The ACGME requires all internal medicine residency programs to have a longitudinal continuity experience. To meet this requirement, the expectation has traditionally been that while on inpatient and outpatient rotations, residents attend one—or in some instances two or three— half-day continuity sessions each week. This requirement frequently leads to fragmentation and distraction as residents are unable to focus on ambulatory training. Additionally, scheduling the continuity session on the same day of the week for consistency can be challenging with resultant poor continuity of care for patients in the outpatient setting.
Our program has successfully transitioned from a traditional 12-month model to a “6+2” block model. In our model, following 6 weeks of a combination of a core rotation with elective or vacation, there is a 2-week ambulatory block followed again by another 6-week combination of core rotations and electives. During these 6 weeks, while the rotations may vary, residents will not attend clinic. With this, residents will be able to focus on management of patients and attend all hospital-based didactic activities. In addition, there will be no hand-offs as none of the inpatient team members are required to leave for clinic.
Rotations and Curriculum
The core curriculum required for all residents includes the following rotations:
Weaved throughout the above rotations is also specialty training in the following areas:
- Patient Safety
- Quality Improvement
- Research and Evidence-Based Medicine
- Community Medicine
- Point of Care Ultrasound (POCUS)
- Transitions of Care
There is also opportunity to participate in Electives in all subspecialty areas with the option to participate in “away” or off-site electives in the PGY2 and PGY3 years.