General Medicine Wards and Night Float
The OUSCM Internal Medicine general medicine wards service is located at Saint Francis hospital. We are privileged to admit the vast majority of our patients to a closed unit, staffed entirely by our residency program. This allows for increased accessibility to patients, the ability to assess and intervene rapidly if needed, and form close longitudinal relationships with our nurses and support staff. At the same time, we still have the ability to admit our patients to other units within Saint Francis if necessary to meet our patients’ needs – for example, to a step-down ICU or cardiac specialty unit. Each of our two wards teams (“Boomer” and “Sooner”) consists of an attending physician, 1-2 senior residents, and 2-3 interns. We operate from 6am-6pm daily, and take admissions on a round-robin basis. Medical students and Physician Assistant students from the OU-TU School of Community Medicine are integral to the function of our teams, rotating with us year-round. Our Night Float service, consisting of one intern and one senior resident, takes overnight call on Boomer & Sooner team patients in addition to staffing overnight admissions from 6pm-6am. Residents on the wards teams participate in a Noon Conference daily on weekdays. First-year residents typically lead conferences on Mondays, attendings on Tuesdays, and senior residents on Thursdays. First-year residents spend 5-6 months on the general medicine wards as this experience is foundational to Internal Medicine training. Senior residents typically spend fewer months on wards and have more flexibility for electives.
Longitudinal Outpatient Resident Clinic
Our schedule is “4+1” (sometimes called “X+Y”) in which residents complete a 4 week rotation (“4”) and then spend one week in our clinic (“+1”). Each resident has a continuity panel of patients, helps with acute visits, and works alongside an assigned faculty member in their practice throughout residency. Each resident completes between 10 and 12 clinic weeks per academic year. The clinic week consists of ten half-day sessions of continuity clinic (with each resident’s own panel of patients), acute clinic (for more urgent appointments), transitional care clinic (for recent hospital discharges), and co-management of a designated faculty member’s patient panel. This training provides the resident with the opportunity to learn primary-care management, attitudes and skills needed to practice ambulatory medicine. The group of residents who share a clinic week is referred to as a “Firm.” Residents are divided into five Firms, and a resident will stay with their firm for the duration of their training. Firms consist of a variety of first through third year residents. The consistency of sharing a clinic week with the same group of residents for three years provides opportunities for increased camaraderie and mentorship. Each Firm also completes a yearly clinic-based Quality Improvement project together (see “Research” for more information). Each resident spends one half-day per clinic week with a designated faculty member, and will co-manage patients with the faculty. This faculty member assignment is consistent for the duration of each resident’s training; this not only allows residents to gain clinic experience outside of a resident clinic, but also facilitates a longitudinal mentorship between the paired resident and faculty member. During the clinic week, residents participate in a Clinical Noon Conference daily. This is lead by faculty and acts as a supplementary curriculum to Academic Afternoon by covering ACP’s MKSAP curriculum most relevant to the outpatient/ambulatory setting (such as preventative medicine, screening guidelines, mens’ and womens’ health topics, and outpatient management of common medical problems). Clinical Noon Conference incorporates MKSAP review, practice Internal Medicine Boards questions, simulations and procedure practice, and journal article discussion.
Evaluation
Residents are given monthly performance evaluations for each rotation. Additionally, residents are given immediate feedback on their clinical skills, history taking and physical exam skills, patient rapport and diagnostic and decision-making skills.
ICU Rotations
Residents are integrated members of the ICU team providing intensive treatment under the supervision of a Critical Care trained attending physician. In this rotation, there is focus on airway management, hemodynamics, and the assessment of multi-system function. The ICU rotation offers hands-on learning on ventilator management, sepsis treatment, intubation, and numerous other procedures. In addition to the general medical ICU, residents also have the opportunity to rotate in a Neuro ICU.
Procedures
Residents are expected to develop competency in routine internal medicine procedures including placement of central lines, LP’s, thoracentesis, paracentesis, joint injection/aspiration, and incision and drainage. You will gain experience in these procedures during rotations in ICU, inpatient wards, and electives such as emergency medicine and interventional radiology. Outpatient procedures (such as I&D, joint injection, simple skin biopsy, or cryotherapy) are commonly performed in the longitudinal outpatient clinic.
Required Subspecialties
- Cardiology
- Critical Care Medicine
- Emergency Medicine
- Geriatrics
- Hospice/Palliative
- Nephrology
- Neurology
- Oncology
- Pulmonology
List of Electives
- Allergy and Immunology
- Dermatology
- Gastroenterology
- Infectious Disease
- Neuro ICU
- Obesity Medicine
- Point of Care Ultrasound
- Research
- Sleep Medicine
- Sports Medicine
- Stroke
- Neurology
- Rheumatology
- Endocrinology
- Interventional Radiology
- Medical Informatics
