RWMC: Internal Medicine Residency: Curriculum

Yearly Schedule
Internal Medicine Residents follow a comprehensive curriculum, rotating through many disciplines and interacting with a range of patients.

First Year:

3-4 months of Ward Months
1-2 months of No-Call Ward Months
2-2.5 months of ICU and CCU
3 months of electives

The remainder of the year is divided among intern float and addiction medicine.

Second Year:

3 months of Ward Months
1-2 month of No-Call Ward Month
1 month of ICU · 1 month of CCU
4 months of electives
0.5-1 month of Emergency Medicine
1 month of Night Float (may also be done in third year)

Third Year:

2 months of Ward Months
1-2 month of No-Call Ward Month
1 month of ICU
1 month of CCU
1 month of Ambulatory Medicine
5 months of electives
1 month of Night Float (may also be done in second year)

Conferences
Conferences are an important aspect of the teaching program. There are at least two hours of scheduled conference each day. Housestaff workloads are regulated so interns are able to attend the majority of conferences.

They may take the form of a didactic presentation or may be in the form of bedside rounds aimed at demonstrating an important physical finding. Scheduled weekly conferences such as Grand Rounds and Clinical Pathologic Conferences provide a forum for the entire academic community (housestaff, attendings, nursing, administration) to discuss and share recent cases and issues. Regularly scheduled conferences include:

Resident's Report
Attending Rounds
Noontime Didactic Conference
Medical Grand Rounds
Journal Club
Clinical Pathologic Conferences
Mortality and Morbidity
Autopsy Conference

Ambulatory Services
The residency program includes the Resident's Practice, which simulates a private practice experience for the house officer. It is supervised by a faculty of academic General Internists and housed in an on-site facility. Patients are seen one afternoon each week by the resident and followed longitudinally by the resident throughout the three-year training program. Residents share night and weekend coverage of the practice. When patients require admission, the resident is "consulted" to assist in management.

In the third year, residents gain further ambulatory care experience by spending one month in an urgent care setting, and by rotating with the excellent primary care physicians in the community.

Internal Medicine:
A Typical Day

On the Medical Wards

Interns are up first and expected to pre-round on all patients before 8 a.m.

8:00 a.m. - Work rounds with the team resident.

10:00 a.m. Morning report occurs daily at this time, where post-call and resolved cases are presented. The focus is on the residents while interns have the option to come.

11:00 a.m. - Three days/week, each team meets with their Teaching Attending for the month for Attending rounds. Grand Rounds are on Tuesdays at this time.

Noon - Didactic Conference with an IM topic presented by a faculty member.

Afternoons - Devoted to daily duties such as: admissions/discharges, continuity clinic (preliminary interns do not have clinic).

4:30 p.m. - Sign-outs for the medical wards.

Evening: The Long Call team admits until 9 p.m. daily, then the Night Float Resident comes in to do admissions.

With the Unit Teams

The CCU team: 8 a.m. work rounds between the 2 residents and 2 interns, at which time new admissions and current patients are discussed at the bedside. This CCU team meets with a Cardiologist three times per week in a one-hour teaching conference. Sign-outs for the CCU team occurs later in the afternoon and the team admits over a 24 hour period.

The ICU team: 8 a.m. rounds on the Unit patients, normally conducted with a pulmonary fellow. A daily teaching conference occurs with the ICU attending at which time all patients are discussed and other teaching points are presented. The ICU team admits over a 24 hour period.

Continuity Clinic occurs one afternoon/week for each categorical resident.