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Department of Medicine

Department of Medicine

   Internal Medicine Residency Program

Rotations and Clinics


 

General Medicine Floors

Residents rotate through the general medicine floors at two different sites: UPMC Montefiore and the VA Medical Center. Both sites run a purely hospitalist-based system. Therefore, each housestaff team has only one faculty attending, who serves as the attending of record for the team's patients as well as the team's teaching attending. Each attending is a member of the Division of General Internal Medicine, one of the largest and most respected divisions in the country. The general medicine attendings are some of our best educators, with national reputations in medical education. Having a general internist as the hospitalist attending and role model increases the efficiency of patient care and ensures that the Department of Medicine's core values for patient care are consistently implemented. Residents learn to care for patients with medical problems spanning the fields of endocrinology, gastroenterology, pulmonology, rheumatology, nephrology, cardiology, hematology, oncology, and infectious diseases. The floors not only provide a great clinical educational experience but also provide housestaff with opportunities for procedures including paracentesis, lumbar puncture, central line placement, venous blood draw, and arterial blood gas measurements. During ICU and inpatient medicine floor months, interns and residents do not have continuity clinic.

SHY General Medicine

Team Structure: There are 3 teams, two team consisting of one resident and two interns and one consisting of 2 residents. There is a night float system in place for cross cover and admissions overnight.

Admission Structure: Each resident-intern team may carry up to 18 patients while the two resident team covers up to 16 patients. Each team will see up to 5 new patients at day, including new admissions overnight.

Supervision: There is one general medicine attending, and the residents on general medicine floors have considerable autonomy and are responsible for leading rounds.

Teaching: Morning report for residents with weekly intern report, noon conference didactics, and afternoon attending-led teaching rounds.

UPMC Montefiore General Medicine

Team Structure: There are seven teams, each team consisting of one resident and two interns. There is a night float system in place for cross cover and admissions overnight.

Admission Structure: Each team covers a geographic area that includes 13 consecutive beds on a specific hospital ward. The overall census cap for the team is 13 – if a patient is discharged and a bed becomes available, the team will admit to fill that specific bed, therefore the overall patient census for each team stays at 13 patients, or 6-7 patient's per intern.

Supervision: There is one general medicine attending, and the residents on general medicine floors have considerable autonomy and are responsible for leading rounds. Rounds in the morning are multi-disciplinary (with the patient's nurse and case managers), and are always conducted at the patient's bedside.

Teaching: Morning report for residents with weekly intern report, noon conference didactics, and afternoon attending-led teaching rounds.

VA General Medicine

Team Structure: There are 4 teams, each team consisting of one resident and two interns. There is a night float system in place for cross cover and admissions overnight.

Admission Structure:
 The 4-day admitting cycle consists of a non-admitting day, long call day, non-admitting day, and short call day. The team admits 7 new patients on long call days and 4 new patients on short call days. Total intern census cap is 10 patients, though typically the census for each intern is around 5-7 patients.

Supervision:
 There is one general medicine attending, and the residents on general medicine floors have considerable autonomy and are responsible for leading rounds.

Teaching: Morning report for residents with weekly intern report, noon conference didactics, and afternoon attending-led teaching rounds.

Junior Hospitalist Medicine

Team Structure: There are 4-6 residents on this rotation at a time, each covering their own service of 8 patients. There is a night float system in place for cross cover and admissions overnight.

Admission Structure:
Each resident is responsible for an 8-bed geographic area of a medical ward. When a patient is discharged and the bed becomes available, the resident admits the next patient that fills that bed. The total resident census cap is 8 patients; on average, a resident takes care of 7-8 patients a day.

Supervision:
There is one general medicine attending with whom the resident consults regarding patients. Residents on this rotation have considerable autonomy.

Teaching: Morning report for residents with weekly intern report, noon conference didactics, and afternoon attending didactic sessions.