Internal Medicine Residency

Curriculum in Internal Medicine

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 all floor rotations, ICU's, night and day floats, cross-cover and Night Acting Chief Resident (NACR) rotations. With our academic year based on 13 4-week rotations, categorical interns have 10 inpatient equivalents, PGY-2's have 7.5 and PGY-3's have 6.5 blocks. There is some slight variation in the distribution of types of inpatient equivalents, with categorical residents completing 5-6 ICU months and no more than 4 months of night float over 3 years.

Interns in the preliminary program complete 10 inpatient equivalents (including 8-9 inpatient and 1-2 Day or Night Float blocks). Preliminary interns interested in anesthesiology may request extra ICU months. Special effort is made to ensure that all interns spend an equivalent amount of time at both University and the VA during inpatient and elective blocks.

Rotations	Year 1 Categorical	Year 1 Preliminary	Year 2	Year 3
Inpatient services (including ICU's)	8	8-9	5	4-5
Ambulatory Blocks	0	0	2	2
Emergency Medicine	0.5	0	1.5	0.5
Electives	2	2	1.5	3.5
Cross Cover/MAO	0	0	1	0
Night Float, Day Float	1	1-2	1-1.5	1-1.5
Night Acting Chief	0	0	0	0.5
Vacation	3 weeks	3 weeks	3 weeks	3 weeks

MAO = Medical Admitting Officer at Mercy Medical Center
Vacation = one 2-week block and a 3rd week taken during an elective.

Conference and Inpatient Work Schedule

Our chief residents have created a marvelous web-based calendar. You can access our calendar at www.my.calendars.net/imres (username and password are imres).

7 am - 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 am - 9 am

Morning Report: Morning Report is a case-based conference, emphasizing problem solving and the evaluation and management of clinical problems. These socratic type learning sessions led by the Chief Residents are the major conferences of the day. Some Morning Reports have different themes, such as Chairman's Rounds and the weekly core curriculum in primary care. A Morbidity and Mortality Conference is held each month with occasional Morning Reports devoted to Epidemiology, Ethics, Palliative Medicine and End-of-Life Care. The Chief Residents send out emails highlighting key points and references from the day's Morning Report, which are then linked to our web-based calendar as a "Virtual Morning Report."

Senior Resident Conference: Each senior resident is required to present a comprehensive literature review of a topic of interest. The residents write a 10-15 page referenced manuscript and create slides for their presentation. The manuscripts are bound for distribution at the end of the year.

9 am - 11 am

Attending Rounds: These sessions are held 7 days per week at all inpatient sites. Led by the attending, these rounds are geared to the resident level and integrate clinical management and teaching with an emphasis on learning at the bedside.

12 pm - 1 pm

Medical Grand Rounds: This is the weekly premier conference for the Department of Medicine and serves as a central meeting place for all residents, fellows, students and faculty. Expert speakers from the Maryland faculty and outside institutions present topics that are clinically relevant and timely.

Ambulatory Care Seminar: This weekly curriculum-based conference covers primary care topics, including Women's Health, Psychiatry, Sports Medicine, Dermatology, ENT, Adolescent Medicine and Geriatrics.

Welcome breakfast on first day of internship.

Journal Club: During this conference, residents present a critically appraised topic (CAT) in an evidenced based medicine format supported by a faculty mentor. This curriculum provides residents with the skills to perform an electronic search through Medline, conduct a critical appraisal of the literature and apply it to a clinical situation. Skills in epidemiology and biostatistics are emphasized.

Clinicopathologic Conference: At the CPC, clinicians - along with radiologists and pathologists - are faced with analyzing a case history and developing a differential diagnosis. Every year a special historical CPC deals with an undiagnosed illness in a famous person. Examples of our previous historical CPC's include Alexander the Great, Edgar Allen Poe (whose postulated diagnosis of rabies was reported by major newspapers around the world), General Custer, Mozart, and Florence Nightingale. Most recently the deaths of King Herod, Christopher Columbus, Booker T. Washington and Abraham Lincoln were discussed. Click here for a review of the Abraham Lincoln CPC.

Board Review: Led by the second year residents and under the guidance of the Chief Residents, this year-long conference progresses through standard board review texts a The second year residents develop a competency based curriculum for each topic and deliver the material to their colleagues.

Acute Medicine Series: Held during the summer months, this series of conferences covers topics pertinent to acute inpatient medicine, such as respiratory failure, GI bleed, pulmonary edema and others.

Afternoon Sessions:

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.

This page was last updated on: July 18, 2008.