Residency

Internal Medicine Residency Tracks

Primary Care Track

(10 positions)

Overview

  • This pathway was developed to meet the regional and national need for well-trained general internists practicing primary care. Graduates of this program are well-prepared and competitive for postgraduate fellowships, chief residencies, careers in academic general internal medicine, and community practice.
  • Trainees in the Primary Care Track have all their long-term continuity clinics at one of the following sites: Harborview, the University of Washington's Roosevelt Primary Care Center, or the VA Puget Sound.
  • Residents provide care to their own panel of patients for the three years of the residency program.
  • Residents attend regularly scheduled attending rounds, interdisciplinary conferences, and didactic sessions organized by senior residents.
  • During outpatient block rotations, residents are expected to conduct literature reviews and prepare topics for presentation, as well as attend weekly conferences including Behavioral Medicine, Evidence-Based Medicine, and a core lecture series.

The R1 Year

  • Eight rotations are spent on general medicine and medical subspecialty inpatient rotations, including the intensive care unit, and one month is spent in emergency medicine.
  • For four months, trainees manage both acute and chronically ill patients in an ambulatory care setting in their continuity clinic as well as in a variety of medicine and subspecialty clinics. These outpatient rotations are under the supervision of physicians with a special interest in primary care.
  • Residents attend a general medicine clinic one afternoon each week.

The R2 Year

  • Five months are devoted to inpatient rotations including three months of ward medicine and two months of cardiovascular care/CCU. While on inpatient rotations, residents attend their primary care clinic one afternoon a week.
  • One month is spent in the Harborview emergency department.
  • Four months are spent in ambulatory block rotations with extensive GIM and subspecialty clinic experience.
    • During the two-month elective clinic period, R2s can choose to train in orthopedics, gynecology, women's health care, ophthalmology, refugee medicine, and dermatology, as well as in medical subspecialties, which include cardiology, infectious diseases, rheumatology, neurology, respiratory disease, gastroenterology, and diabetes/endocrinology. They may also work with selected community physicians in their general medicine practices.
  • Residents spend one month on an intensive ambulatory musculoskeletal rotation.

R3 Year

  • Residents spend three months on inpatient medicine rotations (general medicine, oncology, cardiology, ICU).
  • Residents spend four months in the ambulatory care rotations.
    • In ambulatory care rotations, residents can choose to pursue special interests, such as general medicine inpatient consulting and in-depth outpatient subspecialty training in fields like urology, sports medicine, and those listed above.
    • Residents can also undertake projects in the areas of ambulatory medicine and quality assurance.
  • The seven months of elective rotations may include medical subspecialty and community-based rotations in Seattle and rural medicine rotations in the WWAMI region.
    • Electives may include infectious diseases, gastroenterology, nephrology, hepatology, endocrinology, rheumatology, medical genetics, dermatology, pulmonary medicine, general medicine consults, rural medicine, ambulatory medicine, gerontology, emergency medicine, neurology, hematology/oncology, cardiology, women's health, adolescent medicine, pediatric emergency medicine, occupational medicine, or a research project.
  • Residents continue to follow their outpatient panel throughout the year by attending general medicine clinic one afternoon each week.

Seattle/Boise Categorical Track

(10 positions)

Overview

The Seattle/Boise Categorical Track is similar to the Seattle Categorical Track, except that the R2 year is spent in Boise, Idaho. During the R2 year, the program is based at the Veterans Affairs Medical Center, Boise, a major teaching hospital of the University of Washington.

R1 Year

  • The R1 year is the same as for the Seattle Categorical Track.

R2 Year

  • Residents spend their second year at the Boise Veterans Affairs Medical Center in Boise, Idaho.
  • Boise R2s spend six months on general medicine.
    • Morning activities consist of inpatient work rounds, morning report to the Chief of Medicine, and educational conferences.
    • Two half-days are spent in clinic, where residents develop their own outpatient practice.
    • Night call is approximately every fifth night.
  • The remainder of the year is divided into two months of electives, one month of community medicine, one month of clinic block, and one month of critical care medicine.
    • Elective rotations available include: infectious diseases, dermatology, gastroenterology, endocrinology, hematology, oncology, rheumatology, pulmonary diseases, hypertension, nephrology, cardiology, geriatric medicine, neurology, psychiatry, orthopedics, anesthesiology, radiology, and radiation oncology.
    • Primary care seminars during clinic block and geriatric medicine provide a comprehensive curriculum which includes directed readings, case discussions, role playing, and problem-solving activities.
    • During electives, residents continue to attend their own medicine continuity clinics. There is no night call during these rotations.
  • Residents work with interns from two University of Washington-sponsored training programs based in Boise. Other trainees with whom residents interact include the R4 chief resident(s) and post-doctoral research fellows in pulmonary/critical care medicine. Residents also supervise University of Washington third- and fourth-year medical students assigned to Boise.

