Emergency Medicine/Internal Medicine Residency: Rotation Schedule and Descriptions

Immersion in Each Discipline Maximizes Learning, Relationships

                     
    PGY-1   PGY-2   PGY-3   PGY-4   PGY-5
  EM/IM Resident #1 | Key: Emergency Medicine (light blue), Internal Medicine (dark blue)
1   Orientation   G2 Orthopedics   Resuscitation   EM   EM
2   EM   Tox/EMS/Spec    Neurosurgery   EM   EM
3   OB/Gyn   EM   Neurosurgery   EM   Selective
4   EM   Surgery   Pulmonary consults   Pediatrics   Selective
5   MICU   Endocrine   Red   Selective   MICU Nightfloat
6   Geriatric Med   Green   Nephrology consults   Green   Med consults
7   Green   Rheumatology   EM   Heme/Onc consults   EM
8   Surgery    EM   EM   EM   EM
9   Pediatrics   EM   EM   Selective   EM
10   EM   EM   MICU Nightfloat   EM   Green
11   Blue    MICU   ID consults   Cardiology    Methodist
12   Behavioral Med   Selective   Selective   GI consults   Blue 
13   Red   Blue   Neurology   MICU   Ambulatory
                     
   
  EM/IM Resident #2 | Key: Emergency Medicine (light blue), Internal Medicine (dark blue)
1   Orientation   Green   Pulmonary consults   Heme/Onc consults   Med consults
2   MICU   Rheumatology   Red   Green   Blue 
3   Geriatric Med   MICU   Selective   Ambulatory   Methodist
4   Red   Selective   Neurosurgery   Neurology   EM
5   Pediatrics   Tox/EMS/Spec   Neurosurgery   Pediatrics   EM
6   OB/Gyn   Surgery   EM   EM   Selective
7   EM   EM   Nephrology consults   Selective   Selective
8   Green   Blue   MICU Nightfloat   Cardiology    MICU Nightfloat
9   Behavioral Med   Endocrine   GI consults   Selective   Green
10   Blue    ID consults   Resuscitation   MICU   EM
11   EM   EM   EM   EM   EM
12   Surgery    EM   EM   EM   EM
13   EM   G2 Orthopedics   EM   EM   EM
 

View Emergency Medicine Rotation Descriptions

About Our Rotations

HCMC residents rotate through thirteen four-week blocks each year. Our two EM/IM residents alternate between Emergency and Internal Medicine rotations every 3-4 months.

Continuity Clinic
EM/IM residents see their own primary care patients on Thursday afternoons in the HCMC Internal Medicine Clinic. Having all residents assigned to the same clinic fosters camaraderie and permits focused teaching with the unique perspective of the combined EM/IM discipline.

PGY-1

Orientation comprises the first month of combined training and includes a mix of EM shifts, ambulatory IM experience and Continuity Clinic. This structure enables PGY-1 residents to familiarize themselves with both departments and get to know senior residents and faculty in both programs.

A more relaxed orientation schedule in both departments facilitates attendance at IM’s morning report, noon conferences, the EM stabilization conference on Thursdays, and allows residents to meet colleagues in both disciplines.

During the rest of the PGY-1 year, EM/IM residents join their colleagues as interns on inpatient medicine service, including General Medicine, Cardiology, Renal, MICU, and off-service EM rotations, including Pediatrics, Trauma Surgery, and OB/GYN.

PGY-1 residents serve as primary medical providers in the Emergency Department, supervised by PGY-3 residents and faculty.

PGY-2

The PGY-2 year offers additional responsibility in both programs.

EM/IM Hallway Staff Computer Photo

In IM, combined residents serve as senior residents and manage inpatient teams, including supervising interns and medical students. There is no "resi-tern" or PGY-1.5 in our program; EM/IM combined residents progress in responsibility along with their categorical peers.

In EM, PGY-2 residents gain added responsibility for solo overnight shifts in the Emergency Department, with the opportunity to master ultrasound techniques and perform critical procedures in the stabilization room. EM/IM residents spend off-service PGY-2 rotations as senior residents, managing the Trauma Surgery team, and in experience with Toxicology, EMS (including ambulance and helicopter ride-alongs), and specialty clinics for oral surgery, dermatology, colorectal, and radiology.

PGY-3

During this challenging year, EM/IM residents transition to their new role as Emergency Department "pit boss." PGY-3 residents first complete two months of Neurosurgery training, focused on managing patients with critical head injuries in the SICU. Faculty also train PGY-3 residents in small group didactics for the acute management of critical illnesses, such as airway adjuncts, thoracotomy, and toxicology.

IM rotations include several subspecialty consult services such as Nephrology, Pulmonary, ID, and GI. The program includes six Selective months where residents can explore specialties in depth, undertake a clinical research project, explore our Pathways programs in Global Health or Primary Care, or improve procedural proficiency.

PGY-4

Busy ER Station Photo

IM rotations cover a mix of inpatient (MICU and general medical wards) and consults. These programs focus on supervised autonomy in clinical decision-making, as well as improving formal and informal teaching skills. Two additional selectives provide the opportunity for independent learning.

EM curriculum features continued leadership experience in the Emergency Department, including managing stabilization room cases. EM/IM residents gain a second month of dedicated Pediatrics training, which is unique to the combined program.

PGY-5

During the PGY-5 year, both EM/IM residents serve as chief residents for the combined program. Responsibilities include developing the final schedule, assisting in program administration, assisting with recruiting, and coordinating EM/IM conferences and didactics.

Clinical responsibilities include 5-6 months as EM "pit bosses," and a fifth month in the MICU on night float. PGY-5 residents may also work as hospitalists or intensivists at Methodist Hospital, a private, community hospital located just minutes from downtown in St. Louis Park. The PGY-5 year includes two selectives, scheduled back-to-back to facilitate an experience abroad or extended time for an academic project.