CLINICAL CURRICULUM

The alternating four-month trimester-based schedule assures seasonal variation in exposure to both medicine and pediatrics. At least one half of the total experience is in direct primary care, as required by the Boards of Internal Medicine and Pediatrics. “Internship” level rotations are scheduled for the first 4 trimesters of the residency, of which 12 are PGY-1 level rotations and 4 are “PG-level neutral” (elective, development and behavior, etc) rotations. With this schedule, residents are well prepared to act as supervisory residents in both medicine and pediatrics when they have completed 16 months in the program.

4-year curriculum & Sample schedule

JUL

AUG

SEP

OCT

NOV

DEC

JAN

FEB

MAR

APR

MAY

JUN

PGY-1

CCU

IM Wards

Peds Wards

Newborn Nursery

Neuro

IM Ambulatory

MICU

IM Wards

NICU

Peds Elective

Peds Wards

PICU

PGY-2

IM Elective

IM Wards

Peds Elective

Peds Wards

IM Wards

IM Elective

Adult ED

IM Elective

Peds Wards

Peds H/O

Dev'l / Behavioral Peds

NICU

PGY-3

IM Elective

MICU

IM Wards

Adult ED

Peds Elective

NICU

Peds Elective

Peds Cross Cover

IM NF3

IM Elective

CCU

IM Ambulatory

PGY-4

Peds Urgent Care

Individualized Curriculum

Adolescent

Peds Wards

IM Elective

IM Wards

Medicine Consult

Geriatrics

Peds NF

Peds Elective

Peds ED

Peds Elective

  • Rotations are generally grouped Internal Medicine and Pediatrics experiences over 4 months with 2 exceptions:
    • the initial PGY1 trimester in which PGY1s complete 2 months and shift (an adjustment requested by our residents to avoid feeling “behind” their categorical peers when a first categorical ward experience occurs);
    • the initial PGY2 trimester (again, requested by our residents so they are <2 months away from their most recent Internal Medicine or Pediatrics experience when they start their senior resident roles.)
  • Some PGY1-level experiences extend into the PGY2 year; this allows more elective and ambulatory time in the PGY1 year AND residents to complete 3 ward rotations in Internal Medicine and Pediatrics before taking on senior roles.

All residents participate in the ambulatory curriculum at the Medicine-Pediatrics Primary Care Center (MPPCC), which has several features:

  • Didactic modules through the Yale Primary Care Pediatrics Curriculum and Johns Hopkins’ Physician Education & Assessment Center (PEAC) for Internal Medicine.
  • Formal teaching sessions on ambulatory topics at Med-Peds Forum, presented by both residents and core faculty.
  • Informal teaching huddles at MPPCC held during protected time in the first half-hour of each clinic session, facilitated by both residents and core faculty. Each topic is identical for all clinic sessions during a single week so that all residents and faculty cover the same material.
  • Specialized Enhanced Primary Care Rotation (E-PCR) block for PGY2 residents with a variety of focused sessions: working in inter-professional teams (e.g. psychology, social work, and complex care coordination), motivational interviewing, parenting, behavior, and quality improvement.

Med-Peds Forum is a conference series conducted by the residency program in which literature and topics relevant to the practice of both specialties are discussed and integrated. The series is conducted in both journal club and didactic formats. Residents and faculty jointly contribute to the topic selection and content of each session. The format reflects a respect for the role of residents as faculty colleagues, and allows the content to adapt to current interests and educational needs. The series allows for weekly meetings of residents, faculty, and other interested colleagues for formal and informal interactions and learning.

The Med-Peds Forum conference series has enabled internists and pediatricians, as well as generalists and specialists to confer and collaborate in presenting educational material. The synergy that emerges within these forums has furthered their success and led to the enthusiastic participation of faculty in both departments. Responsibility for journal club forums rotates among resident/faculty pairings, each of whom selects an article pertinent to medicine, pediatrics, or Med-Peds and works with a faculty member to present the topic and critique of the article. Check out our blog posts on recent Med-Peds forum topics!

Med-Peds residents attend conferences that are conducted within each department depending upon the specialty in which they are rotating for that particular trimester, which include daily morning reports and noon conferences. Internal Medicine Grand Rounds and Pediatrics Grand Rounds are held weekly. Med-Peds specific conferences, which are conducted throughout the year, consist of:

  •     Med-Peds Clinic Conference held daily
  •     Med-Peds Forum held weekly
  •     Med-Peds Program Meeting held quarterly

Med-Peds residents also participate in the retreats and individual program curriculum committees within the Departments of Medicine and Pediatrics. Med-Peds residents are fully integrated into each of these departments and are regarded as peers with their categorical colleagues with respect to education, responsibility, program feedback, and participation.

Our residents have been an integral part in the planning and development process of all of the elements of our program and we take pride in their resulting sense of ownership and achievements.