The inpatient general internal medicine service is staffed by five ward teams. Each team includes one supervising resident (PGY-2 or PGY-3), two first-year residents (PGY-1) and two medical students from Texas A&M Health Science Center College of Medicine. Code calls in the hospital are covered by the ward teams on a rotating basis. The teams admit every fifth day with overnight support provided by a dedicated night float team. The interns typically get at least four weekend days off during a block, while the resident is off during weekdays.
Each PGY-1 resident is responsible for the care of up to 10 patients. PGY-1 residents perform initial evaluations, design treatment plans, write all orders and act as each patient’s principal physician during their hospital stay. PGY-1 residents, under supervision of PGY-2 or PGY-3 residents and an attending physician, perform invasive procedures as needed. A dedicated procedure hospitalist is always available for resident supervision.
A teaching attending physician is assigned to each general medicine inpatient service and rounds with the team. New admissions are presented, differential diagnoses and treatment discussed and pertinent physical findings demonstrated.
Cardiology Wards Rotation
The Cardiology Wards (CW) rotation provides our residents with broad exposure to acute and chronic cardiac diseases and cutting edge interventional procedures. The CW team includes a dedicated cardiology teaching attending, one cardiology fellow, one upper level resident and two PGY-1 residents. Daily conferences cover a range of cardiology topics. CW patients are about 80 – 85% telemetry patients and 10-15% Cardiology ICU patients.
Medicine Intensive care Unit (MICU) rotation provides our residents with outstanding critical care training by dedicated intensivists. The team includes one pulmonary and critical care fellow, one upper level resident and two PGY1 interns. The team is responsible for care of up to 16 patients with each PGY1 seeing between 4-6 patients. Multidisciplinary rounds are performed daily on all MICU patients. There is a dedicated MICU conference curriculum.
Emergency Medicine Rotation
During the emergency medicine rotation, PGY-2 residents have an opportunity to work in a level 1 ER. They evaluate, treat and triage patients across a variety of disciplines, including general internal medicine, trauma, and obstetrics/gynecology. Board-certified emergency room physicians supervise and train the residents.
Rotating at the Dallas Veterans Affairs (VA) Medical Center allows our residents to experience medical training in a unique health care system caring for our Veterans. Residents are assigned to a 4 week inpatient internal medicine rotation and have an opportunity to rotate for subspecialty electives as well.
Each categorical resident is assigned to the Baylor outpatient clinic for a half a day each week. Categorical residents follow the same group of patients through three years of training to establish continuity of care and observe the evolution of patients and disease processes over time. Residents are supervised by general internists who are always present in the clinic; however, the residents continue to serve as the primary health care providers for their dedicated group of patients. Patients may be referred to Baylor’s Internal Medicine subspecialty clinics or other specialty clinics such as surgery or gynecology for specific problems. In addition, PGY1 residents spend two weeks in a large primary care internal medicine practice. PGY-2 and PGY-3 residents spend one rotation each working with ambulatory patients at this large internal medicine practice with physicians on the medical staff at Baylor Scott & White.
The outpatient pathway allows a resident interested in primary care to spend half a day a week as an upper level in a large primary care clinic under the guidance of a dedicated experienced clinic mentor. Additionally, core IM subspecialty rotations are modified to be primarily outpatient rather than hospital based.
Residents interested in a career in hospital medicine work one-on-one with a senior hospitalist faculty caring for complex medical inpatients, participating in multidisciplinary rounds and learning about hospital administration and operations.