Our Curriculum

One Program, Many Options.

By having 16 residents per class, we are able to balance workload with flexibility to pursue career goals, and we are able to tailor each resident’s three years to help them achieve these goals. Our graduates have entered into careers in global health, primary care, multiple subspecialties, medical education, public health, hospitalist medicine, palliative medicine, and administrative medicine amongst others. With a close-knit program and many faculty mentors, residents find guidance and exposure through a number of electives, allowing them the best preparation for deciding on a future career.

The majority of our residents complete the Categorical Medicine Track which has an ideal blend of inpatient and outpatient general medicine and subspecialty rotations. Residents who desire a fellowship or are planning a career in hospital medicine typically find that this track best meets their needs and allows the most flexibility.

Up to three residents per class may voluntarily opt into the Primary Care Track (PCT) after the match. This track prepares residents well for careers in primary care internal medicine by weighting residency training more heavily in high-quality ambulatory experiences.

  • General Curriculum by Post Graduate Year  

    For the 2023-2024 academic year, our Internal Medicine program has transitioned to a 4+1 (x+y) model, which means that our residents rotate on a core rotation or elective experience for 4 weeks (x) and then transition to a week of ambulatory experience (y) which includes their continuity clinic. The beauty of the x+y model is that it helps to provide a more consistent presence of our residents for their patients in the clinic as well as ensure that residents have a consistent opportunity for wellbeing throughout the academic year. Click below to get a sense of what a typical block schedule looks like.   Learn more >>

     Ascension St. Vincent Internal Medicine 4+1 Categorical IM Curriculum

    Each four week rotation is separated by one week of ambulatory (continuity clinic and subspecialty clinics) plus a full weekend off duty. 

    PGY1

    16 weeks of Inpatient Medicine Wards
    4 weeks of Inpatient Medicine Nights
    4 weeks of Inpatient Cardiology
    4 weeks of Medical ICU Days
    4 weeks of Medical ICU Nights
    8 weeks of Internal Medicine Subspecialty Electives (e.g.pulmonary consults or endocrinology consults)
    2 weeks of Clinic Chief (acute care visits in Internal Medicine clinic)

    PGY2

    12 weeks of Inpatient Medicine Wards
    3 weeks of Inpatient Medicine Nights
    3 weeks of Inpatient Cardiology
    3 weeks of Medical ICU Days
    3 weeks of Medical ICU Nights
    6 weeks of Internal Medicine Subspecialty Electives (e.g.pulmonary consults or endocrinology consults)
    1 week of Chief Clinic (acute care visits in Internal Medicine clinic)
    6 weeks of Electives (e.g. Medical subspecialty or “other” like administrative med, POCUS, or research)

    PGY3

    9 weeks of Inpatient Medicine Wards
    3 weeks of Inpatient Medicine Nights
    3 weeks of Medical ICU Days
    3 weeks of Medical ICU Nights
    6 weeks of Internal Medicine Subspecialty Electives (e.g.pulmonary consults or endocrinology consults)
    12 weeks of Electives (e.g. Medical subspecialty or “other”like administrative med, POCUS, or research)

    Ascension St. Vincent Internal Medicine 4+1 Primary Care Track IM Curriculum 

    Each four week rotation is separated by one week of ambulatory (continuity clinic and subspecialty clinics) plus a full weekend off duty. Up to 3 residents per class can elect to participate in the Primary Care Track.

    PGY1

    16 weeks of Inpatient Medicine Wards
    4 weeks of Inpatient Medicine Nights
    4 weeks of Inpatient Cardiology
    4 weeks of Medical ICU Days
    4 weeks of Medical ICU Nights
    8 weeks of Internal Medicine Subspecialty Electives (e.g.pulmonary consults or endocrinology consults)
    2 weeks Clinic Chief (acute care visits in Internal Medicine clinic)

    PGY2

    12 weeks of Inpatient Medicine Wards
    3 weeks of Inpatient Medicine Nights
    3 weeks of Medical ICU Days
    6 weeks of Internal Medicine Subspecialty Electives (e.g.pulmonary consults or endocrinology consults)
    3 weeks Rural Medicine
    3 weeks Hospice / Palliative Care
    3 weeks Dermatology
    3 weeks of Electives (e.g. Medical subspecialty or “other” like administrative med, POCUS, or research)

