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Internal Medicine - Education

Internal Medicine

Internal Medicine
Education


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Program Overview

The Department of Internal Medicine at the University of Kentucky offers four residency training tracks:

Categorical (3 years)

This track is the traditional track for most residents. Residents who complete this track are well prepared to pursue a subspecialty fellowship, work as a hospitalist or enter a general Internal Medicine practice. We have 19 categorical positions each year.

PGY-1

PGY-2

PGY-3

UK-Chandler Wards

1

2

1

UK-Samaritan Wards

1

1

VAMC Wards

1

1

1

Night Float (X-cover)

1/2 - 1

UK MICU

1

1

1

UK CCU

1

1

Hematology/BMT

1

Ambulatory Elective

4

4 4

Consult Elective

1 - 1 1/2

1/2

2 1/2

Emergency Medicine

1

Neurology

1

Morehead

1

 

Primary Care (3 years)

The Primary Care Track is geared towards those who are interested in primary care medicine. Residents in the Primary Care Track benefit from additional continuity clinic time as well as exposure to community-based primary care.  Residents participate in longitudinal quality improvement projects in the ambulatory care setting.  Didactics are focused on ambulatory care topics including communication skills, healthcare systems, billing & coding, practice management, chronic disease management, and quality improvement.  Residents in this track spend time supervising medical students in UK's student-run Salvation Army Clinic, working with vulnerable underserved populations.  There are six primary care positions in each year of this program.

PGY-1

PGY-2

PGY-3

UK-Chandler Wards

1

2

1

UK-Samaritan Wards

1

1

VAMC Wards

1

1

1

Night Float (X-cover)

1/2 - 1

UK MICU

1

1

1

UK CCU

1

Hematology/BMT

1

Ambulatory Elective

4

4 6

Consult Elective

1 - 1 1/2

1

Emergency Medicine

1

Neurology

1

Morehead

1

   

Offsite Rotation

 

1

1

 

Medicine/Pediatrics (4 years)

The Med/Peds track is a four-year program offering a unique blending of Medicine and Pediatrics. These residents alternate between Internal Medicine and Pediatrics every four months for the four years of training. By completing two years of both medicine and pediatrics, the graduates of this program are board eligible for both Internal Medicine and Pediatrics. There are six Med-Peds positions each year.

 

Preliminary Year - (1 year)

We offer a general preliminary internship for individuals who require this prior to their residency. This is suitable for persons entering fields such as radiology, dermatology, or the Armed Forces. This typically consists of four ward months, night float, ICU, subspecialty consults, electives, and vacation. There are two preliminary positions each year.

 

Educational Innovation

In an attempt to minimize conflicts between inpatient and outpatient responsibilities, and to provide a continuity clinic experience more reflective of primary care practice after training, the following Educational Innovation was submitted to the ACGME and approved in March of 2012.  The system is based on a rotation of ambulatory blocks every three months.  Residents attend their assigned continuity clinic, as well as a variety of subspecialty clinics, only during their ambulatory rotation.  This schedule maximizes opportunities for longitudinal relationships with patients in primary care and subspecialty clinics.  Additionally, while on service rotations, residents are free to focus their efforts exclusively on patient care in the inpatient setting. 

A

B

C

July

Ambulatory    
August Ambulatory  
September     Ambulatory
October Ambulatory
November   Ambulatory  
December   Ambulatory
January Ambulatory
February   Ambulatory  
March     Ambulatory
April Ambulatory    
May   Ambulatory
June     Ambulatory

 

Rotational Structure

UK- Chandler Inpatient Ward Team

The general medicine ward structure at UK-Chandler consists of three resident teams and one hospitalist teams.  The resident teams each consist of one attending, two upper-level residents, two interns and two to three 3rd year medical students.  Within each team, one upper-level resident and one intern form a dyad that works together on most days.  Teams cycle through the schedule, working a night shift every sixth night.  Our schedule was designed to maintain the physician-patient relationship and maintain the educational value of admitting and following the same patients.  Our teams have a maximum census of 14 patients to ensure an ideal balance of resident education and patient care experience.  At night, an intern working a night float block helps provide cross-coverage to admitted internal medicine patients.

