Ryan Punsalan, MD
Program Director, Hospitalist
Internal Medicine Residency
The size of the Garnet Health Residency Program provides a unique opportunity for a tailored educational plan to meet your individual needs. Our goal is for you to maximize your strengths and work on areas of improvement.
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Learn moreInternal Medicine Residency
ACGME Initial Accredited program
Tailored Educational Plan
Medical, Dental, Vision Plans
Touro College of Osteopathic Medicine Partnership
Stipends
Malpractice Insurance
Thank you for your interest in Garnet Health Medical Center’s Internal Medicine Residency Program.
Garnet Health Medical Center boasts seven floors of state-of-the-art technology and provides 383 beds and employs over 2,400 healthcare professionals. More than 600 doctors have privileges at the hospital and treat thousands of area families, friends and neighbors. We are a Heart (STEMI) Center and a Stroke Center. We utilize EPIC for our electronic health record system. The Internal Medicine Residency Program was granted ACGME Initial Accreditation status in 2018 and received Continued Accreditation status in 2021.
Our medium size residency program (30 residents) at Garnet Health provides a unique opportunity for a tailored educational plan to meet your individual needs. The faculty, curriculum, resources, diverse patient population, and close partnership with Touro College of Osteopathic Medicine in Middletown provides an ideal environment for residency training. Our goal is for you to maximize your strengths and work on areas of improvement.
Our residents are committed to improving the healthcare of our community just as we are committed to training excellent physicians and fostering their success.
For More Information & To Apply
Thank you for your consideration of our Internal Residency Program! Please explore our site for more information about our program - from our didactic schedule, resident benefits, and frequently asked questions.
Thank you for your interest in our Internal Medicine Residency Program. The application process is conducted exclusively through the Electronic Residency Application Service (ERAS). Please visit the ERAS site to apply.
All interviews for the 2023-2024 interview season (residency starting July 2024) will be conducted virtually and held from October through January.
Application Information
- We do not set minimum score requirements and we evaluate each application individually, however passage of USMLE Steps 1 & 2 and/or COMLEX Levels 1 & 2 on the first attempt is preferred.
- The program’s general cut-off date from graduation of medical school to application to residency is generally 3 years - Applications received from recent medical school graduates will be considered first.
- Minimum of two Letters of Recommendation are required.
- At least one LOR from an internal medicine faculty member strongly suggested.
- A Department of Medicine Summary Letter of Evaluation is also suggested.
- For international medical graduates, 6 months of U.S. clinical experience with direct patient care is strongly recommended.
- Regarding 2025-2026 Tiered Program Signals for IM Residency Programs:
- We consider Gold and Silver signals when reviewing applications and making interview decisions.
- Signals help us understand your interest in our program — especially if you believe our setting, values, and training style are a strong fit for you.
- Rotated with us? We still recommend signaling if you’re interested in an interview.
- No signal? No problem. All applications are reviewed holistically. Signals are helpful, not required.
- A signal does not mean a guaranteed interview — but it does highlight your interest and helps us prioritize outreach where there’s strong mutual alignment
- We do NOT currently sponsor visas (H-1 or J-1).
- We do NOT offer observerships or externships.
If you have additional questions about the program, please contact:
Johanna Toledo-Tyson
Internal Medicine Residency Coordinator
845-333-1756
IMResidency@garnethealth.org
Applications to Garnet Health Medical Center’s Residency Programs will only be accepted through ERAS, Association of American Medical Colleges (AAMC) Electronic Residency Application Service.
Explore Our Residency Program
Dr. Ryan Punsalan is Board-certified in Internal Medicine. He received his medical degree from Ross University School of Medicine in Domina, West Indies. He completed his residency training at Stamford Hospital in Stamford, Connecticut. Dr. Punsalan has been the Program Director since 2019 and has a strong passion for resident education, evidence-based medicine, and patient safety/quality care. He is a strong advocate for residents and also serves as the Designated Institutional Official (DIO) of Garnet Health Medical Center
The Internal Medicine Residency Program offers a robust conference series covering acute care, primary care, board review, and evidence-based medicine, including:
- Core Curriculum Lectures
- Board Review Lecture Series
- Grand Rounds
- Morbidity and Mortality Conference
- Resident Report
- Journal Club
Educational Resources:
- MKSAP - The program purchases a digital MKSAP subscription for all residents during their PGY-1 year.
- UWorld - The program purchases UWorld for all PGY 3 residents for board preparation.
- Annual In-Training Exam - All residents take the ACP In-Training Exam (ITE) every year as an opportunity to simulate a board exam and track test-taking skill and acquisition of medical knowledge.
- Healthstreams Quality Curriculum
Simulation Lab:
The hospital has a state-of-the-art SIM Lab where IM residents practice management of mock codes, mock rapid responses, and other emergencies they may encounter in the inpatient setting as part of the Medical Emergency Response Team (MERT).
