Curriculum

A large primary and tertiary patient base provides our residents with experiences and resources to master both disciplines. Patient care responsibilities will cover a spectrum of illnesses that affect newborns, children, adolescents, and adults. All residents’ pediatric inpatient rotations are done at Bronson Methodist Hospital, a designated children's hospital. For the internal medicine blocks, residents alternate between the two affiliated hospitals, Ascension Borgess and Bronson. The following schedules are examples and are flexible based on our residents' career goals.

PGY-1 Schedule

The first year curriculum gives practical skill in the management of both common and complex medical issues for adults and children, setting the framework for skills needed in leadership and patient management as a future supervisory resident. The interns have level appropriate clinical experiences designed to expose them to the frequently encountered issues in both specialties. These experiences include inpatient general medicine, inpatient pediatrics, an ambulatory acute care month and the newborn nursery. During these rotations, interns are taught the management of the very ill and the at-risk patients to help them develop decision making abilities in urgent or acute settings. The intern schedule starts with one month of either Internal Medicine or Pediatrics and then rotates between Internal Medicine and Pediatrics every three blocks.

Blocks Rotation
3 Academic-Internal Medicine
3 Inpatient-Pediatrics
1 Acute Illness-Pediatrics
1 Development Behavior-Pediatrics
1 Term Newborn-Pediatrics
1 Ambulatory-Internal Medicine
1 Emergency Medicine-Internal Medicine
1 Neurology-Internal Medicine
1 ICU-Internal Medicine


PGY-2/PGY-3 Schedules

Years 2 and 3 are consolidated to provide a ‘second-year equivalent’ for both Internal Medicine and Pediatrics.  The education, at this level, is designed to provide our residents with supervisory experience in both specialties.   Four-week long block rotations through our subspecialty systems, including emergency medicine, allow the residents to get exposure to most of the medical and pediatric subspecialties, while gaining additional practical exposure to potential career paths and mentors. More experiences in ambulatory care for adults and children and care for the undifferentiated patient provide generalist education in our program. Years 2 and 3 continue to switch departments every three blocks.

Blocks Rotation
2 Pediatrics Subspecialties
1 Adolescent-Pediatrics
1 PICU-Pediatrics
1 NICU-Pediatrics
1 Emergency Medicine-Pediatrics
1 Med-Peds
1 Internal Medicine Subspecialties
1 Ward-Internal Medicine
1 ICU-Internal Medicine
1 Academic-Internal Medicine

 

Blocks Rotation
3 Pediatrics Subspecialties
1 Med-Peds
1 Inpatient Supervisor-Pediatrics
1 Emergency Medicine-Pediatrics
1 NICU Supervisor
1 Academic/Ambulatory-Internal Medicine
1 Internal Medicine Subspecialty
1 Geriatrics/Palliative
1 Academic Night Float-Internal Medicine
1 Elective-Internal Medicine


PGY-4 Schedule

Year 4 provides the ability for the senior to utilize ambulatory block time as well as additional experiences being the senior resident in the hospital helping manage patient flow, acute care issues and consultations. This experience helps residents feel comfortable in their management abilities while providing support and mentorship to more junior residents. The senior resident can significantly tailor much of the final year in our program to meet his/her specific career-based needs. Year 4 alternates departments every three blocks.

Blocks Rotation
5 Pediatrics Elective
2 Inpatient Supervisor-Pediatrics
3 Academic/Ambulatory Subspecialties-Internal Medicine
2 Internal Medicine Electives
1 Ambulatory-Internal Medicine


Required Sub-Specialty Rotations

Internal Medicine: Cardiology, Geriatrics/Palliative, Hematology/Oncology, Nephrology, Pulmonary, Infectious Disease, Neurology.

Pediatrics: Developmental/Behavioral, Adolescent Medicine, Endocrinology, Hematology/Oncology, Pulmonary, Cardiology, Infectious Disease, Gastrointestinal. 

Electives

Virtually all recognized specialties and subspecialties are available to our Meds-Peds residents. In some cases, residents can customize a rotation by combining two specialties into a one-month rotation. We also offer combined electives, which are essentially 4 weeks of the same adult and pediatric specialty mixed together. 