 

UK- Good Samaritan Inpatient Ward Team

The general medicine ward structure has two resident teams and three hospitalist-only teams.  The UK Good Samaritan is a nice blend of community hospital and academic medical center, located just three blocks (a short walk) from the medical center. This is the perfect environment for our residents to truly function as hospitalists during residency.  We have two resident teams each consisting of an attending, two upper-level residents and two to three 3rd year medical students.  The residents work side-by-side with their attending in a more informal atmosphere and direct patient care responsibility.  Residents rotate a series of late shifts, working until 8pm, but hospitalists admit patients throughout the night.

 

VAMC Inpatient Ward Team

The general medicine ward structure consists of three resident teams and two hospitalist only teams.  Like most VA hospitals, this rotation provides a strong experience with “bread-and-butter” Internal Medicine—heart failure, COPD exacerbations, acute coronary syndromes, renal failure and the like. The ward structure has one attending, one resident, two interns, and two students on each team.   An additional upper-level resident works night shifts, supervising interns on admissions and cross-cover overnight.

 

UK-Chandler Hematology/BMT Ward Team

This team cares for patients with a wide variety of hematologic problems, including acute leukemia and high-grade lymphomas. All of our interns rotate on this team, working with a Hematology attending physician, a Heme-Onc Fellow and several nurse practitioners. Interns do not have overnight call responsibilities.

 

UK-Chandler Coronary Care Unit

Our division of cardiology is quickly becoming one of the pre-eminent cardiac care centers in the country.  The UK CCU has a single team consisting of an attending, fellow and four residents.  Residents rotate blocks of night shifts to admit and cross-cover patients overnight.  

 

UK-Chandler Medical Intensive Care Unit

The MICU is divided into two teams with an attending, fellow and three residents on each team during the first six months of the year.  During the last six months of the year, each team consists of an attending, a fellow, two upper-level residents and two interns.  A resident from each team works a block of night shifts with in-house fellow and attending supervision.  This remains one of our most-popular and highly rated rotations as it is an excellent learning experience.

 

Subspecialty Services

Every categorical resident rotates on the following core subspecialty services:

  • Cardiology
  • Endocrinology (primarily ambulatory setting)
  • Gastroenterology
  • Infectious Disease
  • Nephrology
  • Oncology
  • Pulmonology
  • Rheumatology (primarily ambulatory setting)

 

Off-Site Rotations

St. Claire Regional Medical Center: Each intern is assigned one month at the St Claire Medical Center in Morehead, KY. The interns are supervised by an excellent group of general internists who are interested in teaching. Interns do 14-16 twelve hour shifts per month and round on their patients with the supervising attending.  Morehead is located approximately one hour east of Lexington on I-64 and housing is provided.  This very popular rotation offers interns a true feel for the practice of medicine in a rural setting.

 

Continuity Clinic

Each intern is assigned a primary care continuity clinic at UK Internal Medicine. Primary care practices are staffed by faculty from the Division of General Medicine.  Residents attend a minimum of four half day sessions per week on their ambulatory blocks.  Ambulatory blocks occur every three months in order to ensure longitudinal follow-up and continuity of care with a give patient population.  Residents work with the same attending throughout all years of training to ensure great mentorship from our core faculty members. 

 

Neurology

First-year residents will spend one month on a Neurology team under the direction of attendings from the Department of Neurology.  During this month, they encounter common neurological problems often seen by Internal Medicine physicians.  The month is divided between the general neurology service and our nationally-recognized stroke service.

 

Emergency Department

Each second-year resident will complete one month of ED training in our Level 1 Trauma Center under the direction of the attendings from the Department of Emergency Medicine.  During this month, residents act as the primary physician caring for patients with gynecologic, surgical, pediatric, psychiatric and medical emergencies.  Approximately 16-20 shifts are assigned per month.