    PGY3

    6 weeks of Inpatient Medicine Wards
    3 weeks of Inpatient Medicine Nights
    6 weeks of Internal Medicine Subspecialty Electives (e.g.pulmonary consults or endocrinology consults)
    3 weeks Sports Medicine
    3 weeks Psychiatry
    3 weeks Women’s Health
    3 weeks Ambulatory Cardiology
    3 weeks Advanced Ambulatory
    6 weeks of Electives (e.g. Medical subspecialty or “other” like administrative med, POCUS, or research)

    Ascension St. Vincent Internal Medicine Residency Available Electives

    Addiction Medicine Global Health**  Procedures
    Administrative Medicine  Hematology*  Psychiatry (IP/OP)
    Advanced Ambulatory  Hospice / Palliative Care* Public Health
    Advanced Heart Failure  Infectious Disease* Pulmonology*
    Advanced Pulmonology  LTACH Medicine  Research / QI
    Allergy  Medical Education Rheumatology*
    Dermatology  Mobile ACE Rural Medicine / Private Practice
    Electrophysiology  Nephrology* Sleep Medicine
    Emergency Medicine  Neurology* Sports Medicine 
    Endocrinology (IP/OP)*  Obesity Medicine TOSH
    Gastroenterology*  Oncology* Women's Health
    Geriatrics  POCUS (ultrasound) Wound Care

    * Selective (IM Specialty): Minimum of 6 during whole residency.
    ** Global Health requires approval(application)-- may join ASV annual trip to Honduras or seek another opportunity.

    Internal Medicine Required Longitudinal Curricula

    Point of Care Ultrasound (POCUS)
    LGBTQ Health
    Addiction Medicine
    Healthcare Disparities
    Residents as Teachers
    Wellbeing
    Patient Safety / Quality Improvement (PSQI)

  • Inpatient Curriculum  

    A large portion of time is spent on inpatient rotations, specifically on the “Adult Internal Medicine Service,” which we call AIMS (the general medicine inpatient service, or wards). Our hospital functions as both a primary source of care for patients in the immediate area as well as a tertiary referral center, and as a result residents are exposed to a wide breadth of unique cases and pathology, all with a high level of acuity and complexity. Interns spend time on a traditional teaching team (AIMS A through D) - which consists of one senior resident,two interns, one 4th year “sub-intern,” and two 3rd year students. Interns/Residents receive one day off per week while on Teams A-D.

    Three of our AIMS teams (AIMS F, G & H) function as one-on-one teams - with PGY2/PGY3 residents working alongside their attending in an independent manner.

    Intern/residents attend daily Clinical Reasoning Conferences (CRCs) as well as weekly Academic Half-Days, which are protected educational time for residents to focus on their learning and growth. These academic half days (which alternate between PGY1s and PGY2/3s) typically include a monthly Grand Rounds, faculty and resident-led presentations, Journal Club discussions, Morbidity & Mortality conferences as well as Simulation opportunities. Although the ACGME allows for 24hshifts for interns and residents, we currently utilize both day and night float months and do not plan to transition to a 24h call structure. During AIMS day months, resident teams are on call every fourth day. A standard non-call day is roughly 7a-4p (or later to ensure work is complete). When on call, teams remain in-house until all work from call is complete (but can leave as early as 6p, when the night team is here). The AIMS nights team provides coverage from 6pm to 7am, doing both admissions and cross coverage of patients. The night float team consists of one senior resident with two interns and a supervising nocturnist.

    Further, two months of training are spent working on the inpatient Cardiology service - one month as an intern and one as a senior resident. The teaching Cardiology service consists of a Cardiology attending, a Cardiology Fellow, one senior IM resident, two or three interns, and occasionally a 4th year sub-intern. This service provides care for patients as the primary service and also in consultation, and at all levels of acuity from observation to the cardiovascular intensive care unit. These months provide opportunities for routine and targeted Cardiology didactics including a daily “EKG Lecture” series that continues to get rave reviews from students and residents year after year.

  • Outpatient Curriculum    

    In our x+y model as noted above, residents will have continuity clinic on their Y weeks. For more information on this, please click HERE.


