Sample Categorical Schedule & Rotations by PGY Year

PGY1

During the first year of training, residents will serve as patients’ primary physician under the supervision of an attending physician. The year is divided into 13 four-week blocks. All rotations are at Missouri Baptist Medical Center unless otherwise indicated.

Rotations typically include:

• Inpatient medicine (four blocks)
• Intensive Care Unit (one block)
• Night shift (one block)
• Emergency medicine (one block)
• Selectives (three blocks) include cardiology, pulmonology, gastroenterology, hematology-oncology, infectious diseases, endocrinology, rheumatology, neurology, geriatrics, and toxicology and addiction medicine.
• Elective (one block)
• Ambulatory care (two blocks): During ambulatory blocks, the resident will have five half-day continuity sessions with didactic education; the remaining sessions will be spent in another ambulatory experience, such as dermatology, palliative care, women’s health, ophthalmology, radiology, medical education, quality improvement, LGBTQ health and resident education.
• Vacation will be four weeks, taken from electives and selectives.

PGY2

The second year allows upper-level residents to play an important management and teaching role at the hospital. Residents will undergo teaching seminars to facilitate the transition from internship into residency.

Rotations typically include:

• Inpatient medicine (three blocks)
• Intensive Care Unit (one block)
• Night shift (one block)
• Emergency medicine (one block)
• Selectives (three blocks) including cardiology, endocrinology, gastroenterology, geriatrics, hematology-oncology, infectious diseases, nephrology, neurology, pulmonology, rheumatology, and toxicology and addiction medicine.
• Elective (two blocks)
• Ambulatory care (two blocks): During ambulatory blocks, the resident will have five half-day continuity sessions with didactic education; the remaining sessions will be spent in another ambulatory experience, such as dermatology, palliative care, women’s health, ophthalmology, radiology, medical education, quality improvement, LGBTQ health and resident education.
• Vacation will be four weeks, taken from electives and selectives.

PGY3

Senior residents will further develop teaching and leadership skills and will bring scholarly projects to fruition.

Rotations typically include:

• Inpatient medicine (one block)
• Intensive Care Unit (one block)
• Night shift (one block)
• Selectives (five blocks) including cardiology, pulmonology, gastroenterology, hematology-oncology, infectious diseases, endocrinology, rheumatology, neurology, geriatrics, and toxicology and addiction medicine.
• Elective (three blocks, one of which will be inpatient)
• Ambulatory care (two blocks): During ambulatory blocks, the resident will have five half-day continuity sessions with didactic education; the remaining sessions will be spent in another ambulatory experience, such as dermatology, palliative care, women’s health, ophthalmology, radiology, medical education, quality improvement, LGBTQ health and resident education.
• Vacation will be four weeks, taken from electives and selectives.

Selectives and electives will differ from most training programs in that they will reflect the nature of the consultant’s practice. For example, a resident rotating in endocrinology will spend approximately 95% of their time in the office and 5% in the hospital, while one rotating on pulmonology will spend roughly 60% of the rotation in the office and 40% in the hospital. Residents will be able to participate in procedures specific to the specialty.

Ambulatory Care Training

Internal medicine residents will spend two half days weekly in continuity clinic.

There will be two separate ambulatory experiences for each resident.

1. One continuity clinic in our brand-new, state-of-the-art residents’ clinic in the Clinical Learning Institute. Patients seen here are drawn from the surrounding community and do not have primary care physicians. All visits will be supervised by an experienced internist with broad and extensive experience in ambulatory care.
2. One continuity clinic in a community-based private practice, based on the over 30-year-old Community Oriented Pediatric Education, the only ambulatory training program at St. Louis Children’s Hospital. Each resident will spend three years working in a practice with the same internist, becoming familiar with every aspect of private practice and developing long-term relationships with patients, physicians and staff.

Conferences and Didactic Learning

Core curriculum conference is given twice weekly and follows the outline of the ABIM blueprint. It is didactic-based and organized by specialty. Each specialty follows a three-year curriculum created by the Washington University specialist physicians. Core Conference will also cover topics in quality and wellness.

Scholarship

Scholarship is an important part of Internal Medicine training. Residents are encouraged to submit abstracts to regional and national meetings, and financial support is available through funds provided by an endowment for the residency program through the Missouri Baptist Healthcare Foundation.

We also encourage residents to participate in research projects with the subspecialty divisions. There are opportunities to learn about clinical trials, participate in national trial conferences and undertake quality improvement projects.

Patient quality and safety will be incorporated into specific ambulatory rotations throughout the residency. Residents will be encouraged to identify problems in quality and safety and work with a faculty member to address these problems.