The Emergency Medicine/Internal Medicine resident is considered a resident in both ACGME-accredited Emergency Medicine and Internal Medicine programs. The resident participates in the clinical and didactic educational activities of both departments.
The first year differs somewhat from the three-year categorical EM program. There are three additional months on the Internal Medicine service and only one surgical month spent in the SICU. The second year provides increased clinical responsibility and autonomy on both the Emergency Medicine and Internal Medicine services. Included in this year are two supervisory months on the Internal Medicine service. Internal Medicine elective time is also available. The third year EM/IM resident experiences increased supervisory and clinical responsibilities. During this year, residents assume leadership roles in medical and trauma resuscitations in the Emergency Department. Three months of Internal Medicine elective time are available.
The fourth and fifth years offer more flexibility in both Emergency Medicine and Internal Medicine. Supervisory, teaching and research responsibilities continue to expand. There is additional experience in the intensive care units, pediatrics and elective choices. The DEM/Medical Consult month is unique to the Combined Program. During this month, the combined resident is responsible for the supervision of Internal Medicine residents during their Emergency Medicine rotation in the units. Similarly, the residents assume junior staff responsibilities on the Internal Medicine floors and will be responsibile for academic leadership of their assigned teams.
An Internal Medicine continuity clinic is scheduled during the first four years. Residents will work with a preceptor to learn the subtelties of outpatient medicine and primary care.
Here is an outline of the distribution of rotations across the five years. Within a year, the EM and IM months are staggered so as to not have the resident away from one department for a significant period of time.
| EMIM-1 | EMIM-2 | EMIM-3 | EMIM-4 | EMIM-5 | |
|---|---|---|---|---|---|
| General Internal Med | General Internal Med | General Internal Med | General Internal Med | IM IPD - Junior Staff | IM |
| Heme/Onc IPD | General Internal Med | General Internal Med | General Internal Med | IM IPD - Junior Staff | |
| Pulmonary IPD | Geriatrics | Internal Med. Consult | IM Elective | IM Elective | |
| Infectious Disease IPD | Neurology | IM Elective | IM Elective | IM Elective | |
| Nephrology IPD | Clinical Skills in IM | IM Elective | Cardiac ICU | IM Elective | |
| Cardiac ICU | Medical ICU | IM Elective | EM Consult | Medical ICU | |
| Surgical ICU | Emergency Medicine | Surgical ICU | Pediatric ICU | Pediatric Selective | EM |
| Emergency Medicine | Emergency Medicine | Emergency Medicine | Emergency Medicine | Emergency Medicine | |
| Orthopedics | Emergency Medicine | Emergency Medicine | Emergency Medicine | Emergency Medicine | |
| Anesthesia/EMS | Emergency Medicine | Emergency Medicine | Plastic Surgery | EM Elective / Tox | |
| Pediatric Ward (CHM) | Emergency Medicine | Emergency Medicine | EM Elective | EM Elective | |
| EM Didactics | Obstetrics | Emergency Medicine | Research | Research |
A brief description for these rotations can be found on this page.