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.
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. Half of each new class of residents begins training with Department of Medicine rotations, and the other half begins with Department of Pediatrics rotations. The groups switch between departments about every four months.
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. 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.
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 four-week block rotations.
PGY – 1
PGY – 2
PGY – 3
PGY – 4
|1||Normal Newborn – Eskenazi||Elective – Nephrology||Elective – Research||ICU – University|
|2||Pediatric Hospitalist Nights – Riley||Night Float – VA||Med-Peds Career|
|3||Ambulatory – Pediatrics||General Medicine Wards – VA||NICU – Eskenazi||General Medicine Wards – Methodist|
|4||Elective – Infectious Disease||ED – Eskenazi||Community||Medicine Ambulatory Advanced|
|5||General Medicine Wards – Eskenazi||PICU||Night Float – Eskenazi||ED – Riley|
|6||Hepatology Ward – University||Adolescent Medicine||Geriatrics||Elective – Med/Peds Office Practice|
|7||Ambulatory Medicine||Gastroenterology||General Medicine Wards – VA||NICU – Methodist|
|8||ICU – Methodist||ED – Riley||Elective Dermatology||Developmental – Behavioral Peds|
|9||General Medicine Wards – VA||General Pediatric Wards – Complex Care||Hematology Ward – University||UVC – Eskenazi|
|10||Hematology/ Oncology||ICU – VA||Elective – Allergy||Pulmonary Wards – University|
|11||Hospitalists nights – Riley||Elective – Adult/Peds Endocrinology||Cardiology||Patient Safety – VA|
|12||General Wards – Pulmonary||General Medicine Wards – Eskenazi||General Peds Ward – IU Health North||General Medicine Wards – Eskenazi|
|13||NICU – Methodist||Cardiology Ward – Methodist||Elective – Neurology outpatient||Elective – Infectious Disease consults|
Internal Medicine Rotations
Residents choose five internal medicine electives. Options include Anesthesiology, Bone Marrow Transplant, Cardiology, Cardiac Treadmill Testing, Critical Care, Dermatology, Endocrinology, Gynecology, Hematology/Oncology, Hospitalist Medicine, Infectious Disease, International Health- Kenya, Office Medicine, Nephrology, Neurology, Patient Safety, Pulmonology, Radiology, Rehabilitation, Research, Rheumatology and Women’s Health.
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.
Combined ambulatory Med-Peds rotations may be scheduled on both medicine and pediatric block month. An ambulatory Med-Peds rheumatology block as well as a combined Med-Peds career exploration block are required. Additional combined Med-Peds choices include office practice, endocrinology, neurology, dermatology, gastroenterology and a community hospitalist elective.
Private practice rotations with community-based medicine-pediatric physicians are available in urban, suburban and rural settings. IU School of Medicine partners with four local Med-Peds practices that regularly assist in the training of residents in this combined program.
The Med-Peds didactic series occurs weekly. This includes one or two Med-Peds lectures, one journal club and one board review session per month. The lectures focus on a wide variety of topics, including communication skills and resident wellness.
When residents complete this training, they are competent in the ambulatory, hospital and extended care environments. Graduates 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.
By the end of residency training, an Internal Medicine/Pediatrics residency graduate is:
- An effective primary care provider, delivering comprehensive, continuous patient-centered care utilizing the Medical Home and Advanced Medical Home models
- A manager of the biomedical and psychosocial aspects of care within the framework of the patient’s socioeconomic environment
- An expert in growth, development and adaptation across the lifespan of the individual
- An advocate in disease prevention, early detection of disease, and health promotion within the community
- Competent in the management, consultation, and resource utilization of patients with undifferentiated or advanced illness and diseases of several organ systems
- Competent in the ambulatory, hospital and extended-care environments
- A skilled participant caring for patients within the larger health care system and within diverse cultural environments