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.
Internship
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. Interns also learn the basics of ultrasound at the Durham VA. 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 (Gastroenterology/Geriatrics/Primary Care and Nephrology/Rheumatology/Endocrinology).
Inpatient rotations include:
- General Medicine Wards (Duke Hospital, Durham VA, and Duke Regional Hospital)
- Inpatient Cardiology
- Inpatient Hematology/Oncology
- Inpatient Neurology
- MICU
- CCU
- Night Medicine at Duke Regional Hospital
Interns also have exposure to POCUS and Simulation.
In response to resident feedback, as of 2024-2025, our interns do not take 28-hour call on any rotation.
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.
As of 2026, JAR schedules are now structured in a “4+4” block schedule, with 4 weeks of inpatient medicine followed by 4 weeks of ambulatory, consults, vacation, or specialty elective. The specialty clinic and consult services are organized to be an immersive experience in a particular subspecialty for each 4 week block, such as 2 weeks of oncology clinic with 1 week of oncology consults and 1 week of palliative care consults.
Residents interested in clinical research may apply for the Comprehensive Introduction to Clinical Research Course (CICR), 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 at the Durham VA
Ambulatory Medicine structured in “+4” blocks
Emergency Medicine
Medical Intensive Care Unit
Cardiac Intensive Care Unit
Night Medicine
Elective time, including CICR
In response to resident feedback, as of 2024-2025, our JARs do not take 28-hour call on any 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 a Senior Development Elective (Global Health, Assistant Chief Resident, Research Elective, Targeted Clinical Experience), and to differentiate further along their chosen career path. SAR year is now also structured in a 4+4 schedule.
The typical SAR year includes:
General medicine wards at Duke University Hospital, Duke Regional Hospital, and the Durham VA
Ambulatory/Consult medicine structured in “+4” blocks
Medical Intensive Care Unit
Cardiac Intensive Care Unit
Emergency Medicine
Senior Development Elective (8 weeks), including Assistant Chief Resident, Global Health, Research Elective, or Targeted Clinical Experience