Curriculum


General Overview

The Internal Medicine residency at USF consists of 36 months of inpatient and outpatient training experience and complies with guidelines as mandated by the American College of Graduate Medical Education (ACGME). The program uses an X+Y schedule system for upper level residents.

We provide our residents as much flexibility as possible to shape their individual training experience. Prior to each year all residents complete a rotation preference sheet in which they rank their preferences for rotations by subject, site and time of year. This includes a variety of subspecialty electives. The ability to individualize training greatly enhances resident education and satisfaction and aids in obtaining fellowships.

General Wards (Tampa General and VA Hospitals)

  • General Internal Medicine Ward responsibilities are divided equally between Tampa General Hospital and the Veterans Administration Hospital and account for approximately 14 months of training.
  • Ward attendings are all Internal Medicine board certified hospitalists whose primary responsibility is patient care and education for the ward teams. This allows for timely rounds, dedicated instruction and a unique perspective on inpatient care
  • Morning report, Noon Conference, and Board review occurs at each hospital
  • Subspeciality Conferences are available at each hospital
  • Teaching rounds usually begin after morning report and last approximately until noon
  • Grand rounds are given at noon each Thursday on the main campus and televised to all hospitals
  • Ancillary duties are handled by hospital staff at all of the training facilities. Residents are not responsible for blood draws, transport, etc.
  • The average team census at both hospitals is approximately 12-16 patients.

Tampa General Hospital

  • There are 5 teams, each comprised of 1 senior resident (PGY2 or PGY3), 2 interns and 2-3 medical students.
  • Teams rotate through the following daily schedule: AM team (7 am-11a, 2p-3p), PM team (3pm-7p), Post call (Teams do not take admissions on post-call day), Overflow team 1, Overflow team 2. Overflow teams assume care of patients admitted by overnight admitting resident.
  • ER call is shared with Medicine Attending INpatient Service (MAIN), a team of attending hospitalists.
  • Senior residents do overnight admissions 8pm until 7am, which are then staffed with the overflow team in the morning.
  • The maximum admissions for a team in 24 hour period is 10. Team caps are absolute at 18 patients.
  • On weekends and holidays long call call lasts from 7am to 8pm.
  • There is no overnight call for any senior or intern on any ward team.

Veterans Administration Hospital (VA)

  • There are 5 teams with team structure similar to Tampa General.
  • Teams rotate through 1st, 2nd and 3rd short and long call.
  • 1st, 2nd and 3rd short rotate admissions from 7am to 2 pm with the first admission going to the 1st short team, then the 2nd short team and so on.
  • Long call teams are responsible for admissions from 2pm to 7pm, after which they leave the hospital until the following morning. A separate night float resident is responsible for admissions until 7am the next morning.
  • There is no overnight call for any senior or intern on any ward team.
  • **seniors on wards work from Friday AM until Saturday AM- they cover their team and do some admissions overnight on Friday
  • Non-teaching services handle the increased patient numbers.

Intensive Care Unit Services

Residents will spend 4-6 months throughout their training in either the Medical Intensive Care Unit (MICU) or Cardiac Intensive Care Unit (CCU) at TGH or the VA. The ICUs at all hospitals are "closed", which means patients admitted or transferred to the ICU are cared for by separate unit teams. Attendings for the MICU and CCU teams are all board-certified pulmonologists/critical care specialists or cardiologists, respectively.

Tampa General Hospital

  • Each team (MICU and CCU) has 2 senior residents, one serving as the "day" resident and one the "night". The day resident works six 12-hour shifts per week (7am to 7pm). The Night Float resident works from 7 pm to 7 am with Saturdays off.
  • There is a MICU Day Assist resident who assists the team with admissions and procedures during the day. The Day Assist resident alternates with the MICU Night Float resident for ~14 days on each cycle.
  • The rest of the team is comprised of 2-3 interns and 1-2 medical students who work traditional day shifts.
  • Interns alternate staying every 4th night until 7pm to ensure transition to the night house officer on duty for the 6 ward teams.

