Residency Structure & Curriculum

Wayne State University
Internal Medicine Residency Program
Rotation Schedule

Rotation

Blocks of Training*

PGY I

PGY II

PGY III

Inpatient Floors

8

3

3

Critical Care Unit

2

2

2

Ambulatory Specialty**

0

1

1

Night float**

0

1

1

Research**

0

1

0

Continuity Clinic**

0

0

1

Elective

1

2

3

Oncology

0

1

0

Neurology

1

0

0

Infectious Disease

0

1

0

Cardiology

0

0

1

Geriatric Medicine

0

0

1

Emergency medicine

0

1

0

Vacation**

1

1

1

* Each block of training is 4 weeks in duration.

** The Rotation can be divided into two, two-weeks (half a block) within the same academic year.
 

Brief Description of each rotation:

Inpatient Floors

Description: This is the main rotation during the first year of the residency training. The PGY-1 resident will work under direct supervision of one PGY-2 or 3 residents for the entire 4 weeks of the rotation. A Faculty member will conduct daily rounds with each team. One faculty member is assigned to each team.

Structure: There are four teams during each block. Each team is composed of two PGY-1 and one PGY-2 or 3. One faculty member will round and supervise each team during the rotation.

Day Call: Each team will share one day call every fourth day. All team members are expected to start their call around 7:00 a.m. The team on call is responsible for admitting patients from 7:00 a.m. till 8:00 p.m. The team is also responsible for coordinating the sign out sessions with the other teams and the night float residents. Total number of admissions during the day call should not exceed 5 admissions for each PGY-1 resident.

Night Call: No night calls during this rotation.

Days Off: Each resident is expected to have on average one day off every week

Patient's Load: The PGY-1 resident should not carry more than 8 patients on her/his daily list. Senior residents should not supervise the care of more than 16 patients daily.

Didactics: All residents are expected to attend and participate in the daily morning case presentation (8:30 a.m. - 9:30 a.m.), and the noon conference (12:00 p.m. and 1:00 p.m.).

 

Night Float

Description: Mandatory Rotation for PGY2 and PGY3, will be primarily responsible for admission, complete urgent medical consultations cross-covering teams and it is a good form for all residents to attend medicine rapid responses and codes so long as you are not in a procedure or tending to a critically ill patient.

Structure: Team is composed of two senior residents PGY2 or PGY-3 seven days a week.

Days Off: Each resident is having four days on and 4 days off.

Schedule: 9:00 PM Senior resident will take sign out from the day team. Take admissions until 5:59am. No medical admissions will be taken from the emergency room between 6:00 am and 6:59 am. If an express care admission arrives during that time period, they should be evaluated and stabilized by the night float team, but the night float team will not be responsible for writing up the admission 7:00 AM: Sign out of cross-cover from the night float to the day ward resident and interns. Round with primary team and must leave by 11: 00 AM to ensure 10 hours between shifts

Patient Load: Not exceed 10 admissions in one night.

Days Off: Each resident has four days on and four days Off.

Didactics: 8:30 - 9:30 AM: Morning report. Attendance is expected every morning without fail.

 

Critical Care Unit

Description: The rotation is structured to provide training in managing critical care patients who are admitted to the Intensive Care Units (ICU) and the Cardiovascular Intensive Care Unit (CVICU). The PGY-1 resident will work under direct supervision of 4 PGY-2 or 3 residents and an intensivest for the entire 4 weeks of the rotation.

Structure: The Critical Care team is composed of two PGY-1, two PGY-2, and two PGY-3 residents. Four intensivests will share direct and indirect supervision of the residents.

Night Call: The PGY-1 resident is not expected to have any over night call. The four senior residents are expected to have one over night call every fourth day. The Senior resident on call is expected to start his/her 24 hour call at 8:00 a.m. and be free of duties after signing out at 8:00 a.m. the next day. No more than 4 hours extra are allowed for signing out during the morning grand round.

Days Off: Each resident is expected to have on average one day off every week.

Patient's Load: The PGY-1 resident should not carry more than 5 patients on her/his daily list. Each senior resident should not supervise the care of more than 10 patients daily.

Didactics: All residents are expected to attend and participate in the daily Critical care didactics


Ambulatory Specialties

Description: These two blocks of outpatient rotations suppose to be distributed throughout the second and the third years of training. The objective of these rotations is to provide training in ambulatory specialty medicine. These include dermatology, ENT, ophthalmology, outpatient gynecology, and outpatient rehab medicine. The resident is expected to rotate among the specialty and spend a minimum of 10 workdays in each of them during the two blocks rotations.

Night Call: No night calls during these rotations.

Days Off: Each resident is expected to have all weekends as off days.

Didactics: All residents are expected to attend and participate in the daily morning case presentation and morning report and the noon conference.


Research Month

Description: Research Month is an optional, non-clinical rotation for the second year of the residency training only. The rotation is designed to give the resident the hours and the resources needed to complete research/CQI projects. This rotation needs to be approved by the program director or the associate program director. The resident is expected to develop and deliver a scholarly product during this rotation. Only one research block is allowed during the second year of the residency training.

Night Call: No night calls during this rotation.

Days Off: The resident is expected to have all weekends off.

Didactics: The resident during this rotation is expected to attend and participate in the daily morning case presentation (8:30 a.m.- 9:30 a.m.), and the noon conference (12:00 p.m. and 1:00 p.m.).


Continuity Clinic Month

Description: Continuity Clinic Block will provide the resident with 20 extra continuity clinic sessions to meet the ACGME requirement of a minimal total of 130 half-day sessions of outpatient continuity clinic throughout the three years of residency training. During this month the resident is also expected to gain and utilize her/his skills as a medical educator. The resident is expected to organize and deliver MKSAP Reviews on a weekly basis, organize and moderate daily case presentation during the morning report, and participate in the design and the management of behavioral studies that address adult learning.

Night Call: No night calls during this rotation.

Days Off: The resident is expected to have all weekends off.

Didactics: All residents are expected to attend and participate in the daily morning case presentation (8:30 a.m. - 9:30 a.m.), and the noon conference (12:00 p.m. and 1:00 p.m.).

 

Subspecialty and specialty electives (Including Neurology, Cardiology, Oncology, and Infectious Disease)

Description: Elective rotations are distributed throughout the three years of residency training. During these rotations the resident will be managing patients under the direct supervision of the subspecialty consultant, in both outpatient and inpatient settings. The description of each subspecialty rotation varies among different electives.

Night Call: No night calls during this rotation.

Days Off: The resident is expected to have at least one day off duty every weekend.

Didactics: All residents are expected to attend and participate in the daily morning case presentations (8:30 a.m. - 9:30 a.m.), and the noon conference (12:00 p.m. and 1:00 p.m.).