Program Overview

Conferences

To promote housestaff education, a number of required conferences are scheduled during the work week. These include Noon Conferences, our Thursday Academic 1/2 Day for all residents, as well as Morbidity and Mortality conference and Grand Rounds held weekly at each hospital. Residents on the inpatient service also participate in bedside attending rounds. Each institution is staffed using a teacher/hospitalist attending model, whereby each team is managed by one attending.

Call Schedule

While in training, call schedules vary by institution. At BUMC-T long call is every fourth day on the General Medicine Wards. While on ICU or CCU, overnight call is every fourth night with a senior resident in-house and dedicated to assisting interns assigned to call. At SAVAHCS overnight call is every fourth day. At TMC long call is every fourth day. Night float system is implemented in all three hospitals. Interns and residents are assigned several weeks in the course of the year where they may be called in for "back-up" call in the event that a colleague suffers an illness or other personal or family emergency.

Ambulatory Experience

Our ambulatory training provides the opportunity for residents to establish long-term therapeutic relationships with their patients. Categorical residents participate in continuity clinics throughout all 3 years of their residency. Clinic sites include the main University Campus, South Campus, VA hospital, and private practice. We restructured our program during the 2014-2015 academic year to optimize the outpatient experience. In our 4+1 system, residents participate in various rotations for 4 weeks followed by 1 entire week of clinic. Residents only see clinic patients during their clinic weeks. There are no scheduled continuity clinics during wards, ICU, or elective rotations. During their clinic weeks, each resident will have 5 clinic half-days. The individualized 5 half-days for each resident follow the same schedule for every clinic week. During the half-days a resident is not scheduled to see patients, they have the opportunity to complete patient care tasks, work on quality improvement projects, or participate in an extra subspecialty clinic half-day. Residents may establish an extra subspecialty clinic half-day with a mentor and participate in this extra subspecialty during every continuity clinic week. All clinics are supervised by Attending physicians who offer their guidance and assist with patient management. For additional learning, we use the John Hopkins clinic curriculum, which allows residents to work through question-based didactic modules pertinent to outpatient medicine. During their second year, residents also participate in an additional one month of community-based outpatient medicine where they work one-on-one with an experienced private practice internist. In this setting, residents not only gain further experience in outpatient medicine, but also gain exposure to practical issues of billing, coding, and clinic management.

Electives

Elective experiences are designed to allow residents to customize their training in accordance with their career plans. Elective options are varied and flexible ranging from Internal Medicine subspecialties to Radiology, Pathology, Orthopedics and Palliative Care. Unique memories are available with the Indian Health Services Cardiology and Rheumatology trips which visit multiple sites on the Navajo and Hopi Nations. In addition, many residents elect to pursue research opportunities.

Research

During any year, residents may elect to do formal research projects with a faculty mentor, ranging from bench to clinical research. Many residents have published abstracts and papers as well as received grant support. All of our residents compete in the ACP Clinical Vignette Competition for the State of Arizona and are encouraged to submit clinical and research abstracts for this meeting.


End Result

In all three years of training an emphasis is placed on the team approach to patient care. At each level, residents are encouraged to learn and teach the important aspects of clinical evaluation and the pathophysiology of disease processes. With each year of additional training, greater responsibility for patient care and teaching of other team members is given. The third year resident will experience critical care, medical consultation, community based private practice, ward medicine, electives and continuity clinic. By the completion of the third year, residents are expected to be competent and independent in inpatient and outpatient medicine.

Career Success

Our residents have been fortunate to enter the fellowships and practices of their choice. Recent graduates have entered fellowships at our own institution as well as the Banner Good Samaritan, Cleveland Clinic, Yale, Stanford University, Brown University, Harvard University, Rush-Presbyterian, University of North Carolina, University of Alabama, University of Cincinnati, University of Virginia, University of Wisconsin, UT Houston, UT San Antonio, Loma Linda University, Johns Hopkins, UC-San Diego, Mayo Clinic, Tufts University, Duke, Tulane, Wake Forest, Washington University, UCLA and USC.