Internal Medicine Residency Curriculum

Rotation Schedule

PGY1

Intern year is challenging and exciting.  For the first time, you will step into the role of the patient’s primary physician.  Building on the knowledge learned in medical school, you will learn new skills in patient care and management.  You are the most closely involved in caring for the patient and this patient-physician relationship is one of the most rewarding aspects of intern year.

Categorical Track

7 Inpatient Months: 6 month in General Medicine wards at SNGH and VAMC, 1 month Intensive Care Unit.

5 Elective Months: Includes 1 month in Emergency Medicine, 1 month in Ambulatory Medicine and 3 elective months of your choosing.

Preliminary Track

7 Inpatient Months at SNGH and VAMC

5 Elective Months: Includes 1 month in Ambulatory Medicine

PGY2

As you progress to an upper level resident, you take on a different role and develop new skills as a teacher and leader.  Leading a team, overseeing the care of all the patients and teaching both students and interns make for a challenging and fulfilling year.

5 Inpatient Months: 4 months in General Medicine wards at SNGH and VAMC, 1 month Intensive Care Unit

1 month Night Float/Consults at VAMC

6 Elective Months: Includes 1 month in Geriatrics, 1 month in Ambulatory Medicine and 4 Elective Months.

PGY3

4 Inpatient Months: 3 months Medicine Wards (SNGH and VAMC), 1 month Intensive Care Unit

1 month Day Float in Intensive Care Unit

1 month Night Float/Consults at VAMC

6 months Outpatient/Elective: Includes 1 month Advanced Ambulatory, 1 month Ambulatory Medicine, 4 months Electives

Continuity Clinic

Housestaff provide comprehensive, ongoing care in the primary care setting.  At the beginning of the year, interns are assigned to a continuity clinic site.  Sites include Hofheimer Hall, Sentara Ambulatory Care Center (ACC), and Veterans Administration Medical Center (VAMC).  Each clinic has a designated faculty to supervise and mentor residents as they develop a growing primary care practice.  During inpatient months, residents and interns see patients one half-day per week.  During the Ambulatory Medicine rotation, clinic time increases to three half-days per week.  Clinics do not occur on post-call days or during ICU rotations.

Core Rotations

SNGH General Medicine Wards

The Inpatient Wards team consists of 1 upper level resident, 2 interns and 3rd and 4th year medical students.  The team takes call every fourth night.  However, one unique aspect of call at EVMS is the short-call system.  The short call intern takes admissions from noon until 8pm.  The long-call intern then begins admissions after 8pm.  The two interns on the team alternate between long-call and short-call.  Ultimately, each intern only takes overnight call every 8 nights.  The senior resident arrives at noon each call day.  The hours of 8am until noon are protected from admissions in order to focus on teaching rounds with the attending.

Intensive Care Unit

The ICU team is a busy service, responsible for the care of patients in the Cardiac ICU, General ICU, Vascular ICU and Neuro ICU.  As a Level I tertiary care center, SNGH provides a wide range of pathophysiology and experiences.  Procedural experience is another important aspect of the ICU rotation.  You will gain the experience needed to perform procedures such as LPs, paracentesis, thoracentesis, central lines, and arterial lines.

Ambulatory Medicine

This clinic rotation is based in the Ambulatory Care Center (ACC) affiliated with SNGH.  Morning clinics consist of a wide variety of subspecialties including Rheumatology, Cardiology, Women’s Health, Pulmonary, Podiatry, Dermatology, Heme/Onc, Neurology, Ophthalmology and HIV/Infectious Disease.  Afternoons are spent in a general medicine clinic at the ACC or at the Virginia Beach Health Clinic for uninsured patients.

Advanced Ambulatory (for senior residents)

During this clinic rotation, the resident works one-on-one with an attending developing a management plan for patients following hospital discharge, which is an important aspect of continuity of care.  One of the rewarding aspects of this rotation is witnessing the dramatic clinical improvement as patients transition from the inpatient setting to the outpatient setting.  This rotation also features HTN, DM and Asthma clinics to further enhance your management skills in these common problems.

Night Float/Consults (VAMC)

2 weeks are spent as night float, admitting patients from 4pm – 8am every other day.  The next two weeks are spent on the consult service 8am-4pm Mon-Fri.

Electives

Allergy/Immunology                              Nephrology
Anesthesia   Neurology
Cardiology    Ophthalmology
Dermatology   Orthopedics/Sports Medicine
Endocrinology    Palliative Care
Gastroenterology   Pulmonary/ Critical Care
Geriatrics   Radiology
Hematology/Oncology Outpatient   Rheumatology
Hospitalist Medicine   Sleep Medicine
Infectious Disease   Ultrasound
    Women’s Health