The Department of Medicine administers three accredited internal medicine residency pathways: The Primary Care Track, Seattle Categorical Track, and the Preliminary Internal Medicine Track for individuals going into other specialties but who would like a year of broad exposure to internal medicine.
- The UW School of Medicine was recently ranked first in the nation among public institutions, and second overall, for funding from the NIH.
- Primary care tracks at UW were among the first established in the nation.
- We are one of very few programs that are recognized as leaders in both primary care and subspecialty training.
- UW was ranked #1 in Primary Care by US News & World Report for 18 consecutive years, #1 in Rural Medicine, and #8 in Internal Medicine.
- Residents are highly sought after for positions in academic medicine, fellowships, and community practice.
- WWAMI rotations are unique and popular experiences that give residents opportunities to practice medicine with superb faculty/general internists in small communities in the five-state region of Washington, Wyoming, Alaska, Montana, and Idaho (i.e., Soldotna, AK; Livingston, MT; and Jackson Hole, WY).
- Senior residents may elect rotations in international health and research.
- We are expanding opportunities to perform volunteer work during residency to foster commitment to community service.
- Ambulatory blocks offer superb training in subspecialty clinics for the skills needed in primary care as well as enhancing time in GIM continuity clinics.
- While on clinic blocks, residents have extensive training in behavioral medicine, evidence-based medicine and literature search, and primary care topics in weekly conferences presented by residents and faculty.
- Many of the national leaders in medicine and general internal medicine have been trained at UW, and more UW faculty have served as national president of the Society of General Internal Medicine than faculty from any other institution.
Common to all tracks -
Emphasis in categorical track -
- Inpatient experiences in all of the primary affiliated institutions of the University of Washington.
- While the amount of inpatient and outpatient training differs between the tracks, residents in all tracks have similar experiences and work in a fully integrated manner.
- Night call is no more frequent than every fourth night.
- Research opportunities are available on an elective basis for senior residents.
- Clinic block rotations for all residents consist of a mixture of GIM experiences, subspecialty clinic experiences, and didactics related to primary care internal medicine.
- Residents are evaluated following each rotation.
- Residents meet semi-annually with faculty to discuss performance and career planning.
- Broad training in general internal medicine with greater proportion of time on subspecialty electives.
- Most residents in this track undertake subspecialty training following their residencies and may eventually enter careers in academic medicine.
Emphasis in the primary care track -
- An extensive training experience in longitudinal and comprehensive care of a defined panel of patients.
- In-depth training in psychosocial aspects of patient care.
- A broad curriculum in related specialties needed to practice general internal medicine, such as dermatology, gynecology, orthopedics, otolaryngology, and ophthalmology.
- Most residents in these tracks enter primary care practices. These residents are also competitive for postgraduate fellowship training or academic medicine careers.
The R1 Year -
- This pathway was developed to meet the regional and national need for well-trained general internists practicing primary care. The goal of the primary care track is to train the next generation of general internists to be leaders in academic primary care, health care policy, public health and community practice. Graduates of this program are well-prepared and competitive for chief residencies, postgraduate fellowships, careers in academic general internal medicine and community practice.
- Primary care residents participate together in an immersion block during each year of training. The immersion blocks provide time to explore issues related to primary care practice in depth and are described in greater detail below.
- Primary care residents attend continuity clinic at Harborview’s Adult Medicine Clinic, the University of Washington’s Roosevelt Primary Care Center, or the VA Puget Sound’s General Internal Medicine Clinic.
- Primary care track residents spend 15 of 39 rotations in the ambulatory setting. An additional 7 electives can be spent in either ambulatory or inpatient settings.
- Ambulatory rotations include the 3 immersion blocks, a rural medicine (WWAMI) rotation, and a required block rotation in musculoskeletal medicine.
- Elective ambulatory rotations include HIV medicine, women’s health, global health, homeless healthcare and addiction medicine in additional to traditional rotations in medical subspecialties and non-medical specialties related to primary care (e.g., dermatology).
The R2 Year -
- In the R1 year, primary care residents build basic skills that all internists need regardless of their ultimate career plans.
- The intern year starts with an immersion block. The focus of this block is on a single doctor working to optimize care for a single patient. The goals are to acquire the knowledge and skills necessary to independently manage common outpatient conditions, to develop personal systems of care that allow for efficient and high quality care, and to hone patient interaction skills. The mornings include didactic sessions on the management of common conditions, physical exam, practice management and patient interactions. These sessions are followed by interactive sessions including journal club, chart review and “report.” Interns spend each afternoon at their continuity clinic site building their panel.
- Interns will spend an additional 4 rotations in the ambulatory setting later in the year. These rotations include a course on evidence-based medicine and a course called Patients, Physicians and Society that explores a variety of issues related to health care delivery and policy.
- The remaining 8 rotations are spent in the ED and on inpatient services including ward medicine, ICU, cardiology, neurology and float.
The R3 Year -
- In the R2 year, primary care residents cement their inpatient and leadership skills and then turn their focus to ambulatory care training.
- Primary care R2s have 5 inpatient rotations including ward medicine, CCU, ED and float.
- The immersion block occurs in the fall. The focus of this block is on the doctor as a member of a care team working to optimize the health of a panel of patients. The goals are to continue to build medical knowledge and skills relevant to primary care practice, to understand how clinic processes impact quality of care, and to use data to analyze and improve care for a panel of patients. Morning sessions include didactic sessions, quality improvement seminar (including designing and initiating a QI project), videotape review, journal club, chart review and report. Residents spend each afternoon in their clinic or doing home visits to panel patients.
- All residents do a rotation in musculoskeletal medicine and have the option of electing a rural medicine rotation in the WWAMI region. Other elective ambulatory rotations are as noted above in the overview.
- In the R3 year, primary care residents have the opportunity to address individual needs and interests and to pursue individual goals. Accordingly more than half of the rotations this year are elective.
- Primary care R3s have 4 inpatient rotations including ward medicine, ICU, CCU and float.
- The immersion block is in mid-winter. The focus of this block is on the doctor as a part of the health care delivery system working to optimize the health of a community. Residents will perform a community health assessment and intervention and will have time to complete their QI projects. There will also be time for other scholarly pursuits including creating new didactic elements for the immersion block curriculum. Afternoons will be spent in continuity clinic, at community based clinics and in doing home visits to panel patients.
- The 7 elective rotations may include medical subspecialty and community based rotations in Seattle, an international rotation, and rural rotations in the WWAMI region.
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 -
R2 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.
R3 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.
- 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.
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.
- Eight positions are available to all applicants seeking a one-year internal medicine training experience.
- Residents in the preliminary track will spend four months on general medicine inpatient rotations, and one month of critical care medicine.
- One month is spent on emergency medicine, neurology, cardiology and medicine consultation.
- Preliminary interns also have three elective months which include medical subspecialties and some additional choices (neurology, anesthesia, radiation/oncology, etc.)
For information on the medicine residency program, please visit the websites below -
UW Internal Medicine Residency Program
Providence Internal Medicine Residency Spokane
Boise Internal Medicine Residency