Curriculum

General Overview

The Internal Medicine residency at U.S.F. 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).

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

General Wards (Tampa General and VA Hospitals)

• 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 the ward teams. This allows for timely rounds, dedicated instruction and a unique perspective on inpatient care
• Morning report begins at each hospital at 8:30am and last 45-60 minutes
• Teaching rounds usually begin after morning report and last until noon
• Noon conferences are given 3-4 times a week at each hospital (lunch provided)
• 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.
• Comfortable, individual call rooms are provided at each hospital for those residents taking in-house call
• The average team census at both hospitals is approximately 8-16 patients.

Tampa General Hospital

• There are 6 teams, each comprised of 1 senior resident (PGY2 or PGY3), 2 interns and 2-3 medical students. Teams rotate through the following daily schedule: 1st short (7 am-1 pm), 2nd short(1pm-3pm),  3rd short (3pm-8pm). Every fifth night teams will assume care of new patients admitted overnight by the night float team.   
• 3rd Short call is taken every 5th night, starting from 3 pm and lasting until 8pm. Teams do not take admissions on post-3rd short days.
• A senior float teams handle admissions from 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 20 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)

• Team structure is similar to Tampa General.
• Admit structure is similar to Tampa General with minor differences in times.
• Long call teams are responsible for admits from  3pm to 8pm, 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
• 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 ICU's at both 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), while the night resident works a similar schedule from 7pm to 7am.
• 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 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 is on call every 4th night until 7 pm for cardiology admissions.
• CCU interns alternate staying every 4th night until 7pm to ensure transition to the night house officer on duty for the 5 ward teams.

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

HIV Service

TGH has a separate ward service responsible soley for the care of patients with HIV. The team consists of 1 senior resident and 1 intern and is staffed by attendings from the Department of Infectious Disease. Daily work and teaching rounds are similar to the general ward teams. The average census is 6-8 patients.

Hematology / Oncology Services

At the H. Lee Moffitt Cancer Center, there are two services run by USF faculty and residents. A Hematology services 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 are all hematologists/oncologists associated with Moffitt. 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.  Every fourth night, 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.

Emergency Room

All residents spend at least one month rotating through the Tampa General Hospital emergency room. TGH possesses West Central Florida's only level 1 trauma center.

Continuity Clinics

All residents will attend a continuity clinic one half day per week during their entire three years at the Morsani Center, VA clinic, or TGH Healthpark Clinic. Outpatient curriculum is stnadardized and provided on a weekly basis at all three facilities.  Curriculum includes Quality Improvement and Patient Safety projects.

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, ENT and urology.