THE ROC: Each upper level resident is required to do a total of 2 blocks of the ROC rotation, scheduled once during each of the HO2 and HO3 years. Each rotation will consist of 2-3 HO2's and 2-3 HO3's. The rotation will be structured as follows:
Blocks HO3's HO3 Calls HO2's HO2 Calls 9 2 HO3, PM ED 2 SSOC, HO2 PM ED 3 2 HO3, PM ED 3 GMCO, SSOC, HO2 PM ED 1 3 HO3, PM ED, GMOC 2 SSOC, HO2 PM ED
The days and hours of operation of the ROC team are as follows:
Sunday
–
HO3 and HO2-ED
–
GMOC and SSOC
–
GMOC & SSOC expected to come into the hospital
promptly while on Sunday pager call from
Monday through Thursday
–
HO3, GMOC, SSOC,
HO2-ED
Monday through
Friday
–
PM ED
Each ROC team
will select a ROC Team Leader in the
month prior to their rotation who will establish the schedule, with ACM
facilitation, according to the guidelines above for their respective block
Friday and
Saturday night calls will be distributed as follows:
GMOC divided
amongst the 4 upper levels on the four Gen Med services.
SSOC divided
amongst the 4 upper levels on H/O A, Leuks, Renal, and Cards A.
HO3 divided
amongst HO3's on their elective blocks.
Fridays - HO3,
GMOC, SSOC, HO2-ED in house call from 6pm – 8am.
Saturdays - HO3,
GMOC, SSOC, HO2-ED in house call from 8am to 8am.
For the 9 blocks
when the weeknight GMOC is not covered by the ROC team, the GMOC will be
staffed by HO2's on elective blocks.
Reminders:
-
ROC team members
are expected AND required to attend INOC-ROC
Report from 7:00-7:30am and morning report from 7:30-8:00am. They are free to
stay until the end of morning report but can leave after power learning is
complete.
-
No continuity
clinic during the ROC block. However, you are required to check Logician daily
AND go to clinic Friday mornings to complete clinic paperwork.
-
No vacations are
permitted during the ROC block.
-
No ward blocks are
required after the ROC block.
CCU:
-
Blocks 1-2: 4
upper levels on q4 call
-
Blocks 3-13: 3
upper levels on q3 call.
-
Subspecialty ACM
to coordinate & schedule resident days off on q3 call months.
-
An optional 4th
ICU rotation in the CCU can be selected in Blocks 1&2. This rotation would
count as an “Other” ward rotation.
MICU:
-
The MICU will
have 3 IM upper levels every block except
blocks 6, 7, and 13 when it will be staffed with 4 IM upper levels.
-
An HO3 from
the ED acts as a 4th upper level in the MICU during all other blocks.
- Continuity clinics will be cancelled when their MICU team is post call and/or more than 2 people (either 2 residents or 1 intern/1 resident) have the same continuity clinic day to avoid decimating the ICU.
ED/UIMA:
-
The daytime HO3
ED (7:00am-6:00pm) and UIMA are a combined rotation available to HO3’s only
with 2 weeks dedicated to each experience.
-
No vacations are
allowed on this rotation.
FMH:
-
The FMH rotation
consists of 2 upper levels who rotate on one week blocks on the IPOF service to
obtain a community based Hospitalist experience.
-
FMH fulfills a
Gen Med or “Other” ward requirement.
-
Continuity
clinics are required and attendance is expected at required morning report,
grand rounds and noon conferences during your “off” week at FMH.
-
Contact the ACM
responsible for FMC rotation in order to set up orientation and coordinate
schedule.
-
No vacations are
allowed on this rotation.
HOB:
-
There is one
upper level on Hem/Onc B.
CARDS A:
-
The Cardiology A
service has one upper level and three interns.
-
This rotation is
no longer a requirement, but can count as an "Other" ward
requirement.
AIM:
-
Two - three
residents cover IM consult service from 7:00AM – 6:00PM.
-
Each resident is
expected to be present for the entire day as the AIM team is primary back-up to
the Daytime ED and PM ED from 7:00AM – 6:00PM and is expected to be readily
available to help if needed. .
-
On days when
Daytime ED resident has clinic, one resident covers the ED, the other resident
covers the IM consult service.
-
On days when an
AIM resident has clinic, the other resident is expected to cover the AIM
service.
-
One AIM team
member must round daily (weekdays and weekends), schedule to be determined by the
AIM team.
-
Vacations ONLY allowed
on this rotation if three residents are present.
