Training during residency takes place in a variety of settings. The inpatient service includes two general medical units and one cardiology unit. Each occupies an inpatient floor with 50 beds, and is staffed by four teams that each consist of a resident, two interns, one or two third-year clerks, a subintern and an attending physician.
Patients with complex cardiovascular disease are cared for on the cardiology floor, with specialized nursing care and attending physicians from the Division of Cardiology. The number of admissions and the overall team size are limited. Interns admit no more than five patients per call day and care for no more than 10 patients at a time. A night float system provides coverage for late night admissions and cross coverage, which allows the on-call interns adequate time for rest and reading. A system of admission control and triage, overseen by the Chief Residents, ensures that the sickest and most interesting patients are cared for on the teaching services. The remaining inpatient time is comprised of rotations in the Medical Intensive Care Unit, Coronary Care Unit and oncology inpatient service at Barnes-Jewish Hospital and on the inpatient medicine service at the VA Medical Center. Housestaff also rotate through the Emergency Department to gain a broad experience in acute care.
Training in ambulatory medicine occurs in a continuity clinic throughout residency. The majority of residents see patients in the Primary Care Medicine Clinic at Barnes-Jewish Hospital. There is an option to request to work in a FQHC – federally qualified health center. The program has switched to block clinic scheduling where most clinic sessions are scheduled during weeks when the resident is assigned full time to out-patient medicine. During a week of block clinic time a resident will typically have five personal clinics, two medical specialty clinics, one administrative session, one quality improvement session, and one didactic session. All interns have four weeks of assigned clinic time in the beginning of the year. This Ambulatory Care Rotation includes an extensive lecture series on out-patient medicine. Junior residents spend three to four weeks assigned to an urgent care rotation in the Primary Care Medicine Clinic. In addition to the continuity clinic, residents can choose additional ambulatory electives, including internal medicine subspecialties and non-internal medicine areas such as dermatology, gynecology, or orthopedics. Those interested in a community based experience may participate in the Continuing Ambulatory Experience for Residents (CAER Program) which matches residents with outstanding community internists for a month-long primary care elective. For residents interested in pursuing a career in primary care there is the primary care pathway. This program will train residents for careers in out-patient practice, academic general internal medicine and health policy through a comprehensive three year curriculum with increasing focus on outpatient medicine.
Our schedule provides ample elective time to allow each resident the ability to create a customized curriculum to meet individual career goals while guaranteeing broad exposure to the subspecialties of internal medicine. We are firmly committed to our heritage of training outstanding internists who pursue careers in academic medicine or clinical practice, in either general internal medicine or the subspecialties of medicine.
Find out more information about categorical schedules and rotations here.
Sample Categorical Schedule & Rotations by PGY Year
During the first year of training, you will serve as the patient’s primary physician, under the supervision of an upper-level resident and attending physician. Rotations typically include:
As a second-year resident, you will begin to play an important management and teaching role at the hospital. To prepare you for these responsibilities, you will undergo a four-hour teaching
seminar to facilitate your transition from internship into residency. Rotations for a second-year resident typically include:
As a third-year resident, you will continue to expand your skills on core inpatient services (inpatient medicine, CCU, MICU, cardiology), and take advantage of numerous elective and selective opportunities in medicine and non-medicine subspecialties. Rotations of a third-year resident typically include: