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The objective of the Categorical Track is to provide
a broad experience in the comprehensive field of
internal medicine. Residents develop skills both in
primary patient care and consultative medicine. The
multiple hospitals and clinics provide diversity in
patient populations and practice settings, contributing
to the breadth of experiences for the Categorical Track
residents. Graduates from this track will be prepared to
practice general internal medicine or enter subspecialty
fellowship training.
Responsibilities and Schedule:
R-1 Residents (PGY-1)
The goal of the initial year of training is to acclimate
the R-1 resident to internal medicine in a way that
allows for the assumption of progressive responsibility
for patient care under appropriate guidance and
supervision. Thus, the R-1 resident is the physician
with primary responsibility for the patient's care. Most
of the first year is spent on inpatient services,
including both general medicine and subspecialty wards.
In addition, each Categorical Track R-1 resident has a
month of emergency medicine and a month of ambulatory
medicine. Although patient census is highly variable,
each intern typically cares for 5 to 9 patients at any
give time. Admissions are always evaluated in close
association with the supervising R-2 or R-3 resident,
though writing orders and initiating therapy remain the
R-1 residents' prerogatives. Each service has a single
attending physician who is a full-time faculty member.
Attending physicians are always available to advise and
assist. In addition, all medical and surgical
subspecialty consultants are immediately available 24
hours a day. R-1 residents are generally not required to
draw blood or start peripheral I.V.'s since these tasks
are routinely performed by laboratory technicians and
nursing staff. R-1 residents participate actively in the
teaching of medical students rotating on their ward
services.
R-2 Residents (PGY-2)
The second year of training is aimed at expanding the
breadth of the resident's knowledge base while providing
an in-depth exposure to state-of-the-art practice of the
various medical subspecialties. The PGY-2 year is almost
evenly split between in-patient ward rotations and
consultation services, mostly in the subspecialties.
Other rotations include neurology/nutrition, VA Hospital
Admissions Area (emergency department and walk-in
clinic), and an elective month. On subspecialty
in-patient services, the R-2 resident serves as the team
leader and further develops supervisory and teaching
skills while working with R-1 residents and medical
students. On consultation services, the R-2 resident
initially evaluates patients and then presents the
findings and recommendations to the consult attending
physician for review and discussion. Consultation
services also include participation in subspecialty
clinics, conferences, and other activities of the
divisions. Didactic and bedside instruction is provided
in the special skills and techniques inherent to the
various subspecialties.
R-3 Residents (PGY-3)
As in the PGY-2 year, time is evenly divided between
ward and consultation services. While the consult
rotations are similar to the PGY-2 year, the majority of
ward months for the R-3 residents are spent on the
general medicine inpatient services of the VA Medical
Center, Cooper Green and University Hospitals. The
intention is to match the most senior and experienced
residents with the rotations that require more
responsibility for patient care, supervising and
teaching. Working closely with the attending physician,
the R-3 resident coordinates work rounds and teaching
rounds for the team.
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