In addition to the categorical and preliminary training programs, four optional pathways are open to residents interested in specific areas of study.

Categorical Program

The majority of Duke's Internal Medicine Residents complete the categorical program, a three-year training period that starts with the Internship year and concludes with the Senior Assistant Residency year.

Preliminary Program

The one-year preliminary program provides residents with a solid foundation in internal medicine before specialization. Because preliminary interns have diverse interests, this program offfers elective rotations to allow the interns to tailor their coursework to suit their needs and career goals.


The ABIM-approved Clinician-Investigator Training Track is designed for individuals who have experience in biomedical research, are interested in research development, and wish to develop fundamental skills and expertise to conduct rigorous and original clinical investigation. Beginning in 2018, the Department of Medicine is offering the new Duke R38 Research Pathway for residents committed to a career as a physician investigator. This NIH-funded, ABIM-approved opportunity includes a 4-year Internal Medicine residency that incorporates 18-months of protected time for research sponsored by an R38 Stimulating Access to Research in Residency (StARR) grant.

Global Health

The Global Health Pathway develops academic leaders in global health who work to reduce human suffering caused by health disparities.

Health Care Leadership

The Management and Leadership Pathway provides residents with the knowledge and skills essential to bridge clinical practice and management and become skillful and effective physician executives.

Ambulatory Care Leadership

Physicians planning careers as leaders and clinicians in the ambulatory environment need enhanced training beyond that offered in a traditional academic categorical medicine program.  These physicians will need an in-depth understanding of current and evolving health care delivery models, effective leadership skills, outstanding clinical skills, and the ability to deliver high-quality, cost-effective care across a range of settings.

The Advocacy in Clinical Leadership Track (ACLT) is ideally suited for Duke internal medicine residents not only planning to practice in the ambulatory environment, but also aspiring to function as leaders. These physicians might choose an administrative role such as a clinic chief, an academic role such as a clerkship or residency program leader, or perhaps function as a community leader.