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Internal Medicine/Pediatrics Residency Curriculum

Residents in the Internal Medicine/Pediatrics program follow a curriculum designed to meet the combined guidelines established by the American Boards of Internal Medicine and Pediatrics. The program trains physicians to be effective primary care providers, delivering comprehensive, continuous patient-centered care utilizing the Medical Home and Advanced Medical Home models. Graduating residents have the training to perform as a manager of the biomedical and psychosocial aspects of care within the framework of the patient’s socioeconomic environment and is an expert in growth, development and adaptation across the lifespan of the individual.

Internal Medicine/Pediatrics residents learn to be an advocate in disease prevention, early detection of disease, and health promotion within the community, and they become competent in the management, consultation and resource utilization of patients with undifferentiated or advanced illness and diseases of several organ systems. When residents complete this training, they are competent in the ambulatory, hospital and extended care environments. This program trains physicians to be a skilled participant within diverse cultural environments.

Program Progression

Residents in the combined program spend 13 blocks as PGY1s, each block lasting four weeks. During this time, residents are introduced to rotations on inpatient services at Riley Hospital for Children, IU Health University Hospital, IU Health Methodist Hospital, Eskenazi Hospital and Roudebush VA Medical Center. Inpatient training is interspersed with ambulatory and elective assignments to provide a solid, well-rounded foundation in clinical decision-making.

During the second-, third- and fourth-year of the program, residents continue to switch between departments every four months, allowing for exposure to illnesses with seasonal variation in both adult and pediatric patients. Residents also gain increased supervisory responsibilities during this time, growing as both a clinician and teacher and preparing for a variety of future career options. Elective choices are tailored to individual career needs. Residents can attend conference series in both the internal medicine and pediatrics departments as well as a weekly series specific to these two areas of medicine that includes a lecture, journal club and two board review sessions.

Continuity Clinic

Continuity clinics are located in several community health centers, which are easy drives from the Indianapolis campus hospitals. Internal Medicine/Pediatrics residents provide clinical care in a health center for one half-day per week, where they follow their own patient panel of both children and adults. They are encouraged to participate in the telephone management and inpatient care of their patients. Faculty supervision is also longitudinal and provided by internal medicine/pediatrics-trained faculty who precept in the resident continuity clinics.

Senior Project

Each Internal Medicine/Pediatrics resident must present one grand rounds-style conference in the third or fourth year of residency, utilizing skills in literature review, case presentation and/or research. In addition, residents make presentations during the ambulatory, geriatrics and community pediatrics rotations and for at least one Medicine-Pediatrics Journal Club.

Sample Call and Overnight Schedule

Call for first-year residents occurs as a short call until 9 pm every four to six days, with the structure of the short call varying depending on the hospital and the service. For senior residents, night call varies from every fourth to sixth night. First-year residents are scheduled for two blocks of night float—one each on the medicine and pediatric services—to gain experience in typical overnight call activities. Senior residents may also be scheduled for night float blocks. Residents have a minimum of four days off during inpatient service blocks. There are a number of ambulatory blocks that are call free. The program strictly adheres to current residency training guidelines.

Sample Rotation Schedule

Each program year contains 13 4-week block rotations.

PGY1PGY2PGY3PGY4
1Normal Newborn – WishardElective – NephrologyElective – ResearchICU – University
2Pediatric Hospitalist Wards – RileyNight Float – VAED – Methodist – Combined Adlt/PedRheumatology – Comb. Adult/Peds
3Night Float – RileyGeneral Medicine Wards – VANICU – WishardGeneral Medicine Wards – Methodist
4Ambulatory PediatricsED – WishardCommunity/AdvocacyMedicine Ambulat’y Advanced
5General Medicine Wards – WishardPICUNight Float – WishardGeneral Peds Ward – Wishard
6Hepatology Ward – UniversityAdolescent MedicineGeriatricsElective – Med/Peds Office Practice
7Ambulatory MedicineGastroenterologyGeneral Medicine Wards – VANICU – Combo
8ICU – MethodistED – RileyElective DermatologyDevelopmental – Behavioral Peds
9General Medicine Wards – VAGeneral Pediatric Wards – Complex CareHematology Ward – UniversityED – Wishard
10Hematology/OncologyICU – VAElective – AllergyPulmonary Wards – University
11Elective – Infectious DiseasesElective – Combined Adult/Ped. Endo.CardiologyPatient Safety – VA
12General Wards – PulmonaryGeneral Medicine Wards – WishardGeneral Peds Ward – IU Health NorthGeneral Medicine Ward – Wishard
13NICU – MethodistCardiology Ward – MethodistElective – Neurology outpatientElective – Infectious Disease consults

Internal Medicine Rotations

Internal Medicine rotations include 20 months of direct patient care where the resident serves as the primary decision-maker. Two-thirds of residents’ time is spent providing inpatient care across four hospitals totaling 750 beds, with the other one-third of time devoted to outpatient care. Resident teams gain extensive experience providing both specialized and primary care at the adult hospitals on the Indianapolis campus, each having a distinct patient population and providing a broad educational base. Training includes three months of intensive care units and time in two very busy emergency departments where residents treat a variety of urgent and emergent conditions and determine patients’ need for hospitalization. Ambulatory blocks offer opportunities in areas such as gynecology, neurology, sports medicine, occupational medicine and the range of internal medicine subspecialties. A one-month rotation in geriatrics addresses care for the elderly at home and in long-term care facilities. Residents choose five electives from a variety of offerings.

Pediatrics Rotations

Residents deliver pediatric primary care across three hospitals on the Indianapolis campus and provide specialized care at Riley Hospital for Children that includes training in critical care, emergency care and all other pediatric subspecialties. Residents develop skills in the evaluation and management of well-child care in addition to common pediatric problems such as respiratory illness, infectious diseases, behavioral concerns and minor trauma. Pediatric residents attend high-risk deliveries and provide care to newborns across all hospital nurseries. Almost half of pediatric training occurs in the ambulatory setting, with residents attending to patients in the hospitals as well as a network of urban, suburban and rural sites.

Each resident may choose four pediatric electives. Options include adolescent medicine, allergy/ immunology, anesthesiology, behavioral pediatrics, cardiology, child advocacy, dermatology, developmental pediatrics, endocrinology/ diabetology, gastroenterology, genetics, hematology/ oncology, infectious diseases, metabolism, nephrology, neurology, ophthalmology, orthopaedics, otolaryngology, psychiatry, pulmonology, radiology, rehabilitation research, rheumatology, sports medicine, surgery and toxicology.