Clinical Experiences for Medical Residents
Guidelines for scheduling are listed below and are intended to provide a well-rounded internal medicine experience with flexibility to meet individual training goals.
The intern year is structured as an X+Y schedule with 13 three-week rotations and 13 one-week ambulatory medicine experiences. The X+Y example schedule outlines details of how this schedule works and the benefits it provides to the wellness of interns in the Wake Forest program.
THE CONTENT OF THE THREE-WEEK “X-ROTATIONS” INCLUDES 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 occurs on the 13 “Y-weeks,” outlined in the example schedule.
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 allows for 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:
- 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
- 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
The Primary Care Track requirements are similar. Details and specifics are outlined on the Primary Care Track webpage.
Subspecialty Electives (e.g. Hem/Onc, Geriatrics, Palliative Care, etc.)
Non-Internal Medicine Specialties (e.g. Derm, Ophtho, ENT, etc.)
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
All interns and residents receive six days of vacation over either Christmas week or New Year week. In addition, they receive the following:
Preliminary interns receive two weeks of their choosing (during ambulatory rotations or the ED rotation) for a total of three weeks off.
Preliminary interns complete the year on June 23rd to transition to their advanced training program.
Categorical interns receive two weeks of their choosing (during ambulatory rotations or the ED rotation) for a total of three weeks off.
Categorical Residents complete the program on June 23rd of their HO-3 year to allow time for career or fellowship transitions.
HO-2 and HO-3 residents receive three weeks each year (1 week during an Elective and two weeks paired with HO-3 Board Study or HO-2 night float) for a total of four weeks off.