CATEGORICAL REQUIREMENTS
Total Upper Level Ward Experience: 9 blocks*
-
3* Intensive Care blocks (1-CCU, 1-MICU,
1-either)
-
1 Hem/Onc (H/O A, H/O B, or Leuks)
-
1 ACE Unit
-
2 Gen Med Wards (either 2 Gen Meds or 1 Gen
Med + FMH)
-
2 Other (FMH, Gen Med, Renal, Cards, H/OA,
H/OB, Leuks, or CCU Blocks 1&2 [see CCU above] )
Other
Required Upper Level Rotations: 7-9 blocks
-
1 Academic Internal Medicine (AIM)
-
1
HOIII-ED/UIMA (HO 3 only)
-
1-2
Ambulatory Rotations: DHP (HO3 only); MACC-OPD
(HO2/3); UIMA (HO2/3)
-
*NOTE –
all
upper levels must do at least one Ambulatory Rotation (DHP/MACC-OPD/UIMA)
during either your HO2 or HO3 year.
-
If you choose to take vacation on UIMA,
it does not count towards your ambulatory requirement.
Subspecialty
Exposure:
- Categorical residents will complete a consultative rotation at WFUBMC in all SIX of the following subspecialties that are not adequately represented on the inpatient services:
Endo / GI / ID / Pulm / Rheum / Renal
-
These
rotations provide both outpatient and inpatient consultation experiences.
-
Hem/Onc
and Cards outpatient are considered elective rotations for categorical
residents.
Required
for Primary Care
-
Residents participating in the 2-block
ambulatory block may apply to receive credit for a consult block in a
subspecialty (usually Endo, Rheum or Allergy). This decision will be made
on a case by case basis after consultation with the Associate Program Director
for Subspecialty Medicine and the relevant subspecialty consult block
director. Residents should inquire about this in advance.
Elective
Blocks: 6-8 blocks
-
Review
our homepage to see the curricular outlines of core competencies that we expect
of our graduating residents so that you can make an informed decision about
where to best invest your elective time.
-
NOTE:
You MUST submit
your elective rotation request AT LEAST
EIGHT WEEKS prior to the start date of your rotation. You may pick up these request forms from
Betsy.
-
We
are able to accommodate TEN two
contiguous month Ambulatory Blocks for self-styled immersion in ambulatory
skills.
All
blocks are available except blocks 7 due to holiday scheduling.
Block
1 is unavailable for rising HO3’s.
-
Examples
o
Subspecialty
(e.g. Hem/Onc, Geriatrics, Palliative Care) Electives
o
Non-Internal
Medicine Specialties (e.g. Derm, Ophtho, ENT, Sports Medicine)
o
Research
Electives
o
Clinical
and Basic Research:
Tinsley
Harrison Research Experience. (two contiguous blocks)
A written research proposal with the
name of your research mentor must be submitted to the program director SIX
WEEKS PRIOR to the start date of your research rotation.
o
EBM
and Medical Systems/ Systems Improvement.
PRIMARY CARE REQUIREMENTS:
-
8
ward blocks (2-Gen Med, 1-MICU, 1-CCU, 1-ACE, 3-other)
-
One-block
Ambulatory Hem/Onc
*
Separate
requirement
-
One-block
Ambulatory Cardiology
*
Separate
requirement
-
One-block
ED/UIMA rotation
-
One-block
AIM rotation
-
One-block
Community-based Primary Care General Medicine
*
May
be elective for categorical residents
-
Two-Block
Ambulatory Immersion Block
*
May
be elective for categorical residents
-
At least 3 of 6
Subspecialty Consultative Blocks (one of which must be Renal):
*
Endo / GI / ID / Pulm / Rheum / Renal.
-
DHP
walk in clinic for ambulatory requirement during HO3 year
*
OPD/UIMA
will not fill this requirement
VACATIONS / LEAVE OF ABSENCE/ INTERVIEWS:
-
The
ABIM requires that residents must complete at least 33 blocks of training to
sit for the certifying examination. If
more than 3 blocks are missed during the 3 year residency, the ABIM requires
that residency be extended accordingly. Obviously,
careful and deliberate planning is needed to anticipate any planned absences
during your residency training.
Vacation
We
allow 3 weeks vacation during HO1 year (2 separate weeks and 6 days at Holiday
Season), and 4 weeks (3 separate weeks and 6 days at Holiday Season) in both
HO2 and HO3 years.
Vacation
may only be scheduled during consult or elective rotations.
No vacations allowed during block 7 due
to holiday scheduling.
Vacation
Request Forms must be completed and approved
AT LEAST EIGHT WEEKS before the start of the rotation in
which vacation is desired.
