Rotation Schedule

The Duke Internal Medicine Residency Program rotation schedule is designed to promote graduated levels of responsibility as well as team-based learning in a variety of supportive but challenging patient care settings. We emphasize that, as a resident, you are the primary doctor for your patients.

We use a “4+2” model for our intern and JAR (PGY-2) schedules and a modified “4+2” model for our SAR (PGY-3) schedules to accommodate special electives such as the short term global health rotations that are 6-8 weeks in duration. This means that you will typically have 4 weeks of an inpatient rotation followed by 2 weeks of ambulatory medicine, consultative medicine, or vacation.  The chart below illustrates the typical breakdown by months, of your inpatient rotations, for each year of training.

  Intern Categorical Intern Preliminary Junior Assistant Resident (JAR) Senior Assistant Resident (SAR)
GM Ward Rotations 4 3 2 2.5
Ambulatory Medicine 7 two-week blocks 7 two-week blocks 7 two-week blocks 2.5
MICU† .5 -- 1.5 1
CICU † .5 .5 1 1
Subspecialty Ward Rotations * 3.5 4 -- --
ED -- 1 1 1
Night Medicine .5 .5 1.5 .5
Day Float -- -- -- .5
Elective (Consults) .75 .75 2 2.25 ‡
Vacation 1 1 1 1

^ Ambulatory medicine is structured into “threads” for interns and JARs to experience longitudinal contact with specialty attendings.  In each year, you will participate in two threads, each lasting 6 months in duration.  Interns attend the “Renal/Rheumatology/Endocrinology” and the “VA/Geriatrics/Gastroenterology” threads to encompass specialties not seen on the inpatient specialty wards.  JARs attend the “Pulmonary/Hematology” and the “Cardiology/Oncology” threads, supplementing what they learned on inpatient specialty wards as interns with outpatient experiences in these domains.  SARs attend our local Federally Qualified Health Center as well as specialty clinics such as Dermatology, Sports Medicine, Women’s Health and more during their ambulatory blocks.  During each week, you attend your continuity clinic (primary care) for three or four half days, and all trainees participate in academic half day on Friday mornings.  Interns have an additional academic half day on Wednesday afternoons. 

* Subspecialty Ward Rotations include Cardiology, Malignant Hematology, and Neurology services.

While on Cardiology, Hematologic malignancies, Neurology, and CICU rotations, interns work on the night team with JAR, SAR, fellow or attending supervision, an average of 4-6 weeks total for the year. There is no 28-hour call.

† Interns will average 4 weeks in the ICU (combination of Duke MICU days, VAMC MICU days and Duke CICU. JARs average 8-10 weeks in the ICUs including Duke MICU and Duke CICU. SARs average 4-6 weeks either in the CICU or MICU (VAMC). There is no 28-hour call.

‡ Includes International Elective and Assistant Chief Resident rotations as well as other senior development electives.