Curriculum

From start to finish, our program’s curriculum is designed to optimize clinical experience, autonomy, and resident-faculty mentorship at every step of the way.

PGY-1 

During the first year, residents obtain exposure to core subspecialties, critical care medicine, and general internal medicine. Residents are supervised by senior residents, fellows and faculty, yet retain primary responsibility for patients. Within this first year, we empower residents to develop proficiency in treating a wide spectrum of common medical problems encountered in the inpatient setting. Rotations within the first year typically include:

• General Inpatient Medicine
• Ambulatory Medicine
• Continuity Clinic
• Cardiology
• Critical Care Medicine
• Electives
• Emergency Medicine
• Gastroenterology
• Infectious Diseases
• Nephrology
• Night Float

PGY-2

As a second-year resident, responsibilities shift toward providing experience in consultative medicine. Second- and third-year residents take on supervisory roles, working with both first-year residents and medical students. Second year residents obtain additional elective time to explore specialties of interest while continuing to develop their clinical reasoning in general internal medicine.

PGY-3

As a third year resident, the focus is on refining skills of clinical knowledge, junior mentorship, leadership, and preparing for the next stage of one’s career — whether that be entering a career upon residency graduation or carrying on to fellowship.

PGY-4

Senior residents gain additional experience in the intensive care units. In addition to maintaining their ambulatory continuity clinics, second and third year residents also rotate in:

• Electives
• Endocrinology
• Geriatrics
• Hematology/Oncology
• Neurology
• Palliative Medicine
• Pulmonary
• Rheumatology

Categorial Internal Medicine Rotations

Explore the rotation schedule for internal medicine residents as they move through all three years of the program.

Residency rotation schedule

4+1 Block Schedule

Our resident curriculum is designed as a 4+1 ambulatory block schedule. By adopting this model, our residents have separate blocks of inpatient and ambulatory rotations. Each resident is placed into one of five cohorts at the beginning of their residency.

How it works

Each week, a different cohort rotates through the continuity clinics, and this cycle repeats every five weeks. On any given week, there is one cohort on a continuity clinic week (referred to as the “+1″ or “plus 1” week), while the remaining four cohorts are on inpatient service or subspecialty rotations. Thus, instead of going to clinic one half day per week, residents have five consecutive afternoon sessions during their ambulatory “+1″ week.

Schedule benefits

We’ve found this 4+1 structure allows for improved predictability for each resident’s schedule and a better concentration of ambulatory medicine and primary care, all while maintaining patient continuity. Our +1 schedule also allows for mornings during the +1 week dedicated to specialty clinic experiences, our formal QI/Patient Safety curriculum, administrative/research time, ambulatory didactic sessions and procedure training in our simulation lab.

Since converting to this 4+1 curriculum in 2014, we’ve been able to optimize resident satisfaction with both the inpatient and outpatient experiences. Inpatient rotations experience less disruption and continuity clinic is more enjoyable since residents are not responsible for ongoing care for inpatients while in clinic. In addition, our ambulatory week tends to be light on call, allowing residents to recharge after busy inpatient rotations.

Quality Improvement/Patient Safety (QI/PS)

Our residents participate in a QI/PS curriculum during each of their “+1” weeks. The Institute for Healthcare Improvement (IHI) Open School provides the foundation of the curriculum, with each resident earning the Basic Certificate by the end of their PGY-2 year.  Most importantly, in small groups of 6-7, residents design and implement a QI/PS project with faculty mentorship. The project culminates in a poster or oral presentation at UMKC’s Quality and Patient Safety Day each Spring. Groups develop a new QI/PS project each year, which means that each categorical resident completes at least three QI projects during residency.

Procedure and Simulation Training

UMKC’s School of Medicine has been providing simulation-based education to health professions students, residents in training and faculty for many years. The Internal Medicine Residency program utilizes the state of the art Clinical Training Facility (CTF) and Youngblood Medical Skills Laboratory as a site for simulation, procedure training, and point-of-care ultrasound (POCUS) education.

The CTF offers Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) training programs through the UMKC Emergency Medical Services program as well as a Mastery Learning program in Central Line Training facilitated by UMKC faculty. Additionally, our residents obtain training in lumbar puncture, thoracentesis, paracentesis, arterial lines and venous line placement.

The program has an annual POCUS/Echo course for residents. Residents get hands-on training in diagnostic cardiac, thoracic, and abdominal ultrasound.