Curriculum - Internal Medicine Residency
Residents have inpatient rotations on general medicine and subspecialty services (e.g., ID and oncology), MICU, CCU and night/day floats.
The schedule is carefully arranged so each resident has exposure to general medicine, subspecialties, clinical floors and intensive care units, while not allowing any one area to dominate.
The remainder of their time is spent on clinical or research electives, including subspecialty outpatient experiences during the mornings of their Y blocks.
During the 36 months of training, residents in the categorical program participate in the following curriculum. The number of inpatient rotations -- or inpatient equivalents -- is fixed for each year of training and consists of floor rotations (general medicine, Med-ID and oncology), ICU's (MICU and CCU/telemetry), night and day floats, and Night Acting Chief Resident (NACR) rotations.
Each academic year consists of 13 blocks of 4 weeks each. The total number of ICU rotations is capped at 6 months and the total number of night float rotations are capped at 4 months.
- Interns have 8.5 inpatient blocks (7 floor or ICU rotations plus 1.5 day or night float rotations)
- PGY-2 residents have 7 inpatient blocks (5.5 floor or ICU rotations plus 1.5 day or night float rotations)
- PGY-3 residents have 6.5 inpatient blocks (5 floor or ICU rotations plus 1.5 day or night float rotations)
|Night Float, Day Float||1.5||1.5||1|
|Night Acting Chief||0||0||0.5|
|Electives (with 2 wks vacation)||1.5||1.5||2.5|
|GRE-Geri, Rheum, Endocrine||0||0.5||0|
|Urgent Care clinic (VA)||1||0||0|
Inpatient and ambulatory rotations are structured using an X+Y format. All inpatient, elective and ER rotations are part of the X component with spaced 2-week ambulatory blocks during the Y component. For more information about Academic GIM and our FleX+Y system, see Ambulatory Program.
Conference and Inpatient Work Schedule
7-8 am | Work Rounds
First year residents pre-round on their patients in preparation for resident-run work rounds at 7 am. The team resident is responsible for supervising the clinical activities and for teaching the members of the team.
8:15-11 am | Attending Rounds
Held 7 days per week at all inpatient sites. Led by the faculty, these rounds integrate clinical management and teaching with an emphasis on learning at the bedside.
12-1 pm | Didactic Education
Most of our conferences are held from 12-1 PM with other key conferences scheduled at other times. These conferences are considered protected time. See Didactic Education for more details.
4-5 pm | Sign-Out Rounds
These sessions are held daily between 4-5 pm and are led by the team resident. First year residents present the results of clinical work for the day and plans for subsequent management of their patients. Residents directly transition patient care to the covering residents in person-to-person sign-outs.
When on Call on GIM Services
- 4 - 6 pm: Drip admission process with interns taking no more than 2 admissions within these 2 hours and no more than 1 admission in the final hour.
- 12 - 9 pm: The Day Float resident takes admissions after the long call team reaches their cap and assists with any clinical work for the teams during the afternoon and for the on-call team until 9 PM.
- 6 - 9 pm: A moonlighter does all the patient cross-cover during this time, relieving the on-call team from this responsibility.
- 9 pm: Long call ends and the on-call team signs out to the Night Float Team.
- 9 pm - 7 am: Residents and interns on the Night Float team admit patients and cross cover patients on the floor services.