NRMP 206616
The three-year program consists of inpatient and outpatient experiences in assigned and elective rotations designed to give residents a broad exposure to the discipline of internal medicine and to prepare them for the practice of internal medicine or further training in the subspecialties of internal medicine.
The PGY-I Year
All residents accepted as a categorical PGY-I resident in this program are expected to complete three years of training in internal medicine, leading to board certification. It is during this critical year that the interns acquire the basic attitudes and work habits which will remain with them for their careers as physicians. All residents rotate in two and four week blocks on a schedule where residents are assigned to all locations
The internal medicine resident services at three different sites provides an excellent opportunity for first-year residents to care for a large and varied patient population with an appropriate distribution of medical problems. First-year residents have major responsibility for the primary care of these patients in an academic environment. They are responsible for gathering initial data, developing diagnostic and therapeutic plans and maintaining accurate medical records. They are given the opportunity to perform procedures and function as the physician of record in a supervised environment. The residents work with third- and fourth-year medical students assigned to their service. A first-year resident functions at all times under the appropriate supervision of second- and third-year residents and faculty attending physicians, as vital members of the health care team.
Rotations for the PGY-I year consist of six to seven months of general internal medicine ward service at the James H. Quillen Veterans Affairs Medical Center, Johnson City Medical Center, and Holston Valley Medical Center.
At James H. Quillen Veterans Affairs Medical Center, Interns work six out of seven days each week with our daytime hospitalist; night shift is covered by the VA Medical Center staff only.
At Holston Valley Medical Center, interns work six out of seven days each week on a daytime rotation or on a nighttime only shift; alternating day or night assignments.
Every intern will have four blocks of continuity clinic and exposure to the Intensive Care Unit at the VA Medical Center; Several subspecialty rotations are also included.
The PGY-II and PGY-III Years
Senior residents assume more responsibility in complex patient evaluation and in the supervision of junior residents and medical students. Residents assigned to Bristol Regional Medical Center will receive experience in ICU/critical care settings.
Residents interact with faculty from all of the disciplines of medicine, serving as a consultative specialist and interacting with other services and disciplines. There is a required emergency room rotation during the second or third year. Residents are assigned to a continuity clinic team and work with their preceptor. Over a period of three years, the resident has an opportunity to develop a meaningful relationship with a single population of patients in an environment which permits continuity of care. The patient mix in the long-term general internal medicine clinics is excellent and provides experience in all aspects of ambulatory general internal medicine.
PGY-II and PGY-III residents will have one to two inpatient months at the VA Medical Center, working six out of seven days on a daytime only hospitalist rotation. Two additional months are spent at either Holston Valley Medical Center or Johnson City Medical Center. At Johnson City Medical Center, four seniors provide coverage in a Hospitalist style rotation, which includes one week off after each week of night call. At Holston Valley Medical Center, seniors rotate through both daytime and nighttime shifts in a non-traditional service.
Seniors will do one block of Critical Care Unit/Intensive Care Unit at Bristol Regional Medical Center each year, working alongside our Fellows. PGY-II and PGY-III residents will do 8 weeks of clinic each year, the remaining time will be spent in subspecialty electives.
Categorical Curriculum
Scheduled in Blocks, but months given as estimate.
Key:
JCMC - Johnson City Medical Center- VAMC - Veterans Administration Medical Center
- BRMC - Bristol Regional Medical Center
- HVMC - Holston Valley Medical Center
Post Graduate Year I
- 4-8 weeks Inpatient Service – VAMC
- 12-16 weeks Inpatient Service whih includes night float – HVMC
- 2-4 weeks Night medicine- JCMC
- 6-8 weeks of elective (subspecialty)
- 2-4 weeks of ICU and/or Psych – VAMC
- 8 weeks of Continuity Clinic
Post Graduate Year II
- 4-8 weeks Inpatient Service – VAMC
- 4-8 weeks Inpatient Service – JCMC
- 4-8 weeks Inpatient Service- HVMC
- 4 weeks ICU- BRMC or JCMC
- 12-16 weeks electives (subspecialty or general)
- 8 weeks of Continuity Clinic
Post Graduate Year III
- 4-8 weeks Inpatient Service – VAMC
- 4-8 weeks Inpatient Service – JCMC
- 4-8 weeks Inpatient Service- HVMC
- 4 weeks ICU
- 16-20 weeks electives (subspecialty or general)
- 8 weeks of Continuity Clinic
All categorical residents are assigned to a long-term continuity clinic consisting of 8 weeks per year. Over a period of three years, the resident has integrated exposure to outpatient subspecialties like Rheumatology and Endocrinology.
Residents have access to the same facilities and support staff as do the faculty in their own clinics. Daily educational sessions addressing ambulatory topics are provided in the clinics. Residents measure the care they provide to their continuity clinic patients along various preventative and chronic disease management metrics using tools acquired during quality improvement didactics. All residents will participate in an ongoing quality improvement project based at their continuity clinic assignment.