A typical day during inpatient service at Memorial Health University Medical Center looks like this:
- 7:00-7:30 am, Patient handoff and sign-out rounds
- 7:30-9:00 am, Resident work rounds
- 9:15-10:00 am, Morning report (inpatient teams only)
- 10:00 am-12:30 pm, Attending rounds
- 12:30-1:30 pm, Lunch conference
- 1:30-4:00 pm, Work rounds and inpatient duties; complete attending rounds, if needed
- 4:00-4:30 pm, Afternoon patient handoff and sign-out rounds
- 9:00 am-12:00 pm OR 1:30-5:00 pm, Half day of outpatient continuity clinic per week
Educational conferences have varying formats and are a large part of our program. Our conferences complement our curriculum and include team-based learning, case presentations, Journal clubs, and much more. These conferences are highly rated and well attended. An explanation of each conference is provided below.
Morning Report
Monday, Tuesday, and Thursday, from 9:15-10:00 am, for all house staff and faculty currently on medical wards. This is a resident-driven conference in which one to two cases recently admitted are presented to a teaching faculty member for an in-depth interactive teaching session focusing on differential diagnoses, treatment modalities, and interpretation of laboratory and radiographic data.
Team-Based Learning
This is an active learning initiative that has generated considerable excitement. Residents are divided into teams to develop in-depth understanding about various medical problems. Half of the residents attend the morning session and half attend in the afternoon.
Resident Career Enhancement
A career-enhancement program is scheduled monthly. This covers areas such as obtaining a job, contracts, overhead, healthcare financing, bank loans, disability insurance, setting up an office, promoting a practice, how to get a fellowship, and opportunities in clinical research.
Grand Rounds
Conferences are held on Fridays from 8:00-9:00 am in the state-of-the-art Medical Education Auditorium at Memorial Health University Medical Center. Distinguished and renowned guest lecturers present a broad spectrum of topics.
Performance Improvement Conference
Scheduled on the fourth Wednesday of every month, this conference provides a forum where faculty and residents can examine current cases in an effort to provide continuous quality assessment and improvement.
Noon Core Conferences
These daily meetings are held Monday through Friday, 12:30-1:30 pm, for all house staff and teaching faculty. There is a three-year revolving curriculum addressing all aspects of internal medicine in preparation for the American Board of Internal Medicine Examination given by subspecialist and general medicine faculty.
Evidence-based Medicine (Journal Club)
Four to five formal evidence- based medicine conferences are scheduled per month. The residency is divided into four teams, with one team presenting two articles each week. These conferences provide comprehensive coverage of emerging evidence and the format ensures that the content is current with the medical literature.
ACGME Competencies
These monthly conferences use innovative methods to teach important concepts regarding the six competencies.
Monthly Board Tests
Once a month, the residents take an internally prepared test based on specific areas of internal medicine.
Tumor Board
This multidisciplinary conference is attended by radiation oncology, pathology, hematology/oncology, surgery, and residents on hematology/oncology service (or any other rotation). The board discusses interesting oncology cases and upcoming evaluation and treatment plans.
Outpatient Internal Medicine Clinic
Interns and residents spend a half day each week in their own continuity clinic and provide hospital follow-up care to patients seen at Memorial Health University Medical Center (occurs pre-call day if on medicine wards). Our Center for Internal Medicine clinic allows residents to practice medicine in a real-life private-practice setting.
MedStudy Board Review Course
All PGY-3 residents are required to attend a 10-day internal medicine board review course in May at the expense of Memorial Health University Medical Center. The course is an excellent way to solidify clinical knowledge at the end of training.
A typical day during inpatient service at Memorial Health University Medical Center looks like this:
| Time | Activity |
|---|---|
| 7:00am - 7:30am | Patient handoff and sign-out rounds |
| 7:30am – 9:00am | Resident work rounds |
| 9:15am - 10:00am | Morning report (inpatient teams only) |
| 10:00am - 12:30pm | Attending rounds |
| 12:30pm - 1:30pm | Lunch conference |
| 1:30pm - 4:00pm | Work rounds and inpatient duties; complete attending rounds, if needed |
| 4:00pm - 4:30pm | Afternoon patient handoff and sign-out rounds |
| 9:00am - 12:00pm OR 1:30pm - 5:00pm |
Half day of outpatient continuity clinic per week |
Inpatient Teaching Services
There are five general ward services comprised of an attending, resident, two interns, medical students, and, occasionally, a pharmacy or physician assistant student. The ward teams take call every fifth day from 7:00am to 7:00pm.
There is no intern overnight call. Night teams arrive at 7:00pm and continue until morning the following day.
We fully comply with ACGME requirements for residency training programs with particular attention to the number of weekly hours and the number of patients each intern or resident can admit and manage.
All members of the house staff are given a minimum of one day off per week averaged over four weeks.
Duty Hours
All caps and ACGME work-hour requirements are strictly enforced. A web-based program allows residents to log their hours.
Night Team
The department of internal medicine has developed a night team system. Monday through Saturday from 7:00pm to 7:00am are covered by an upper-level resident and two interns. This system is strongly supported by the house staff. No intern or resident works more than six night shifts in a row.
Intern PGY1
The PGY1 interns take call while assigned to internal medicine wards. Call is every fifth day in house, and runs from 7:00am to 7:00pm.
Residents PGY2 and PGY3
The PGY2 and PGY3 residents take call while assigned to internal medicine wards. Call is every fifth day in house, and runs from 7:00am to 7:00pm.
The PGY2 and PGY3 residents work from 7:00pm to 7:00am when they are assigned night shift.
ICU
Each ICU team has one intern and three residents. Call is divided among the team members who each take one week of ICU.
Subspecialty and Elective Rotations
Residents on subspecialty services do not take in-house call. Generally, the resident will take call with the respective subspecialist and in the morning pick up any new patients admitted overnight.