R3 year

  • Residents return to Seattle for their R3 year.
  • R3s spend four months on inpatient medicine rotations (general medicine, oncology, cardiology, ICU), one month in the Harborview emergency department, and the remainder of the year on elective rotations.
  • Electives may include medical subspecialty and community-based rotations in Seattle and rural medicine rotations in the WWAMI region.
    • Electives may include infectious diseases, gastroenterology, nephrology, hepatology, endocrinology, rheumatology, medical genetics, dermatology, pulmonary medicine, general medicine consults, rural medicine, ambulatory medicine, gerontology, emergency medicine, neurology, hematology/oncology, cardiology, women's health, adolescent medicine, pediatric emergency medicine, occupational medicine, or a research project.
  • R3s attend a general medicine clinic one-half day a week throughout the year, with the opportunity to assume care once again of many of the patients they followed as R1s in the clinic.

Seattle Categorical Track

(28 positions)

Overview

The Seattle Categorical Track provides broad training in general internal medicine and medical subspecialties in both the inpatient and outpatient settings. Most residents in this program pursue academic careers in general internal medicine or medical subspecialties. Residents may choose research electives in their R2 and R3 years.

R1 Year

  • Heavy emphasis is placed on the care of patients with complex medical illnesses. The entire year is spent in direct care of patients under the guidance of internal medicine R2s, R3s, and attending physicians.
  • Three months are spent on general medicine inpatient rotations.
  • Two months are spent on ambulatory medicine.
  • Two months are spent on critical care medicine.
  • One month is spent on each of the following rotations: cardiovascular medicine, medical oncology, a neurology inpatient service, a gerontology service, and the emergency room.
  • R1s attend a weekly general internal medicine continuity clinic.

R2 Year

  • Three months are spent on inpatient medicine rotations that include caring for patients on general medicine wards, and two months are spent on coronary and intensive care units.
  • R2s have a two-month full-time ambulatory medicine rotation with experiences in general medicine as well as specialties that are primarily outpatient-based, such as rheumatology, dermatology, and endocrinology.
    • Residents may choose to have this rotation either in Seattle at their continuity site or at teaching sites in central Washington, Wyoming, Montana, or Alaska which have been developed as part of the WWAMI program.
  • One month is spent in the emergency room and three months on elective rotations.
    • Electives may include infectious diseases, gastroenterology, nephrology, endocrinology, rheumatology, medical genetics, dermatology, pulmonary medicine, general medicine consults, rural medicine at a WWAMI site, ambulatory medicine, gerontology, emergency medicine, neurology, hematology/oncology, cardiology, women's health, adolescent medicine, pediatric emergency medicine, occupational medicine, or a research project.
  • All residents attend a weekly general medicine continuity clinic.

R3 year

  • Residents spend about two-thirds of the year on consultative subspecialty rotations.
    • Subspecialties available include infectious diseases, gastroenterology, nephrology, hepatology, endocrinology, rheumatology, medical genetics, dermatology, pulmonary medicine, general medicine consults, rural medicine at a WWAMI site, ambulatory medicine, gerontology, emergency medicine, neurology, hematology/oncology, cardiology, women's health, adolescent medicine, pediatric emergency medicine, occupational medicine, or a research project.
  • Residents may also elect to spend one or two months doing research, choose general medicine consultation or rural medicine electives or a two-month full-time ambulatory medicine rotation to include additional outpatient subspecialties (in Seattle or at WWAMI sites) to those undertaken in the R2 year.
  • R3s spend four months on inpatient services (general medicine, oncology, cardiology) and in the ICU/CCU.
  • R3s attend a weekly general medicine continuity clinic.

Preliminary Internal Medicine Track

(6 positions)

Overview

The preliminary track provides a year of broad clinical experience for individuals who wish exposure to internal medicine before entering a residency training program in another discipline.

  • Six positions are available to all applicants seeking a one-year internal medicine training experience.
  • Residents in the preliminary track will spend five to six months on general medicine inpatient rotations, one month of critical care medicine, and one month of inpatient hematology/oncology.
  • One month is spent on both emergency medicine and neurology.
  • Preliminary interns also have two elective months which include medical subspecialties and some additional choices (neurology, anesthesia, radiation/oncology, etc.)

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