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Overview
The Wright State University Internal Medicine clinical curriculum offers a combination of inpatient and ambulatory experiences to gain exposure to general medicine and subspecialty care. Residents assume increasing responsibility as they progress from fully supervised interns to independently practicing clinicians on graduation. Rotations are arranged in 13 four-week blocks. As part of the curriculum, residents are expected to participate in elective rotations covering core Internal medicine subspecialties (Cardiology, Endocrinology, Gastroenterology, Hematology and Oncology, Infectious Diseases, Nephrology, Pulmonary and Critical Care, and Rheumatology). Throughout our program, residents learn to incorporate the tenants or Patient Safety and Quality Improvement which are discussed in formal conferences, case reviews, individual assignments and clinical projects.
The initial year of training focuses on acute care and hospital management of patients. Rotations during this year are predominantly hospital-based and include ward, night float and ICU blocks. While residents in the first year do not have continuity clinic as part of our novel curriculum, a 6-week Ambulatory elective allows exposure and introduction of outpatient medical management. An ambulatory didactic curriculum supports the educational program throughout the year ensuring ambulatory medical knowledge is made available to residents in every year of residency.
During the second year, residents focus on gaining proficiency managing ambulatory medical problems. As much as 50% of the year is spent in clinic to ensure residents gain adequate exposure on how to manage medical problems in the outpatient setting. When R2s are inpatient, they will assume a senior resident supervisory role on the inpatient teams.
In the final year of training, residents prepare to become independent inpatient and outpatient providers. The rotations are designed to represent the traditional mix of diseases seen by internists in both ambulatory and hospital settings. Upon completion of the final year, residents are expected to be ready to independently manage patients across the spectrum of clinical settings in Internal Medicine.
Typical Resident Schedule
R1
- 16 weeks inpatient medicine
- 4-8 weeks night float
- 8 weeks ICU
- 6 weeks ambulatory
- 4 weeks neurology
- 4 weeks cardiology
- 4-6 weeks subspecialty elective
R2
- 6-8 weeks inpatient medicine
- 4 weeks night float
- 4 weeks ICU
- 12-18 weeks ambulatory
- 8-14 weeks subspecialty elective
- 2 weeks research (optional)
- 4 weeks EM
- 4 weeks geriatrics/palliative care
R3
- 6 weeks inpatient medicine
- 4-6 weeks night float
- 4 weeks ICU
- 12-18 weeks ambulatory
- 12-16 weeks subspecialty elective
- 2 weeks research (optional)
Each resident has 3 weeks of vacation per year and additional sick leave
Ambulatory Education
Ambulatory education is the focus of the second year of residency. R1s have a six-week ambulatory block with a didactic ambulatory curriculum. Residents in the second and third year have assigned patients in their continuity clinic throughout the year. Our main ambulatory practice site is the Five Rivers Health Center, a Federally Qualified Health Center (FQHC) and level 3 accredited patient center medical home. Our residents and patients benefit from a high level of support and multidisciplinary care including onsite nurses, clinical pharmacist, clinical nutritionist, clinical psychologist and psychiatrist, social workers and a dispensing pharmacy.