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Program Structure and Curriculum

Scheduling Guidelines

Clinical Experiences for Medical Residents


Department of Internal Medicine



Guidelines for scheduling are listed below and are intended to provide a well-rounded internal medicine experience with flexibility to meet individual training goals.

Intern Year

In the 2018-19 academic year, the intern year will be structured as an X+Y schedule with 13 three-week rotations and 13 one-week ambulatory medicine experiences. See the separate document on details of the transition to the X +Y system for the intern year in the Wake Forest program.

The content of the three-week “X-rotations” will include the following dedicated experiences:

  • 10 blocks of inpatient wards (including Night Medicine, CVICU, and MICU)
  • 1 Emergency Medicine block (ED)
  • 2 ambulatory blocks, including the VA (Categorical and Primary Care Interns) and Acute Care Clinic

The remaining ambulatory training will occur on the 13 “Y-weeks,” outlined in the separate document.


Upper-level Years

For upper-level residents, each academic year consists of thirteen 4-week blocks. The upper-level schedule is also an X+Y schedule (4+4) which was implemented in 2013 and has been highly successful. In general, a ward rotation is followed by a non-ward rotation, and continuity clinics take place during the non-ward rotations only. Coupling this schedule with the 3+1 structure in the intern year will allow for improved overall team continuity and full dedication to inpatient training for both upper levels and interns on ward services.

The content of the upper-level years is as follows:


1)   Total Upper-level Ward Experience: 10 blocks

3 blocks Intensive Care (1-CCU, 1-MICU, 1-either)
1 block ACE Unit (Acute Care of the Elderly)
2 blocks Gen Med Wards (Includes Gen Med and Hospitalist)
1 block Hem/Onc (Hem/Onc A or Leukemia)
1 block Other Wards (Gen Med, Hospitalist, Hem/Onc A, Cardiology, Leukemia, Renal)
1.5 blocks Resident On Call (one two-week blocked is paired with two weeks’ vacation)

2)   Other Required Upper-level Rotations: 12 Blocks

2 blocks HO-3 Consult-Procedures-Complex Care (HO-3 CPCC) – Internal Medicine consultation to ED and non-IM services, outpatient preoperative consultation, procedures/ultrasound, and quality improvement for care of complex patients.
1 block Acute Care Ambulatory Rotations: DHP (HO-3 only); OPD (HO-2 and HO-3)
1 block VA Outpatient Clinic (HO-3)
6 blocks Subspecialty Consult Months (Endocrine, GI, ID, Pulmonary, Renal, Rheumatology —These rotations provide both outpatient and inpatient consultation experiences.)
1 block Board Study (two weeks) which is paired with two weeks of vacation
1 block Outpatient Internal Medicine (two weeks) and Elective (two weeks)


Other Elective Experiences: 4 Blocks

See separate document for specific requirements of Primary Care Track
Subspecialty (e.g. Hem/Onc, Geriatrics, Palliative Care, Allergy) Electives
Non-Internal Medicine Specialties (e.g. Derm, Ophtho, ENT, Sports Medicine)
Research Electives, including Tinsley Harrison Research Pathway (2-3 blocks)
Community-based experiences & other self-styled electives (including international electives)
Evidence-based Medicine (EBM)
Medical Systems and Quality Improvement



Preliminary interns receive six days of vacation over Christmas or New Years and two other weeks of their choosing (during ambulatory rotations or the ED rotation). In addition, preliminary interns complete the year on June 23 to transition to their advanced training program.

Categorical interns receive six days of vacation over Christmas or New Years and two other weeks of their choosing (during ambulatory rotations or the ED rotation). Categorical Residents complete the program on June 23 of their HO-3 year to allow time for career or fellowship transitions.

HO-2 and HO-3 residents receive six days of vacation over either Christmas or New Year's and three additional weeks each year (1 week during an Elective and two weeks paired with HO-3 Board Study or HO-2 night float).


Quick Reference

Internal Medicine Residency
Heather Yates
Residency Program Administrator

Residency Office

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Watlington Hall, 3rd Floor
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