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Medical College of Wisconsin Department of Medicine Curriculum & Schedule

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General Internal Medicine

A major focus of the residency curriculum is General Internal Medicine (GIM). Activities include:

  • Direct inpatient care at three different hospitals: Froedtert Hospital, the Clement J. Zablocki VA Medical Center and St. Joseph
  • Private Practice clinic rotations
  • General medicine care of the geriatric patient
  • Continuity Care Clinic with a focus on patient-centered medical home model
    • Categorical residents and their patients are assigned to a care team. Patient care, continuity, and resident education are optimized for their resident group over the three years.
Subspecialty Inpatient Rotations

Residents need focused time on subspecialty inpatient rotations to learn about the care of acutely ill patients with major organ disease.

Our curriculum provides subspecialty inpatient rotations in:

  • Cardiology
  • Medical Intensive Care
  • Hematology/Oncology
  • Neurology
  • Geriatrics
Consultative and Ambulatory Subspecialty Medicine

A comprehensive program in the medical subspecialties is offered to all medical residents. Each subspecialty offers a structured block rotation utilizing inpatient and outpatient consultative activities, ambulatory clinics, and educational conferences to provide an intensive introduction to the subspecialty area.

Rotations include:

  • Allergy/Immunology
  • Cardiology
  • Endocrinology
  • Gastroenterology
  • Geriatrics
  • