The University of Florida Internal Medicine program is an innovative program and is constantly developing new programs which are increasingly being emulated by other internal medicine programs. Some of the unique features which distinguish it from other programs include:
Transparency and Cooperation
The hallmark of the Internal Medicine Program is collegiality and cooperation. This attitude permeates the entire Department of Medicine and is the reason why so many of our residents stay for fellowship and for their career. The administration regards the residents as essential members of the staff and has several ways to get their input on important issues for the residency program and the hospital as a whole. The Housestaff Advisory Committee (HAC) is comprised of elected representatives from each year, the chief residents, the program director, and associate program directors who discuss upcoming changes to the program and issues of concern for the residents. All major changes to the program are vetted in this setting and tweaked to be suitable for all parties. The chief residents also meet with the residents monthly without any administrators to hear concerns and explain recent changes to the program at “Breakfast with the Chiefs.” These avenues assure that the voices of the residents are always heard and their input is incorporated into systems changes at all levels.
Hospital Medicine Team
These are teaching teams at UF Health Shands Hospital and the Malcom Randall VA Medical Center intended to simulate life as a hospitalist. It consists of two upper level residents (Shands) or one upper level resident (VA) and an attending hospitalist. The residents function largely independently including rounding separately with the attending. They are also free of outpatient clinical duties during this rotation in order to further simulate the hospitalist experience. This is a highly desirable rotation for the hospitalists, therefore only the very best are allowed to staff this service.
The “Bridge” is an upper level resident (one at Shands hospital and one at the VA) whose responsibility is to receive sign out from the housestaff teaching services and respond to emergency response calls from Monday through Friday from 7am to 7pm. This resident serves as a “bridge” between the day and night teams, allowing the day teaching teams to leave the hospital prior to 7pm after their admissions and work responsibilities for the day are complete. Their sole purpose is to support the inpatient teaching services.
All categorical interns rotate through this service in order to prepare them to perform standard internal medicine invasive procedures including paracentesis, thoracentesis, lumbar puncture, central line placement, and joint injections. It consists of supervised time in a state-of-the-art simulation lab at the VA as well as a consult based service that assists all services at the VA with invasive procedures. As a result, at the start of their second year of residency all PGY-2 residents are competent, confident, and ready to supervise these procedures.
All interns rotate through the Oncology, Cardiology, and GI/Hepatology services during their first year. These are ward teams staffed by attendings from their respective subspecialties giving the interns an opportunity to learn how to manage complex medical problems from the experts themselves, making them more prepared to handle these problems as upper level residents. This exposure to the three most competitive specialties during their intern year helps many interns decide on a career path and lets them cultivate research opportunities and relationships with faculty early in their training.
In addition to the excellent clinical experience provided at UF, there is also a longitudinal and multifaceted approach to preparation for the American Board of Internal Medicine (ABIM) exam. Noon conferences are divided into organ system blocks according to their representation on the board exam. Topics are then assigned to faculty who have demonstrated superior commitment to education and have given excellent lectures in the past. In addition, on Thursdays after Grand Rounds, a one-hour board review session is offered targeted for upper level residents. Finally, June of the PGY-3 year is entirely dedicated to board review, with no clinical duties aside from 1 day of clinic per week.