Ideally, we want you to spend most of your training on the steep part of your learning curve where you are adequately challenged and supported, however, not overwhelmed. When exercising you want the treadmill going fast enough to get a good workout, but not so fast that
you get tired too quickly or fall off! We think of your residency experience in the same way!
All of our residency classes stay together on the same discipline for the first two years of training, with clinical blocks lasting 4 weeks long. All residents start together in internal medicine and rotate together on a 4-5-4 schedule for the first two years of residency.
PGY1 and PGY2 -
Intern year - 4 blocks IM, 5 blocks Peds, 4 blocks IM
Second year - 4 blocks Peds, 5 blocks IM, 4 blocks Peds)
PGY3 and PGY4 - While a general 4-5-4 structure exists, the schedule is flexible. Residents move flexibly between IM and Peds based on their learning and curricular preferences.
Year after year our residents tell us how amazing it is to rotate together between IM and Peds those first two years. Why?
It allows each class to forge close bonds early in residency because you are always on the same side together. Early bonding = friends for life!
It makes switches easier and less stressful because you are never without your Med-Peds friends, especially with the first switch from IM to Peds.
We believe that having every class stay together during those critical first two years is a very important part of why we have such a low drop-out rate and high residency satisfaction.
During the first two years of residency we switch on a 4-5-4 block schedule. We refer to this as the “Goldie Locks” approach. Why Goldie Locks? Because 4-5 block switches are "not too long, and not too short". We have found this frequency of switching in the first two years allows for:
Development of skill, autonomy, and confidence after 4-5 blocks (hard to achieve in a combined specialty!) where you can relax a bit by the final block.
Optimal learning the first two years of residency for you stay at the steep part of your learning curve and avoid becoming bored or overwhelmed.
Seasonal variation in pediatrics – Think bronchiolitis and flu here, you want two winters of exposure, but not four.
Evening out of your conference series attendance in internal medicine and pediatrics, both of which have a series of early conferences for the incoming residents.
Providing our residents with a world-class ambulatory training experience is a major focus of our residency program. Since 2006 our internal medicine residency program has centered their ambulatory training experience around a long block model (starting in month 16 of residency) which allows for a concentrated ambulatory experience separated from the inpatient training experience. In order to align our ambulatory training experience with our internal medicine colleagues, we use an X+Y clinic block schedule while on inpatient IM rotations. In this model our residents do not have clinic half days while on IM inpatient rotations. Instead, Med-Peds residents have their clinic for these rotations combined into 2-week clinic blocks. This allows for ease of internal medicine inpatient schedules and provides our residents with a concentrated ambulatory experience while on these blocks. During these clinic blocks our residents have two to four half days of continuity clinic over a week (depending upon level of resident), other clinical experiences related to ambulatory medicine, one half-day for administrative time, and one wellness half-day over a two-week period.
Our pediatric colleagues still function on a schedule that allows them to have clinic for one half day per week while on inpatient rotations. As such, our residents continue to have clinic for one half day per week while on pediatric rotations and do not have clinic blocks during these experiences.
An example of our block schedule and how clinic block experiences are arranged can be viewed here! Med-Peds Block Schedule 23-24.
In addition to multiple clinic blocks and ambulatory experiences, there are 10.5 blocks of elective time during residency during our residency. Med-Peds residents have equitable access to all IM and Peds electives, a selection of over 100 different experiences across our academic health center. We also have individualized Med-Peds electives and designer electives that can be co-constructed with our chief resident. Our goal is to provide you with the optimal experiences to meet your learning needs.
Our residents are never supervised by categorical residents at the same PGY during residency. We are able to structure the schedule so that rotations early in the second year are senior-only rotations, Our residents are team leading like their categorical peers by the middle part of their second year. This parity is due to the front loaded design of our curriculum, which keeps you up to speed with the categorical residents.
