In the Wake
Forest Internal Medicine Program, our overarching goals are to promote a
progressive growth of proficiency in Internal Medicine knowledge and clinical
skills throughout the three years of training. Interns enter a collegial
environment that fosters appropriate autonomy early on in training, with a high
level of support and guidance. As residents progress through the
curriculum, they develop as team leaders and are well-positioned to practice
Internal Medicine independently upon graduation.
The HO-1 year
is designed to offer a broad exposure to direct patient care in internal
medicine. This year, we are transitioning to a new schedule model (X+Y) for the
intern year based on prior years’ feedback. We will institute a 3+1 model which
showcases three weeks on an “X” service (Wards, ICU, Nights, Urgent Care
Clinics, VA Clinic, Emergency Department) followed by one week of ambulatory
medicine, which features a variety of clinic experiences and educational
conferences. Throughout the year, interns learn to manage patients in a
variety of clinical settings with excellent exposure a broad range of patient
populations and have the opportunity to learn directly from subspecialist on a
variety of inpatient services and outpatient clinics.
The HO-2 and
HO-3 years are designed to facilitate the growth and maturation of the house
officer into a skilled internist. Upper level residents transition to a
role of leader and manager of the general medicine and subspecialty inpatient
services (cardiology, hematology/oncology, leukemia, nephrology and geriatrics).
Additional blocks include 1.5 blocks of night float coverage, and the medical
and cardiovascular intensive care units. The remaining blocks consist of
subspecialty consults and clinic experiences, private practice internal
medicine clinic, general medicine acute care clinic, VA outpatient clinic, as
well as Board Study and other various electives, and one block of combined
general internal medicine consults, ED consults, procedures, and perioperative
clinic. Elective time allows tailoring of the upper level schedule to the
interests of each resident. Most residents schedule at least one research
HO-2 and HO-3 years of the program, the schedule follows a general structure of
alternating between 4-week ward services and 4-week non-ward rotations.
Continuity clinics are not scheduled during inpatient ward services.
Resident continuity clinics are organized into practices, and residents have
two half-days of continuity clinic per week during their non-ward blocks that
include dedicated sessions for ambulatory quality improvement.
interdisciplinary ward teams generally consist of 2-3 interns, 1 upper level
resident, and 1 attending, as well as medical students, acting interns,
clinical pharmacists, nursing case managers and other helpful ancillary
staff. Upper levels supervise the care of 10-20 patients on the ward
services. The medical intensive care unit is staffed by two teams each
consisting of 3-4 interns, 2 upper levels, fellow, and attending. The
cardiovascular intensive care unit is staffed by 2-3 interns, 2-3 upper
level residents, fellow, and attending.
call system consists of a block night float system for ward services and a
short stretch in the MICU and CVICU.
level call system consists of a night float that covers Sunday through Thursday
and overnight call on Friday and Saturday. Upper levels on ward services cover
the Friday and Saturday calls: a total of two overnight calls per ward
block. In the MICU, call is every fourth or fifth day. The CVICU will
have a night float system where upper levels rotate short stretches of nights
throughout the rotation.