Residency Rotation Descriptions

Residents attend weekly half day continuity clinic in a newly renovated setting. Focus is on education in broad spectrum of ambulatory care with emphasis on preventative medicine, Patient Centered Medical Home, longitudinal continuity of care, and practice based improvement.

Residents interested in primary care and community health as a career, are also offered the opportunity to have another continuity clinic at Covenant Health, a Federally Qualified Health Center, with emphasis on community health and provision of comprehensive care (medical, dental, psychiatric) to an underserved patient population. Both clinic have onsite phlebotomy and social workers to facilitate a comprehensive Patient Centered Medical Home experience.

Several Interns will be assigned to the intensive care units each month along with a supervising senior resident. Teaching rounds are held twice daily. Morning rounds are at 7 a.m. and afternoon rounds are at 3 p.m. along the team with the attending/fellow. Other teaching educational activities on the rotation vary based on fellow/attending. On weekends, interns may leave when all work is complete, this is generally around noon.

This month allows for abundant procedures, such as ultrasound guided central venous catheter insertions, arterial catheter insertions, lumbar punctures, and much more. You will also develop expertise in ventilators. The acuity of patients from the Detroit Metro area is both diverse and educational, with a large volume of patients and excellent supervision.

There is no clinic while on MICU.

All Interns will spend one month in 2-ELL which is the in-patient nephrology floor. Categorical residents also spend one month on the nephrology floor in the PGY2 year. The team will consist of a senior resident, and two or three interns. A nephrology fellow may also be assigned to the team and participates in patient care and teaching activities. The team is supervised by an academic Nephrology faculty member.

This month allow educational opportunities and exposure to knowledge in Nephrology, as well as managing dialysis and renal transplant patients.

Two interns will be assigned to the night float rotation along with one or two supervising senior residents. One intern is responsible for 5 admissions to the staff service and coverage of staff patients. The other Intern will cover admissions to either 2-ELL (Nephrology service), Academic Medicine service, or Staff service. In addition, they will provide coverage for the 2-ELL service. All admissions will be reviewed with a senior resident, or House Officer.

Night Float runs Sunday night – Thursday night with Friday and Saturday off. The hours are from 8p.m. to 7a.m., followed by sign out rounds with the admitting team and attending physician.

This month provides education and experience in ambulatory care in the office of primary care physicians in the community. It highlights the patient centered medical home concept, and insight into the business aspect of running a practice.

This is a non-call month with weekend off.

We have 3-4 preliminary medicine residents each year.Our preliminary medicine schedule was designed with the goal of producing a competent highly functional resident who will come out of the year prepared for their next year of residency.

Our preliminary medicine schedule is as follows:

• Academic Cardiology – 1 month
• Inpatient Internal Medicine floor – 4 months
• Medical ICU – 2 months
• Nephrology floor (2ELL) – 1 month
• Outpatient medicine – 1 month
• Emergency medicine – 1 month
• Night floor – 1 month
• Anesthesia / subspecialty elective – 1 month
• Vacation – A total of 3 weeks, which can be taken as individual weeks or 3 continuous weeks during non-floor/unit month such as academic cardiology, outpatient medicine, and anesthesia/elective months.

Each R1 will have four months of staff medicine, inpatient floor rotation, supervised by an R2 or R3, resident and a faculty attending. Other members of the team include Third and Fourth year medical students.

The rotation focuses on inpatient rounds highlighting diagnosis, management and treatment of a wide spectrum of patient care issues. Insight into aspects of community health, as well as focus on safe, effective transition to the outpatient setting.

All Interns will spend one week in the anesthesia department. During this time they gain experience in intubation and airway management. You will also gain experience in the use of sedatives, management of anesthetics, and common procedures. The rest of the month is reserved for requested vacation time and/or elective. The subspecialty elective is either Nephrology, Infectious Disease or Hematology/Oncology.