Internal Medicine

Clinical Rotations

Our program utilizes a 4+2 block system to ensure adequate time in the ambulatory setting and to provide separation of inpatient and ambulatory rotations. The year generally takes the cadence of 4 inpatient or elective weeks, followed by a 2-week ambulatory block. The ambulatory blocks primarily consist of continuity clinic time, and vacation may also be taken during these blocks.

Overall, about 2/3 of the clinical time is spent in the inpatient setting, and 1/3 of the clinical time in the ambulatory setting. 

Intern year intentionally focuses on building basics, with the vast majority of clinical time spent in the inpatient wards, ICU, and continuity clinic. 

PGY2s spend the first half of the year focusing on subspecialty exposure on consult rotations where they are often 1:1 with an attending.  This allows for growing independence, and then the second half of the year focuses on developing leadership skills as a senior resident on the wards and ICU. 

PGY3s year is a mirror image – the first half of the year focused on wards, ICU and clinic to allow for more experienced senioring of new interns early in the academic year, and the latter part of the year focused on subspecialties.  Elective time is provided throughout the three years, mostly focused during the PGY2 and PGY3 years.  Through meetings with mentors and the Program Director, elective time is designed to allow residents to explore their unique passions and gain experience toward their future area of practice.

All clinical rotations are shift-based, meaning we have a night float system rather than 24-hour call.  Since we do not have fellowship programs, residents work directly with attending physicians on their subspecialty and ICU rotations, which maximizes hands-on experience and autonomy.  We have a small group of faculty preceptors in clinic, and academic hospitalists on the wards, which allows our faculty to get to know our residents well and help coach their progress consistently.

Conferences

Academic Half Day: interns and seniors have separate protected afternoons each week for small group, active learning sessions mapped to ABIM board objectives.  These sessions are led by faculty, chief residents, or senior residents and require residents to engage in pre-reading or pre-listening and come ready for a case-based discussion on a topic.

Morning Report: Morning report occurs from 7:30-8:00AM Tuesday and Fridays to allow time for pre-rounding and give some focused teaching prior to floor rounds beginning at 8:30.

Resident-led Tumor Board: Monthly a resident on the Oncology consult service prepares a resident-focused Tumor Board presentation consisting of recent oncology cases with a focus on diagnosis and guideline-based treatment.  Residents also are invited to attend our Interdisciplinary Tumor Boards hosted by the Cancer Center at UM Capital Region Health.

Friday Lagniappe Series: The Chief Residents select topics and speakers for a Friday noon conference series based on interest of residents.  Lagniappe is a French-Cajun word meaning “a little something extra”, and not surprisingly this is a favorite resident education series.

Grand Rounds:  Grand Rounds occur on Wednesdays and brings outside expert speakers on special topics. Grand Rounds is a time for both resident and faculty development and includes our research and process improvement curriculum.

Morbidity and Mortality / Journal Club: These sessions occur at least monthly and are folded into other conference slots as above.  Each resident is required to lead one of each of these conferences prior to graduation alongside a faculty mentor.

Longitudinal Curricula

Board Review:  Residents are expected to use MKSAP Tracker (provided by the program) and receive individualized study plans based on this starting their PGY2 year.

Ambulatory Curricular Threads: There are self-directed modules, experiential shadowing half-days, and reflections built into the clinic blocks for PGY1s in the following domains: trauma informed care, care of the underserved patient, care of the patient with co-morbidities, and relationship-centered care.

American Board of Lifestyle Medicine:  A combination of self-directed modules and group discussion centered around Lifestyle Medicine occurs during the PGY2 clinic blocks.  For residents who are interested, they may pursue additional elective(s) in Lifestyle Medicine which can go toward this board certification following graduation.