A portion of electives offered in the Med-Peds program includes:

  • Allergy/Immunology
  • Anesthesiology
  • Cardiology
  • Endocrine
  • Genetics
  • Gastroenterology
  • Hematology/Oncology
  • Infectious Disease
  • Nephrology
  • Neurology
  • Pulmonary
  • Radiology
  • Rheumatology
  • Orthopaedics
  • Sports Medicine
  • Surgery


Didactics

Our residents attend morning report, grand rounds, and block conferences in each specialty, gaining at least 7-8 hours of didactics per week. Additionally, residents attend specific Med-Peds conferences and meetings on a regular basis.

The following conferences are held jointly with Med-Peds, Pediatrics and Internal Medicine:

Conference Description
IM Grand Rounds
Pediatric Grand Rounds

A combination of presentations led by faculty, experts in the fields from within the institution as well as renowned invited speakers. In addition, resident specific presentations including Clinical Pathological Conference (CPC) within internal medicine and senior resident led Pediatric Grand Rounds.

IM and Pediatric Jeopardy
IM Board Review
Pediatric Board Review

Educational learning opportunities in various platforms via Curriculum exams, rapid review or visual rapid review.

Internal Medicine Journal Club
Pediatric Journal Club

Residents and/or faculty present topics or cases. Emphasis is on women's health topics in adolescent medicine.

Yale IM Pre-Clinic
Yale Pediatric Pre-Clinic

Access to the Yale IM and Pediatric Pre-clinic series. These are discussed prior to clinic or via a Microsoft Teams Platform on a regular basis.

Med-Peds Resident Meeting

Limited to Med-Peds residents and faculty only. A lunchtime meeting to discuss program-related issues.

Wellness Conference

A wellness initiative focusing on resident wellness interdepartmentally among IM, MP and Pediatric residents through a series of didactic sessions are held annually.

Osteopathic Workshop
Osteopathic Journal Club
Osteopathic Board Review
OMT Resident Care Presentation
OMT Hands-on Practice

For MD or DO residents within the Osteopathic Recognition Program, Osteopathic workshop is held on a monthly basis with a multitude of different educational platforms with an emphasis on osteopathic principles and practices.

Monthly Med-Peds Board Review

Held via Microsoft Teams on a monthly basis to discuss board relevant topics in Internal Medicine and Pediatrics.

Landmark Trials Review

A resident led presentation highlighting the landmark trials and their summaries.


Research

Our curriculum includes the principles of research design, methodology biostatistics and analysis, and the ethical principles of clinical, translational research, and quality improvement. Our faculty provide research mentorship with a wide variety of interests in the discipline, and also collaborate with faculty in other departments and programs.  Many resident projects are presented at the annual Western Michigan School of Medicine Research Day, which is the annual research day for the medical school. Moreover, many resident projects are also presented at other prestigious regional and national venues, and are published in peer-reviewed journals.

Procedures

Our residents gain hands-on experience to become proficient in the procedures that are necessary for their future in medical practice. That experience includes ample opportunities to perform both the internal medicine and pediatric procedures, including:

  • Abdominal paracentesis
  • ACLS
  • Arterial blood gas
  • Arthrocentesis and joint injections
  • Bladder catheterization
  • BLS
  • Bone marrow asp/bx
  • Carpal tunnel injections
  • Casting/Splinting
  • Chemotherapy of warts
  • Chest tube placement
  • Conjunctiva foreign body removal
  • Conscious sedation
  • Cryotherapy
  • Dequervene's injection
  • Digital nerve block
  • Ear/nose foreign removal
  • Echocardiography
  • Endotracheal intubation
  • Flexible sigmoidoscopy
  • Fundamental of Critical Care Support (FCCS)
  • Incision/drainage of abscess
  • Internal jugular vein central line
  • Lumbar puncture
  • Morton's neuroma injection
  • Nail resection/removal
  • Nasal cautery/packing
  • Nasogastric tube insertion
  • Neonatal circumcision
  • Neonatal Resuscitation (NRMP)
  • Nursemaid's elbow reduction
  • PALS
  • Paracentesis
  • Pulmonary artery catheter
  • Removal of dermal foreign bogies and cysts
  • Removal of skin tags
  • Shoulder reduction
  • Skin biopsy
  • Skin biopsy (punch and excisional)
  • Spirometry
  • Subclavian vein central line
  • Suprapubic bladder tap
  • Suturing
  • Thoracentesis
  • Treadmill testing
  • Treatment of warts
  • Trigger point injections
  • Umbilical artery line
  • Umbilical vein line
  • Venipuncture
  • Ventilator management