Internal Medicine Residency at SLU is premised on the idea that medicine is best learned at the bedside with active reflection and feedback to hone performance.
Residents have roughly two-thirds of their rotations at our main teaching hospital – SSM- Saint Louis University Hospital – and one-third at John Cochran Veteran’s Medical Center.
A typical day looks like this:
|Saint Louis University Hospital|
|7:00 a.m.||Hand over (sign out) of existing patients
(8th Floor Fitch Conference Room)
|Held daily at 7:00 a.m. for existing patients AND from 7:00 to 7:30 a.m. for new patients with night medicine admitting team (at SLUH); overnight teams will transfer both patient care content AND professional responsibility to receiving teams. This will involve face-to-face communication with opportunity to ask questions, and read-back of critical information and tasks that need to be done.
|7:00 a.m. – 8:00 a.m.||Existing patient care team work rounds|
|8:00 a.m. – 9:00 a.m.||Night medicine rounds|
|9:00 a.m. – 9:30 a.m.||Discharge rounds|
|9:30 a.m. – 11:00 a.m.||Teaching rounds*|
|11:00 a.m. – 11:45 a.m.||Team work rounds & discharge planning|
|12:00 p.m. – 1:00 p.m.||Medicine Noon Conference|
|Held Monday-Thursday, these seminars constitute the core didactic training experience for residents. They are designed to comprehensively cover the biologic basis of disease including the physiology, pathophysiology and molecular biology of disease. Complementary conferences that address moral, ethical, professional, societal and systematic (systems-based practice) issues are thoughtfully incorporated into this forum.|
|4:00 p.m. – 5:00 p.m.||Resident report (combined)|
|Held Monday through Thursday for students, interns and residents at SLUH from 4:00 p.m. to 5:00 p.m. (or 9:30 a.m. – 10:30 a.m. at JCVAH) these conferences provide an opportunity for learners to present and discuss, in-depth, a case from a previous clinical encounter.|
|7:00 p.m. – 7:00 a.m.||Night Medicine Coverage|
|10:00 a.m. – 10:30 a.m.||Multidisciplinary Rounds (team based rounds - Geriatrics)|
We have 5 resident teams on the medical services:
- 2 interns and 1 resident each. Each team has a “cap” of 16 patients.
- Teams rotate call where they admit all general medicine patients from 7 am to 7 pm every 5 days.
- There are two “short-call” days where teams accept no more than 4 overnight admissions from the night medicine service with direct sign out in the presence of the attending during sign out rounds.
We also have an uncovered service staffed by academic hospitalists.
There are also sub-specialty rotations on hematology/oncology, cardiology, liver, GI, nephrology.
John Cochran Veteran’s Administration Hospital
|7:30 a.m. – 9:30 a.m.||Teaching Attending Rounds (except Friday)|
|9:30 a.m. – 10:30 a.m.||Resident Morning Report|
|12:00 p.m. – 1:00 p.m.||Medicine Noon Conference|
Held bi-weekly, 2-3 articles from peer-reviewed medical journals are appraised. Journal Club evaluates hypothesis testing and statistical modeling while emphasizing the application of evidence-based medicine.
Rotating Thursday Conference
On Thursdays, a rotating schedule of conferences focused on patient safety, quality improvement, and medical decision-making are held. These conferences are held in lieu of noon conference and are scheduled to coincide with senior resident 4-week blocks:
- Morbidity and Mortality
- Resident UNderstanding of Decision Making Conference (RUN-DMC or “Stump the Chump”)
- RightCare rounds alternating with Schwarz rounds
- Housestaff meeting
Internal Medicine Grand Rounds form the cornerstone of the Department's educational programs. Held every Friday at 7:30 a.m. (or 12 p.m. at JCVAH on Wednesdays) these conferences highlight important advances in basic and clinical sciences as well as state of the art reviews of core medicine topics.
The first year of residency – internship – is full of diverse patient care experiences with a smattering of electives.
- Rotations are month-long.
- Continuity clinic for interns is one afternoon a week (cancelled for MICU).
- Preliminary positions have the same schedule format.
- Holiday schedule – dedicated 5 days off (in addition to vacation) during either Thanksgiving, Christmas, or New Years.
Our preliminary positions have the same schedule format. Intern rotations are month-long
|Rotation||Number of months|
Categorical 2nd and 3rd years:
The latter 2 years of categorical residency are broken into an innovative 4 week bloock schedule – alternating “inpatient” months with “non-inpatient (mostly ambulatory)” months. In 2 years of residency, there are a total of 26 four-week blocks, thus a resident has 13 inpatient and 13 non-inpatient blocks.
Continuity clinic as an upper level is during the “non-inpatient block” – consisting of 2 half-day sessions per week, for a total of 8 sessions in 4 weeks. There is no clinic during inpatient blocks, allowing you to focus on conducting inpatient care without having to rush to clinic in an afternoon.
This schedule is tailored to provide you flexibility in tailoring a curriculum centered on your career interests, while providing breaks between busy inpatient rotations and outpatient rotations where you have weekends off, consistently.
The rough breakdown of the schedule over those two years is a follows:Inpatient:
|Rotation||Expected number of rotations as senior||Minimum total of 3 years of residency||Maximum allowed over 3 years of residency|
|General Floors (VA and SLUH)||3||2||5|