Part of this training is accomplished by attending a continuity of care general internal medicine clinic, held one afternoon each week for three years with the same attending physicians. A sequence of on-call months on the medical ward teams, MICU and CCU is combined with electives in the various medical subspecialties. During the second and third years, residents assume increased responsibility in diagnosing and managing patients, both on the wards and in the intensive care setting. Senior residents also enhance their skills at teaching and supervising first-year residents and medical students, and learn to become efficient and experiences consultants in the inpatient and ambulatory settings. A first-encounter emergency medicine experience also is provided for upper level residents.
More time also is available to pursue elective training.
All residents are expected to be available for their continuity clinic patients by pagers unless on vacation. In the intensive care units, prior on-call teams stabilize their patients and record their progress notes on the day following call. They may then sign out with their attending's concurrence. Ward teams, consisting of a supervisory resident, two first-year residents and a medical student take call together every fourth night and admit patients to their internal medicine service from 12 p.m. until 7 a.m. the next morning.