The program follows a 3+1 rotation format. 1 week of ambulatory clinic rotation is followed by 3 weeks of other rotations (ICU, inpatient floors, night medicine, electives etc.) During these 3 weeks, while the rotations may vary, resident will not attend clinic. This provides for a separation between the inpatient and outpatient experiences, thus enhancing the education in both settings and permitting the residents to focus on the task at hand.
| Rotation | PGY-1 | PGY-2 | PGY-3 |
|---|---|---|---|
| Inpatient Medicine | 14 | 10 | 6 |
| Day Medical Admitting Team (DMAT) | 4 | 2 | 2 |
| Night Medicine | 4 | 4 | 4 |
| Intensive Care Unit (ICU) | 6 | 8 | 8 |
| Ambulatory | 14 | 14 | 14 |
| Cardiology | 2 | 0 | 0 |
| Geriatrics | 0 | 0 | 3 |
| Neurology | 0 | 2 | 0 |
| Emergency Medicine | 0 | 0 | 2 |
| Electives * | 2 | 8 | 9 |
| Vacation | 4 | 4 | 4 |
| Total | 52 | 52 | 52 |
* Subspecialty electives are in blocks of 1-3 weeks duration
Stipends
You will be offered the following stipends:
- PGY-1:
- $750 educational/exam stipend
- $1500 food stipend
- 2 lab coats
- PGY-2:
- $750 educational/exam stipend
- $1500 food stipend
- PGY-3:
- $1500 educational/exam stipend
- $1500 food stipend
Other
- Medical, Dental, Vision Plans
- Malpractice Insurance
- iPads are given to all new Residents
Yearly Salary:
- PGY-1: $65,700
- PGY-2: $68,590
- PGY-3: $76,545
GHMC Fellowship Match List
- Hematology/Oncology - St. Joseph's University Medical Center (2025)
- Hospice and Palliative Care - Nuvance Health (2023, 2024)
- Critical Care - Cooper University Hospital (2022)
- Nephrology/Critical Care - Westchester Medical Center (2021, 2024, 2025) East Carolina University (2025)
- Infectious Disease – Rutgers Robert Wood Johnson Medical School (2024)
- Pulmonology/Critical Care - West Virginia University (2024)
- Sleep Medicine - SUNY University at Buffalo (2022)
- Endocrinology - Lehigh Valley Health Network (2021)
- Gastroenterology – Guthrie Robert Packer Hospital (2021)
- Infectious Disease - Mount Sinai (2021)
- Cardiology – Deborah Heart and Lung Center (2020)
- Endocrinology - Lehigh Valley Health Network (2020)
- Gastroenterology – Kent Hospital (2020)
- Palliative Care - Advent Health (2020)
- Clinical Informatics - Geisinger Health System (2019)
- Gastroenterology – Hackensack UMC Palisades (2019)
- Pulmonary/Critical Care– Westchester Medical Center (2019)
Residency Retention
We aim to create a working environment that promotes a sense of community and joint purpose. We take great care and pride in training our residents to be great physicians with the goal of having some join the team and academic mission as attendings.
Since 2019, we have been fortunate to have 10 of our graduates join the Hospitalist Department and 3 graduates join the Primary Care Department. Additionally, we have 4 other graduates practicing locally.
Our residents have presented their scholarly activity (notably research, case reports, and quality improvement projects) at the regional, national, and international conferences, including:
- ACP Annual National Meeting
- ACOI Poster Contest
- American College of Cardiology Annual Conference
- Annual Digital Congress of the European Society of Intensive Care Medicine
- American Thoracic Society
- CHEST Annual Meeting
- Garnet Health Medical Center Annual Poster Competition
- Medical Society of the State of New York Poster Symposium
- New York ACP Scientific Meeting
- New York State Osteopathic Medical Society Experimental Research Scientific Poster Competition
- New York Thoracic Society
- Northern NJ SHM Abstract Competition.
- Society of Critical Care Medicine Critical Care Congress
- Society of Hospital Medicine Conference
All students interested in completing an audition rotation (2 or 4 weeks in duration, depending on availability) in Internal Medicine at Garnet Health Medical Center may email our Program Coordinator, Johanna Toledo-Tyson, at IMResidency@garnethealth.org with:
- Dates you are requesting for your rotation.
- Copy of your CV
IM Visiting Student/Audition Application form (open this PDF link and complete the form)
- Letter of Intent
Audition rotations are limited, so please submit your request early. Applications must be received a minimum of 60 days prior to your requested rotation date. Applications will be reviewed on a rolling basis. All applications will be evaluated in the order in which they are received. You will generally be notified within 2 weeks of your submission of our decision. All acceptance letters will be sent via email to the address provided on your application. Please allow a minimum of 10 business days before contacting the program for a response. Once your completed application is approved and you are notified by our program coordinator, you will have 1 week to accept the rotation.
All rotating students are given access to electronic library resources, wireless internet, and free on-site parking. Housing is not provided by hospital, but the hospital has discounted rates for nearby hotels available.
Please enjoy a short virtual tour video for prospective residents showcasing our our facilities: