Simulation scenarios in medical education have proven to be an extremely valuable educational tool as they provide training as well as an opportunity for assessment of clinical competency. Internal medicine programs have incorporated high fidelity simulation to teach trainees procedural skills, advanced cardiac life support, and inpatient emergency scenarios. These curricula have demonstrated improved performance, self-reported clinical skills, and trainee confidence. Currently, there is no structured curriculum, and no structured evaluation methodology to better elucidate the efficacy of this curriculum. We aim to form a longitudinal simulation-based curriculum consisting of standardized and objective assessment, to improve trainee experience and performance during in-hospital critical events. We then aim to develop a three-week iterative curriculum for residents.