Veterans Administration Hospital

  • The MICU team structure is the same as TGH, with senior residents splitting days and nights.
  • The MICU day assist covers the service on Friday until Saturday morning (6a-6a) which gives both the day and night resident Friday off.
  • The CCU has 2 teams, each team is composed of 1 senior resident, 1 intern,1-2 medical students. In addition, there is one night CCU resident.
  • The CCU residents alternate taking admissions until 7 pm for cardiology.
  • CCU interns alternate staying every 4th night until 7pm to ensure transition to the night house officer on duty for the 5 ward teams.
  • The CCU day assist covers Friday night, giving the night resident a night off, and the residents on days split up working Saturday and Sunday.

Residents on subspecialty months provide call coverage only on Saturdays, on average one call a month per resident.

Hematology / Oncology Services

At the H. Lee Moffitt Cancer Center, there are two services run by USF faculty and residents. This is an incredible opportunity for our residents to gain exposure to a unique population of patients, and work with world renowned Hematologists and Oncologists at an NCI-designated comprehensive cancer center. A Hematology service cares for patients with malignancies of the bone marrow and lymphatic system. An Oncology service cares for all other solid tumor malignancies. Each team is comprised of 1 senior resident, 2 interns and 1-2 medical students. Attendings on the Hematology service are all Moffitt Board Certified Hematologists or Oncologists. Attendings on the Oncology service are Board Certified Hospitalists. Daily work and teaching rounds are similar to the general wards.

There is a night float resident and intern on service from 7pm to 7 am. The night float resident manages all admissions overnight, and the night intern manages all patients already admitted to the ward services. Every fourth day, the interns on the hematology and oncology service stay until 7pm to ensure proper signout to the night float house officer.

Subspecialty / Elective Rotations

Approximately 1/3 of resident training will take place on subspecialty or elective rotation. For specialties with inpatient emphasis these rotations are offered at all three of our affiliated hospitals. Clinical facilities located at the VA hospital and the Morsani Center as the primary sites for elective rotations that involve outpatient care. Residents work Monday-Friday and are not responsible for weekend or holiday coverage. Residents attend all morning reports and scheduled conferences. During these months senior residents will be responsible for 1 24-hour cross cover call and interns will cover 1 12-hour calls.

The Inpatient subspecialty rotations include Cardiology, Pulmonary and Critical Care Medicine, Gastroenterology, Hematology and Oncology, and Infectious Diseases.

The Outpatient subspecialty rotations include Allergy and Immunology, Dermatology, Endocrinology, Geriatrics, and Rheumatology. There are also two rotations in Ambulatory Hematology and Ambulatory Oncology where residents get to rotate through outpatient clinics at Moffitt Cancer Center in different clinics, i.e. Thoracic, Breast, Genitourinary, GI, and Cutaneous for Oncology and Acute Leukemia, Plasma Cell, Lymphoma, Hematopathology, and Myeloma Clinic for Hematology.

Emergency Department

All residents spend at least one month rotating through the Tampa General Hospital and VA Hospital's Emergency Department. TGH possesses West Central Florida's only level 1 trauma center. Residents are able to peform procedures, run traumas, and triage patients.

Continuity Clinics

All interns will attend a continuity clinic one half day per week during their first year of training. Second and third year residents are on an X+Y schedule and spend 2 weeks in continuity clinic followed by 6 weeks of inpatient and outpatient rotations. The upper level clinic experience is a mixture of continuity clinic and subspecialty clinic with a focused didactic time each week. In addition, the curriculum includes Quality Improvement and Patient Safety projects as well as training in PCMH.

Clinical Outpatient Rotation (COR)

All residents will spend one month on this rotation, which combines experiences in outpatient primary care settings as well as "non-internal medicine" specialties that deal with problems commonly seen by primary care providers. This includes dermatology, ophthalmology, orthopedics, interventional radiology, gastroenterology, ENT and urology. Additionally, residents on COR work with the Quality Improvement chief on a QI project that often leads to an abstract publication and/or poster presentation at a national meeting.