The remaining seven to eight months are spent on subspecialty rotations and other elective experiences, none of which require on-call responsibilities. The third-year resident serves three to four months on ward medicine and is on call every fourth night during this time. The remaining eight to nine months are experiences in internal medicine subspecialties or other electives and require no on-call responsibilities. Interns carry six to 10 patients with two to five admissions per call. Residents carry 12-25 patients with four to 10 admissions per call.
Externs carry three to five patients with one to two admissions per call.
There is a short-call system where teams not on call admit one to two patients per day. No team admits patients post-call. The goal of ambulatory-based training is for each resident to learn the expanse of diagnostic, therapeutic and preventive care required for internal medicine practice in the outpatient setting. Each resident sees four to eight patients at each session. The resident is the primary care physician for this group of outpatients.