Internal Medicine Categorical Program

Our Internal Medicine programs provide residents with a strong foundation to succeed as an internist or a subspecialist. Our Learner-Manager-Teacher Model is the foundation upon which our curricula are built.

Our programs provide robust general medicine and subspecialty learning experiences that focus on the knowledge, skills and attitudes that are essential to a general internist. All residents receive additional training in leadership, research, teamwork and collaboration, teaching skills, quality improvement and simulation.

Our Internal Medicine 3-year categorical residency program provides a challenging, intellectual environment with a flexible curriculum and broad experience necessary for residents to acquire the knowledge, skills, and attitudes essential to excel in the practice of internal medicine and its subspecialties.

> How to apply to the Internal Medicine Residency's categorical program.

Rotation Schedule

As you gain competence in our Learner-Manager-Teacher Model, you will progress from a high degree of supervision to an increasing amount of autonomy.

PG1: Learner Year

Internal Medicine Residency Categorical Curriculum PG1

PG2: Manager Year

Internal Medicine Residency Categorical Curriculum PG2

PG3: Teacher Year

Internal Medicine Residency Categorical Curriculum PG3

Day in the Life of a PG1 Resident at the Outpatient Clinic

7:25 am	I arrive at High Street Health Center with my cup of coffee that I picked up from Starbucks down the road, and park in the employee parking (not the patients parking!)
7:30	I attend ambulatory morning report where one of the senior residents is presenting the (SPRINT) trial. My ambulatory chief resident and a faculty member are there to facilitate the discussion.
8:00	I head to my team pod to meet my precepting attending, team nurse, and MA and start my morning clinic session.
noon	My morning session is over, I sit at my desk to finish my notes. I check my inbox messages and see that a patient is asking for his amlodipine to be refilled. I quickly confirm his dose in the system and send refills for him.
12:15 pm	Back to the conference room for lunch and a lecture by a 3rd year resident about osteoporosis. (Yesterday we had a lecture by one of the pharmacists and the day before our chief resident had us do medical jeopardy, which is always fun.)
1:00	Everyone is back to their pod, however I head to the subspecialty pod as I have a GI session with one of our gastroenterologists. My first patient is Spanish-speaking. I don’t speak much Spanish, but I don’t panic—I go to the interpreters pod to ask one of the certified medical interpreters to join me.
4:00	I’m done seeing patients and back at my desk to finish my notes and check my inbox messages one more time. Once I’m done I head to the gym for a quick workout.
6:30	I meet my friends for dinner and we plan a trip to Boston for the upcoming weekend.
8:30	Back home, I review my patients for tomorrow’s session. I quickly read about migraine treatment as I’m seeing a patient tomorrow for follow up after she was started on topiramate.
9:00	I watch the latest episode of Game of Thrones before someone spoils it for me the next day at work.
10:00	Bed time

Day in the Life of PG1, PG2, PG3 Residents on Inpatient Wards

Baystate Medical Center is a large tertiary care center with 716 beds. For better work flow and to promote interdisciplinary teamwork as well as learning, our inpatient medical ward rotations are based on geographical rounding. Medical admissions to all of our medical teams are also based on geography to help ensure continuity of patient care.

PGY1: Learner Year

Patient Caps

First 6 months: 6 patients
Second 6 months: 7 patients
Admissions: We operate on a drip system. Our intern team receives 1 admission a day. Me and my co-intern will swap admission days. The admission can come to my floor between the hours of 12:00 - 3:30pm.

6:30 am	Arrive for sign out from night float team, pre-round, and see patients.
8:30	Bedside rounds begin. Rounding teams consist of one attending, one PGY3 (teacher), and 2 PGY1s (learners). I present my patients at beside to my PGY3 (teacher). My co-intern helps me with pulling up labs as well as other diagnostics on the computer while I'm presenting. She also helps place my orders during rounds as well.
10:30	Complete patient notes, follow ups, and place consults. PGY3s (teachers) assist me with this and are present to help me with any questions that I have.
1:00 pm	Simulation lab: Patient simulations with an interactive mannequin. Cases are 30 minutes with a 30 minute debriefing and teaching session afterwards.
2:00	Finish up day’s tasks. Complete ad hocs, which are sign out sheets for night float team.
4:00	Sign out to night float team with IPASS system.

PGY2: Manager Year

Patient Caps

First 6 months: 7 patients
Second 6 months: 8 patients
Weekends: I cover my co-manager's patients with a cap of 12-14 depending time of the year (Attending covers 2 patients)
Admissions: We operate on a drip system. I receive one admission a day between the hours of 11:00 - 3:30pm

7:00 am	Receive sign out from night float team.
7:30	Attend morning report and present at morning report.
8:00	It's Wednesday, so we have Grand Rounds.
9:00	Round on patients independently, tableside rounds with precepting attending, place consults and orders, complete notes.
noon	Lunch with Dr. Bryson. These lunches are designed to debrief difficult cases as well as to introduce patient-doctor concepts such as care goal discussions. Dr. Bryson also incorporates medical jeopardy at the end of each manager block during which special lunch is provided.
1:00 pm	Finish day’s work and sign out to night float with IPASS. Night float is available for sign out at 4pm.

PGY3: Teacher Year

I am the acting “attending” for my interns. I have a supervising attending for backup. I also direct my interns' teaching and running bedside rounds.

Patient Caps

Dependent on intern caps
Weekends: I cover my interns' patients for a total of 12-14 depending time of the year
Admission: I help my interns with their admissions, and help to make the decision of which intern will receive the admission.

7:00 am	Receive sign out from night float team.
7:30	Attend morning report and present at morning report.
8:30	Start bedside rounds with interns and attendings.
noon	Thursday Teacher Lunch Meetings with Dr. Shaaban.
1:00 pm	Teachers run intern simulation lab. I help to direct the simulation case and debrief the interns afterwards with the assistance of the IM chiefs.
2:00	Help my interns with the remaining day’s work and observe sign out.