Our Internal Medicine training is a mixture of inpatient and outpatient time. Resident interns complete 4 blocks of inpatient medicine, each block consists of 3 weeks inpatient and 1 week outpatient. The second year includes 2 blocks of night float (inpatient medicine), plus 3 blocks of medicine subspecialty (cardiology, Pulm/ICU, and neurology). Third year residents complete a final two blocks of inpatient medicine.
The inpatient service is 23 residents plus an attending team, typically covering a census of 1220 patients plus 12 critically ill patients. Common diagnoses include community-acquired pneumonia, hospital-associate pneumonia, CHF exacerbations, COPD exacerbations, chest pain, sepsis/shock, pancreatitis, diabetic ketoacidosis, PEs, and stroke.
Our attendings are 50 percent Internal Medicine trained and 50 percent Family Medicine trained. The hospitalist service works together with the residency service to ensure that we have the right balance of patients to ensure good learning so that our census is neither too light nor excessive. During our time on internal medicine we continue with 12 half days in clinic to provide our patients with continuity of care.
ICU/Pulmonology, Cardiology, and Neurology
Our medicine subspecialty blocks give us one-on-one time with community attendings for clinical teaching both in the hospital and the office.
We help with pulmonary, cardiology, and neurology consults. We are taught ventilator basics and develop critical care skills. We assist with cardiology consults, interpret EKGs and review different cardiac diagnostic modalities. We are taught the keys to a thoughtful neurologic work up and a skillful exam.
We are fortunate to have the support of the medical community.
The night-float rotation is considered a learning-rich experience and consists of two 4-week blocks or four 2-week blocks. The float resident is responsible for taking care of the entire service overnight and does admissionsa lot of autonomy is developed, though faculty is always available.
Our float system will allow us to continue our current curriculum with minimal changes even with new work-hour regulations.