Essentially, the year is divided into 10 five-week blocks excluding the two weeks in the middle of the academic year (the winter holiday weeks of Christmas and New Year’s).  Four weeks of each block are devoted to General Inpatient Internal Medicine, ICU, Emergency Medicine, and other core rotations, selectives or electives. The fifth week of the block is devoted to the ambulatory curriculum, including five half-days in continuity clinic as well as other clinical and protected time.  Here is a sample 5-week portion:

Week
1
2
3
4
5
FIRM 1
Core / Elective
Ambulatory
FIRM 2
Ambulatory
 Core / Elective
FIRM 3
 Core / Elective
Ambulatory
Core / Elective
FIRM 4
 Core / Elective
Ambulatory
  Core / Elective
FIRM 5
 Core / Elective
Ambulatory
Core / Elective

There are “Firms” consisting of residents  from all PGY levels who will move through the schedule together and provide a team framework for planning and coverage. This “Firm” concept offers a robust structure for collegiality, project development and mentoring.  In addition, residents will partner with each other to help create a seamless longitudinal experience for their primary care patients.  Practice Partners will support one another by shifting blocks on a staggered basis in order to best reduce fragmentation of coverage for their continuity clinic patients.

During the core 4-week block, residents have NO AMBULATORY DIRECT PATIENT CARE REQUIREMENTS, thereby improving efficiency, reducing fragmentation, and allowing better focus on the specific rotation. This ensures that residents remain attentive to and available for their patients, their team, and their specific educational experience.

The “+1” Week

The “+1” week of each 5 week block will be an ambulatory and research/teaching week. It is during this time that 5 half-days will be devoted to the residents’ continuity clinic experience. By providing regular contact with their longitudinal practices, this model immerses residents into the outpatient experience and should maximize resident satisfaction with NO CONCOMITANT INPATIENT RESPONSIBILITIES. The remaining 5 half-days of this week are divided into other experiences, including subspecialty clinics, longitudinal hospice experience, supporting the underserved community in the Faith & Deeds Clinic (Free Clinic of Rome) and a half-day devoted to Simulation skills development.  There is also dedicated protected time for residents to perform scholarly activity, learn Quality Improvement skills and develop QI projects.

For our Osteopathic residents we offer a special clinic experience working with Dr. Chris Knitig, Director of Osteopathic Medical Education, which will include developing and perfecting OMT and other osteopathic focused care.

Below is a sample schedule:

Monday
Tuesday
Wednesday
Thursday
Friday

AM

CONTINUITY CLINIC
free clinic OF ROME/ADMIN TIME

 

CONTINUITY CLINIC
free clinic OF ROME/ADMIN TIME

 

CONTINUITY CLINIC

PM

PGY-1: AMBULATORY SUBSPECIALTY CLINIC
PGY-2: qi rESEARCH
pgy-3: LONGITUDINAL HOSPICE
CONTINUITY CLINIC
gim/aMBULATORY cONFERENCE
simulation skills
CONTINUITY CLINIC
ACADEMIC HALF-DAY

Golden Weekend

The other benefit of having a “4+1” schedule is that fabulous GOLDEN WEEKEND!  All residents will have their “+1” week built into their schedule for essentially all three years of their training.  And with every “+1” week comes a guaranteed full weekend off to spend with family, significant others, exploring, traveling, studying or just catching up on sleep.

Inpatient Medicine

General Medicine
All inpatient general medicine teams are modeled on the traditional one supervising (PGY-2/3 ) resident and two interns (PGY-1) along with at least one 3rd-year and often one 4th-year medical student . Teams are supervised by full-time clinical faculty who are committed to teaching and mentoring residents and students in the practice of hospital-based Internal Medicine.  All teaching teams admit patients on the “trickle” system 7 days a week with a cap on both admissions and total patients to maximize the focus on clinical teaching.

ICU Medicine
The ICU experience engages house staff in primary care of critically ill patients with disease processes of all types.  Capitalizing on a high acuity patient population at our primary teaching hospital, ICU teams consist of two supervising residents and two interns and are geographically based in both the medical-surgical and cardiac intensive care units.  Like the general medicine teaching teams, patients are admitted or transferred to the ICU team on a “trickle” system 7 days a week with a daily cap on both admissions and total patients to maximize the focus on clinical teaching.  Supervised by intensive care focused Hospitalist faculty and supported by a team of Critical Care specialists, the ICU experience is an immersion in education on managing single and multiple organ-system failure disease.

Admission Team/Night Medicine:  Both interns and senior residents will experience the unique setting of acute care medicine under the supervision of Hospitalist faculty and will involve admissions of both general and critical care medical patients, cross-coverage of general medicine patients by PGY-1 residents, of ICU patients by PGY-2/3 residents and medical consults for non-medical patients.  Residents will be part of the code-blue teams and have access to faculty for both direct and indirect supervision.

SAMPLE SCHEDULES

PGY-1

  • Inpatient/General Medicine: 14 Weeks
  • Night Medicine: 2-3 Weeks
  • Admission Team:  4-5 Weeks
  • ICU: 5 Weeks
  • Cardiology: 4 Weeks
  • Emergency Medicine: 4 Weeks
  • Procedure & Simulation: 1 Week
  • Radiology: 1 Week
  • Ambulatory/Continuity Week: 10 Weeks
    • Osteopathic Tract/OMT Clinic: Every +1 Week
  • Vacation: 3 Weeks + 1 Week Christmas or New Year’s

PGY-2

  • Inpatient/General Medicine: 6 Weeks
  • Critical Care: 6-7 Weeks
  • Night Medicine: 3 Weeks
  • Admission Team: 6 Weeks
  • Neurology: 4 Weeks
  • Selective/Elective: 12 Weeks
  • Ambulatory/Continuity Week: 10 Weeks
    • Osteopathic Tract/OMT Clinic: 1 Week + Elective
  • Vacation: 3 Weeks + 1 Week Christmas or New Year’s

PGY-3

  • Inpatient/General Medicine: 4 Weeks
  • Critical Care/Procedure Team: 4 Weeks
  • Night Medicine: 2-3 Weeks
  • Admit Team: 4 Weeks
  • Geriatrics/Palliative Care: 4 Weeks
  • Addiction Medicine: 2 Weeks
  • Selective/Elective: 20 Weeks
  • Ambulatory/Continuity Week: 10 Weeks
  • Vacation: 3 Weeks + 1 Week Christmas or New Year’s

CORE SELECTIVES (2-4 WEEK BLOCKS, DURING PGY-2 and/or 3)

  • GastroenterologyHematology-OncologyRheumatologyEndocrinologyNephrology, Infectious Disease, Pulmonary Medicine

ELECTIVES (1 to 4 WEEK BLOCKS)

  • Allergy/Immunology, ENTOffice Orthopedics/Sports MedicineDermatologyOphthalmologyPhysical Medicine & Rehab/Pain ManagementRadiology, Vascular Medicine, Hospital Medicine/Consult Service, Primary Care, Business of Medicine/Policy and Advocacy, Wound Care/Hyperbaric Medicine
  • Osteopathic Specific: OMT Clinic
  • Additional Core Selective exposure
  • PGY-2/3 elective schedules will be tailored to fit the needs and future plans of the individual resident