The Department of Medicine at the Ramon Ruiz Arnau University Hospital (HURRA) consist of approximately 25 on-site faculty members. Clinician/educators and clinician/investigators are the mainstay of our teaching activities. Our faculty views residents as their colleagues and professional relationships flourish here. Whether it is through patient consultation or teaching, house staff and faculty work in concert to provide the best available care to our patients at HURRA.


All residents are required to complete a research project during their training. The research has to be approved by Dr. Robert Hunter, Research Director for the program.

Simulation Training

All  residents  will  participate  in  an  Observed  Structured  Clinical  Evaluation  (OSCE)  in  the fall  of  the  internship  year.  This will assess interviewing skills, communication skills, and aspects of professionalism.  Components  of  the  OSCE  will  be  reviewed  by  the  Associate  Program Director and other staff, and formative feedback will be provided.

Patient Population

As the only academic tertiary care center in Bayamon, HURRA provides care to a population of around 100,000. Our medical center covers an area that stretches from rural Naranjito and Comerio to the south, west to Corozal, Toa Alta and Toa Baja, east into Guaynabo and north to Cataño municipality.  Our faculty and house staff also provide primary care to communities of the Bayamon area. Our patients are rated in the highest group on the National Hospital Index of patient illness severity and complexity.

Information Technology

All outpatient training sites include a full electronic medical record system. The entire HURRA campus is equipped with wireless access for use with laptop and/or tablet computing. The Universidad Central del Caribe Medical School library provides access to over 40 digital textbooks and medical literature databases with search capabilities .The librarians offer practical lectures and regularly scheduled workshops on manipulating resources and navigating medical data bases available on the web.

Fellowship Programs

HURRA does not offer fellowship programs, but residents are allowed to do elective rotations in other institutions to enhance their educational experience as well as to enable their fellowship application process.

Clinical Training

Clinical experiences at HURRA are divided between our two major teaching sites, Ramon Ruiz Arnau University Hospital and the Out Patient clinic at IPA 344, which is located approximately 2 miles from HURRA. These two institutions offer a wide spectrum of clinical disease severity, patient demographics, and medical delivery systems.

HURRA is an academic, tertiary care medical center providing primary care for the local population, and subspecialty referrals, critical care, and tertiary care for the regional area. Our case mix severity index is equivalent to others academic centers in Puerto Rico.

Inpatient Services

Inpatient services are divided into General Medicine and Critical care which provide a mixed Medical/Surgical ICU and Coronary Care Unit. HURRA residents rotate through all of these services during their training.

Outpatient Services

Outpatient services at HURRA include a busy General Internal Medicine clinic and a full array of subspecialty ambulatory clinics. Residents have a continuity clinic throughout their training, and also have the opportunity to work in the subspecialty outpatient clinics throughout the three years of their training. Outpatient services are delivered at our affiliated ambulatory care center (IPA 344), in which residents serve as primary physicians for a panel of patients, with responsibility for chronic disease management, management of acute health problems, and preventive health care.  Residents also rotate through the Emergency Department where they have first-contact responsibility for a sufficient number of unselected patients to meet their educational needs.

Educational Conferences

The Department of Medicine offers ten to twelve hours of educational conferences weekly with numerous other subspecialty, clinical and research conferences. Conferences and reports include:

  • Residents’ Morning Report 7:00 to 8:30 a.m., Monday through Friday. The format is case-based with teaching points reviewed at the end. House staff attend during most rotations. The Program Director, Department Chair, and GIM attending’s facilitate the learning during this Chief Resident run conference;
  • Interns’ Report 11:00 am to 12:00 p.m., Tuesday. This one-hour “protected time” for all interns is held once a week and the focus of the conference is practical management skills of inpatients and development of an organized approach to evaluation of common medical problems;
  • Journal Club 12:15 to 1:15 p.m. Thursday. Review of research study design, evidence-based medicine, critical appraisal of the literature, review of classic and recent studies, and presentations of ongoing research;
  • Morbidity & Mortality Conference 12:15 to 1:15 p.m., Wednesday. A case-based conference widely regarded by the faculty and house staff as our most engaging and thought-provoking conference;

 Additional Conferences

  • Ethics Rounds with Jose Ramirez, MD, MACP
  • Outpatient Didactics With Michelle Castellanos, MD


Program Director                              Juan A Ruiz-Ramos MD

Associate Program Director           Jose A. Rivera-Valles, MD, FACP

Department Chair                            Melba I. Colon-Quintana MD

Program Coordinator                       Carmen N. Rivera-Rodriguez, BBA


Eligibility Requirements

  • Medical School: Eligible applicants must be graduates of a medical school accredited by either the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association (AOA) or of an international medical school listed by the World Health Organization published World Directory of Medical Schools. International Medical Graduates must expect to have a current, valid certificate from the Educational Commission on Foreign Medical Graduates (ECFMG) by the beginning of training;
  • USMLE/COMLEX Examinations: Applicants must have passed Steps 1, 2 (Clinical Knowledge and Clinical Skills) of the United States Medical Licensing Examination (“USMLE”) or COMLEX equivalent;
  • Non-Discrimination: The Internal Medicine Training Program will not discriminate with regard to gender, race, age, religion, color, national origin, ancestry, disability, veteran status, marital status, familial status, pregnancy, or sexual orientation;
  • Meet Essential Standards: Applicants must meet the essential standards of an internal medicine resident, as listed at the end of this document.

Selection Policy

  • National Matching Programs (NRMP): The Internal Medicine Training Program participates in the national matching program;
  • Electronic Residency Application System (ERAS): Applicants must submit their complete application using ERAS. Applications by e-mail, mail, fax, or other delivery will not be accepted.

Applications must include:

  • The common application form;
  • USMLE / COMLEX scores;
  • ECFMG report and certificate for international medical graduates
    (this includes U.S. applicants attending medical schools outside of the U.S.);
  • An official transcript from the applicant’s medical school;
  • Medical Student Performance Evaluation;
  • The Department of Medicine letter (when available);
  • Two additional letters of recommendation;
  • The personal statement;
  • NOTE: A photograph is not required for application

Appointment Requirements

After successfully matching into the Internal Medicine Residency Program, applicants must:

  • Consent to a criminal background check;
  • Submit to a pre‐employment drug and alcohol screening;
  • Supply proof of ECFMG certification (Foreign Medical Graduates only);
  • Non‐citizens must have Permanent Resident Status, current Employment Authorization Card or be eligible to obtain an appropriate visa no later than the date of hire;
  • Submit proof of successful graduation from medical school;
  • Updated USMLE/COMLEX results, if applicable;
  • Submit to a health examination and supplementary test(s), which includes tests for drug and/or alcohol abuse, and receive the required immunizations in compliance with the sponsored program hospital’s policy and all applicable federal, state, and local laws and regulations. It must be determined the applicant is in sufficient physical and mental condition to perform the essential functions of appointment. The results of all examinations shall be provided to the Hospital’s Employee Occupational Health Services;
  • Attend required GME orientation.

Essential Functions for Internal Medicine Residents

Residents must, without an intermediary, be able to:

  • Take a history and perform a physical examination of patients.
  • Communicate with patients and staff, verbally and otherwise in a manner that exhibits good professional judgment and is appropriate for the professional setting. Please be aware that Spanish is the primary spoken language in Puerto Rico.
  • Read charts, monitors, and other sources of clinical information.
  • Complete appropriate medical records and documents and plans according to protocol and in a complete and timely manner.
  • Possess sufficient sensory and motor function to elicit information from patients by palpation, auscultation, percussion and other diagnostic maneuvers.
  • Be able to execute motor movements reasonably required to provide general care and emergency treatment to patients.
  • Perform all job functions while dressed in protective clothing required for clinical duties, including tolerating a mask, gown, and gloves.
  • Move throughout the Medical Center to address routine and emergent patient care issues and to attend required educational programs.
  • Utilize a computer for medical record review, documentation, decision support, research, and education in an efficient and timely fashion.
  • Possess the emotional health required for full use of their intellectual abilities, the exercise of good judgment and the prompt completion of all responsibilities attendant to the diagnosis and care of patients.
  • Have the emotional maturity to self-assess, know own limitations and seek advice or counseling in situations that might impair own learning or performance in the care of patients, and to proactively seek appropriate treatment including leaves of absence.