Most of the 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.
The intern year consists of inpatient and ambulatory rotations, broken into a "4+2" block schedule. In this format, interns rotate on inpatient teams for four weeks, followed by two weeks of ambulatory medicine, geriatrics, vacation or consults. During the ambulatory weeks, interns work in their continuity clinic, other specialty clinics at Duke and the Durham VA, participate in Evidence-Based Medicine curriculum, and learn the basics of Quality Improvement. Specialty clinics are organized into 6 month “threads” where interns work with the same attendings in a specialty clinic across all ambulatory weeks. The two intern threads focus on specialties that do not have ward rotations in intern year (Infectious Diseases/Gastroenterology and Nephrology/Rheumatology/Endocrinology). Inpatient rotations include general medicine wards (Duke Hospital, Durham VA, and Duke Regional Hospital); inpatient cardiology; inpatient hematology/oncology; inpatient pulmonology; neurology, MICU and CCU, as well as night medicine at Duke Regional Hospital.
Junior Assistant Residency
The goals of the Junior Assistant Residency (JAR) year are for each resident to learn to lead a ward team, to manage patients with independence on the night medicine rotations, to gain greater experience in ICU medicine and to begin to differentiate along a chosen career path.
JAR schedules are also structured in the “4+2” block schedule, with ambulatory, consults, vacations, and specialty electives focused on the “+2” blocks. Specialty clinics remain organized in threads, allowing JARs to see the outpatient management of Cardiology/Hematology and Pulmonary/Oncology.
Residents interested in clinical research may apply for the Clinical Research Training Course (“Clin Epi”), which is a didactic course that includes training in statistics and clinical research methods. Residents design a research project during this rotation, and many of these projects have been conducted and presented at scientific meetings.
The JAR schedule includes:
- General medicine wards – two rotations, at the Durham VA Medical Center
- Ambulatory medicine – structured in the “+2” blocks
- Emergency medicine – one rotation
- Medical intensive care unit – 1.5 rotations
- Cardiac care unit – 1 rotation
- Electives – structured in the “+2” blocks
- Night medicine – one rotation
Senior Assistant Residency
The Senior Assistant Residency (SAR) year is the pinnacle year of training. The goals of this year are for SARs to serve as "almost attendings" on the general medicine service, to participate in specialty experiences (global health, assistant chief resident, research elective) and to differentiate further along their chosen career path.
The typical SAR year includes:
- General medicine wards – two rotations, one at Duke and one at Duke Regional Hospital
- Ambulatory medicine – three rotations
- Intensive care unit – one rotation
- Night float and Day float– 0.5 rotation each
- Urgent care or emergency medicine – one rotation
- Electives – 3.5 rotations