Vacation
is taken 1 week at a time.
o The exception is that residents on the Two-Block Ambulatory Block can take a 2-week vacation.
o Requests for alternative vacation plans will be considered on a case-by-case basis. These requests must be submitted to the Program Director AT LEAST EIGHT WEEKS in advance.
In order to minimize educational disruption during consultative rotations, residents are strongly encouraged to take vacation either at the beginning or end of rotations, and these vacations should be coordinated with your peer so both residents are not absent during the same week.
To get credit for successful completion of a rotation, a resident must be present for a MINIMUM OF TEN DAYS. This includes time missed for clinic, vacation, interviews, etc. If less than ten days present on a rotation, the rotation may need to be repeated.
Interviews
The residency program acknowledges the
necessity and importance of fellowship and job interviews and allows house
staff UP TO FIVE DAYS
for this purpose over the course of the 3 years.
Requests for additional time will
be dealt with on a case-by-case basis. The additional
time may be taken from remaining vacation
days.
House staff must
make arrangements for clinic, ward and jeopardy
coverage as far in advance as possible and these arrangements
must be conveyed in writing to the ACMs and Christine Brandon to ensure
that no conflicts occur with clinical duties.
Failure to give prior notification of
fellowship and/or job interviews will result in loss of vacation days.
Leave of Absence
If
you or your spouse is expecting a baby please plan your schedule accordingly
and inform the Program Director of
your plans.
Residents
may be granted up to 6 weeks of paid
leave. For time off longer than 6
weeks, the additional weeks will be unpaid.
The
6 week leave includes 4 weeks of sick leave and 2 weeks of vacation.
If
you foresee needing any family leave after your schedule has been completed
then
YOU
are responsible for finding coverage while you are away or trading blocks with
fellow residents.
In
addition, you must submit the appropriate forms for family leave/absence (forms
in Betsy’s office).
Jeopardy will NOT be used to
cover planned absences such as family leave unless emergencies arise.
LOGISTICS
OF PICKING SCHEDULES:
Those interested in choosing a Two-block
Ambulatory Block must decide these blocks before any other rotations are
chosen and must include two consecutive
blocks. Residents must contact
Meredith Welch or Dave Townsend prior to 4/4/08
to schedule their Ambulatory Block.
Fixed continuity clinic days are
predetermined by forwarding your current clinic day by 3 business days. (Monday clinics become Thursday, Thursdays
become Tuesdays, etc.) Therefore, you
will no longer be picking your clinic day and this protocol will be followed
annually to ensure residents have different clinic days throughout their
training.
Residents selected for the Tinsley
Harrison Research Experience (Two contiguous research blocks) must contact
Meredith Welch or Dave Townsend prior to 4/4/08
to schedule their Research Block.
“Draft numbers” are chosen and picking
progresses sequentially through the list.
Tentative
Rising HO3's Order of Picking:
HO3 ROC block
July wards
ICU’s (no more than 2 people can have the same continuity clinic day)
Wards & ACE Unit (must have separate clinic days unless 3 residents ACE)
ED-UIMA/DHP Walk-In
Consults/Electives
VII. All other rotations are opened for selection when the above are ALL filled.
NOTE: All of the
following blocks must be filled by HO3's for the entire year
*
All
July wards, HO3 ED/UIMA, DHP, HO3 ROC blocks.
NOTE:
The rising HO3s who are on the ROC in June are NOT required to rotate
onto an inpatient service on Block 1.
Tentative
Rising HO2's Order of Picking
HO2 ROC blocks
ICU's (no more than 2 people can have the same continuity clinic day)
Wards
Consults
Electives (open for selection once all consult blocks filled)
-
ROC
and CCU/MICU can not be scheduled back-to-back because you can not be away from
clinic for >four consecutive weeks.
Since becoming the best internist you
can be necessitates diverse experiences, aim to choose the broadest educational
schedule; try to avoid >2 consecutive blocks on inpatient wards. Back to back unit blocks are not
recommended. If you have upcoming family
obligation(s), such as pregnancy or your Uncle Larry’s wedding, make this a
priority around which you choose your other blocks.
It is
each resident’s OWN RESPONSIBILITY
to ensure they meet the requirements for graduation from this residency. If
rising HO3’s do not properly choose their schedule to fit within these
scheduling boundaries, their schedules will be subsequently altered to meet these
educational parameters, or their residency will be extended and they may be
ineligible to begin a subspecialty fellowship, start a job and/or sit for the
ABIM.
IF APPLYING FOR FELLOWSHIP
in the upcoming year,
please plan accordingly and reserve
Blocks 8-10 for electives, if at all possible, in order to minimize the
strain of having to find alternate coverage when on interviews.
It may also be necessary to trade jeopardy weeks for other
times in the year if jeopardy falls during interview season.