Training at Duke

"From the top down, Duke has built a program that values their trainees and puts a premium on their growth, education, and well-being." 

Maxine Chan, PGY-4

Curriculum

Medicine-Pediatric residents are regarded as categorical residents by both departments and are highly respected. Because Medicine-Pediatrics residents bring a special wealth of knowledge to both departments, their expertise is valued. We welcome applicants whose career goals are academic medicine, the practice of general internal medicine or pediatrics, or disciplines that require these backgrounds.

Internship

Intern year is 12 months in duration and is divided into four, three-month blocks on internal medicine and pediatrics. Although specific rotations may vary from year to year, a special effort is made to provide residents with an effective balance of intensive care, ambulatory, and inpatient ward experience. The pediatric blocks contain one ambulatory rotation, two nursery rotations (full-term and intensive care), two inpatient ward rotations and community rotation. The medicine half of the internship consists of one-month rotations in geriatric medicine, two subspecialty rotations (Hematology/Oncology and Cardiology), two general medicine experiences, 2 weeks in the cardiac intensive care unit, and 2 weeks of an adult community rotation.

Second and Third Years

These two years are categorized as junior residency. Residents continue to rotate between medicine and pediatrics every three months to maintain a continuity of experience and proficiency in both disciplines. The experience in each department is very similar to that offered to the categorical medicine and pediatric residents to achieve board eligibility. The rotations include inpatient wards, intensive care units, electives, ambulatory clinics, the local federally qualified health center (FQHC) both on medicine and pediatrics, and emergency department experiences.

Fourth Year

Medicine experiences consist of an inpatient supervisory general medicine rotation at DRH, inpatient specialty electives, an intensive care month, and an emergency medicine acute care rotation. The pediatric portion of the schedule includes six one-month rotations with electives and inpatient experiences at Duke and an option at Wake Med.

View a sample of the Duke Medicine-Pediatrics Residency Program four-year curriculum

Combined Medicine-Pediatrics Continuity Clinic

We serve a diverse patient population with a wide range of medical conditions and socioeconomic status. Our residents have a combined medicine and pediatric clinic on a regular basis throughout the four-year program. Interns have approximately one half-day per week in clinic depending on the rotation, and upper level residents have up to two half-days weekly in clinic. The clinic is strategically placed within the north Durham community and on a bus route; it is approximately a 15-minute drive from the main hospital in the Duke Medical Plaza on North Duke Street. It is an integrated office building with pediatric, and med-peds faculty practices. The clinic is a primary care medical home accredited by the Joint Commission, serving patients with complex medical issues and social needs. The clinic has on-site social work, nurse clinicians, lactation consultants, lab services, and mental health triage nurse and licensed counselors for our patients. We have 4 Spanish interpreters on site as well as video interpreters for all other languages. In addition, we benefit from sharing clinical space with our pediatric Healthy Lifestyles (obesity), pediatric mental health, and child abuse and foster care clinics. Since the COVID-19 pandemic, DukeHealth has been a leader in telemedicine. Our residents are trained in telemedicine and have conducted patient visits using telehealth platforms according to need.

Combined Medicine-Pediatrics trained faculty precept the house officer continuity clinic. Interns and residents are encouraged to follow the patients they discharge from the hospital, nursery and care for in the Emergency Department, and these patients help form each resident’s clinic population over a four-year period.

Pre-clinic conferences on ambulatory topics in both medicine and pediatrics are held weekly. Conferences are a collaborative experience with residents and faculty.

The residents establish a continuity experience with their patients and have annual adult exams, pediatric well child checks, return appointments and acute visits scheduled weekly. Residents have a balanced outpatient experience and see approximately 50% pediatric and 50% adult patients in each session.