    The patient population at the PCC is diverse, both culturally and socioeconomically. We strive to provide a team-based approach - with pharmacy, social work, psychiatry, and financial services in-house.


    Residents in clinic may spend either a half day (8a-noon or 1p-5p) or whole day in clinic seeing continuity patients.

     

    Areas of focus in Continuity Clinic

     

    Hepatitis C Clinic

    Residents interested in providing care for patients with hepatitis C infection receive training and then provide care for these patients under the direction of two of our IM faculty. Many of our residents planning to enter primary care, infectious disease fellowship, or gastroenterology participate. 


    Opioid Use Disorder

    Comprehensive training in care of patients with substance use disorder is provided through a longitudinal curriculum, didactics, a Y week experience in PGY-2 year, an elective rotation, directed self-study, and provision of care in continuity clinic where residents can prescribe buprenorphine/naloxone for patients with opioid use disorder under the direction of our IM faculty. 

     

    Clinical Article Discussion 

    Residents assigned to continuity clinic gather once weekly to discuss an article in the literature that has been recently published relevant to ambulatory medicine or that addresses a topic applicable to care of patients in the outpatient setting. 



  • ICU Curriculum    

    Residents typically spend 2 blocks per year (4 weeks of ICU days and 4 weeks of ICU nights. Exception: Primary Care Track residents) in the Intensive Care Unit (ICU). Again, we stick to a day/night model. ICU Day residents work on a traditional teaching team consisting of an Intensivist, one senior resident, and two to three interns, with occasionally one 4th year “sub-intern.” ICU Night residents work on a team that consists of an Intensivist, a senior resident and two interns.


    Residents work exclusively in the Medical Intensive Care Unit (MICU), though have the opportunity to work in the trauma-neuro ICU or cardiovascular ICU if they elect to pursue the “Advanced Pulm” rotation elective in their senior years (especially palatable for those interested in critical care fellowship).


    Residents undergo procedure training through simulation prior to working in the ICU during orientation, and with refreshers that are offered periodically throughout the academic year. During ICU months, interns become proficient at central lines, arterial lines, and intubation with opportunities to learn other procedures including bedside ultrasound, placement of dialysis catheters and para- and thoracentesis. Our medical ICU has a high acuity with medically complex patients and diverse diagnoses and clinical scenarios - the educational opportunities are endless. We do have a pulmonary critical fellowship at our institution with two fellows per class, who help periodically supervise teaching teams in the MICU and help lead educational and procedure workshops throughout the academic year. Our residents otherwise have ample opportunity to complete procedures, run codes, and have end of life discussions with patients/families.


    Residents work on either a month of days or a month of night float. ICU day residents work from 7a-6p (or later if work is not complete) and night float residents provide coverage from 6p-7a, doing both admissions and cross coverage.


  • Focused Tracks 
    The following tracks allow our residents to enhance their skills in areas of interest. The Primary Care Track is available to three new PGY-1s and typically determined post-match. The other tracks below (Clinician Educator, Quality and Patient Safety, Women’s Health, Hospitalist, and Global Health) are available during PGY-2 and PGY-3 year.

    Primary Care Track
    The Primary Care Track is designed to equip residents with the extra skills and experiences they will need to practice as outstanding primary care physicians in the urban, suburban, or rural setting. The curriculum tilts rotational requirements toward ambulatory experiences in the PGY-2 and PGY-3 years. Mentorship is emphasized from early in residency. Ambulatory rotations are designed to optimize flexibility to allow residents to gain experience in areas of interest or in areas where growth is needed. Our Primary Care Interest Group meets outside of work and with speakers who are practicing in a variety of settings in primary care IM. Most graduates from the Primary Care Track practice primary care internal medicine, but others have become hospitalists or completed fellowships. Our program leadership actively seeks feedback from residents who have completed the track as we continually work to meet the training needs of our current residents.

    Primary Care Track Curriculum

    Clinician Educator Track (CET)

    The Clinician Educator Track (CET) is a one to two year certificate program for residents who are interested in teaching and scholarly activity. With mentorship from a faculty member, residents develop additional training and skills in communication, teaching, assessment, educational leadership, curriculum development and scholarship. Residents in the track have the option of a dedicated CET elective month to assist in completion of the track requirements. Graduates of the track have gone on to faculty appointments in Internal Medicine residency programs, and would be helpful for residents interested in academic medicine following a subspecialty fellowship as well.

    Global Health Track

    The Global Health Track (GHT) is an option for our PGY1 and PGY2 residents that carries through to their PGY3 year. This track helps to guide residents interested in developing a better understanding of global health systems, cultural impact on health, and epidemiology of diseases. It includes didactics and opportunities for scholarly work in a global health related area, as well as participation in two weeks of international service and experience. Ascension St. Vincent Graduate Medical Education hosts a multidisciplinary trip annually, sending a group of faculty and residents to Honduras to partner with a Honduran healthcare team and medical professionals from other institutions.

    Hospitalist Track

    The Hospitalist Medicine Track allows residents to develop diverse skills to efficiently and effectively provide high value compassionate patient care. Under the guidance of a core teaching faculty mentor, residents enrolled in the hospitalist track will develop skills that allow them to competently perform best clinical practices and patient care, understand the business of hospitalist medicine, and participate in the advancement of hospitalist medicine through committee and leadership opportunities.

    Patient Safety & Quality Improvement (PSQI)

    The Patient Safety & Quality Improvement (PSQI) is an evidence-based curriculum for internal medicine residents with an interest in quality and safety education, research and administration. This twenty-four month track provides additional knowledge and skills to equip its graduates with tools to become innovative leaders in Quality or Patient Safety.

    Pocus Track

    The POCUS (Point-of-care ultrasound) Track is a curriculum focused on training up physicians withan expertise in an increasingly useful modality -bedside ultrasound. The ASV IM Residency has a longitudinal curriculum to train all residents at some level in the use of POCUS. This track takes that training to the next level, ensuring competence in cardiac, pulmonary, vascular, and abdominal POCUS. It is available to PGY-2 residents, continuing into the PGY-3 year. The track includes access to modules, hands-on teaching by ultrasound-trained faculty, creation of a personal image portfolio, and participation in monthly POCUS didactics with opportunities for leadership and teaching. Training in POCUS has proven to be useful in preparing residents for multiple potential career paths, including Hospitalist, Outpatient Primary Care, Critical Care, and Cardiology, making this track a highly desired opportunity by many of our residents.

    Women’s Health Track

    The Women’s Health Track is an evidenced based, women’s health curriculum for Internal Medicine residents with an interest in diseases and health issues specifically affecting women. Residents in this curriculum will receive additional education and procedural experiences specific to women’s health. Interested residents may enroll any time prior to the start of the PGY-2 year.

    Women's Health Track Curriculum


  • Medical Spanish Program   

    Providing medical care in the patient’s native language helps foster a stronger patient-physician relationship and can also assist with patient adherence to recommended therapies and interventions. With approximately 42 million people in North America who speak Spanish, it is important to cater to the diverse linguistic needs of the various patients.

     

    The primary objective is to learn medical Spanish terminology in order to complete a medical encounter in Spanish effectively and efficiently. The self-guided terminology documents are designed to prepare for the official medical Spanish language proficiency exam administered by Ascension St. Vincent language services department. This self-directed program has been designed to allow learning of the terminology based on the participant’s baseline knowledge of Spanish language as a whole and of medical Spanish. This track is designed for those individuals who already possess an advanced conversational level of Spanish language and will not include a resource on grammar. Additional resources such as an electronic flashcard deck will be provided to participants to assist with studying. Individuals who complete this track will graduate with a certification of completion from the Internal Medicine Residency.

     

    The Medical Spanish Program consists of the following components: 

     

    • Terminology review 
    • Electronic flashcard deck review 
    • Advanced understanding of Spanish grammar
    • 50-question online exam
    • ASV Language Proficiency Exam  

    Upon successful completion of this course, individuals are considered “bilingual providers” who are proficient in the target language (Spanish).  Note that this does NOT mean that you are a “certified interpreter”.  Bilingual providers are able to complete encounters in the target language but cannot interpret for other individuals.  If you wish to become a certified interpreter, you should seek out resources at Luna or other national accrediting bodies for medical interpretation certification.