The block begins with inpatient medicine. This rotation provides the backbone and structure to the majority of later clinical learning. It provides the opportunity to present and discuss the pathophysiology, diagnosis, and therapies of various diseases and to understand the reasoning and decision-making processes behind various diagnostic and therapeutic options. At UPMC Shadyside, teams generally consist of one PGY 1 and one PGY 2. Two teams are assigned to an attending physician who is responsible for teaching rounds each month.
Long call is every sixth night.
To facilitate communication between attendings and residents, the teams are as geographically localized as possible. Weeks PGY 1 and PGY 2 residents have one half day and PGY 3's and PGY 4's two half days in their continuity office practice. In UPMC Shadyside's Shea Medical Center, residents are precepted by Internal Medicine faculty whose only responsibility for that half day is to teach. Each session starts with a one half-hour discussion of an ambulatory topic, such as approach to pharyngitis, low back pain, headache or hypertension, thereby ensuring that the ambulatory knowledge base is formally taught to all residents. Residents also have access to a number of subspecialty clinics within the Shea Medical Center, including Dermatology, Musculoskeletal Medicine, Gynecology, Cardiology, Endocrinology, and Gastroenterology.