for trainees including resident physicians, fifth-grade interns and seventh-grade interns. We emphasize on problem-based and patient-centered training, and offer clinical services integrating primary medical care. By clinical discussion, bedside teaching, teaching round, outpatient clinic teaching and enhancement of clinical experience, we have trained clinical physicians familiar with modern medicine and having problem-solving ability. In recent years, our demonstration center has trained many clinical teachers in general medicine fully understanding and practising six core competencies that were defined by ACGME. All clinical teachers are constantly improving their teaching ability on the topics including medicine ethics, gender and health, evidence-based medicine, medical quality and legal knowledge. In the future, we hope to enhance our general medicine training and lead other hospitals to establish teaching ward, combining the general medicine training and the residency review committee (RRC) in order to carry out a resident physician training including core abilities.

1. clinical problem-solving skills
2. Communication skills
3. A duty of care to patients