The IM months of fourth year are a mix of inpatient (MICU and general med wards) and consult rotations.  The emphasis is on supervised autonomy in clinical decision making as well as improving formal and informal teaching skills.  Two more selective months this year offer opportunity for independent learning.  On the EM side, months in the department as a G4 consist of pit boss shifts including managing stabilization room cases.  A second month of dedicated peds training is unique to the EM/IM program.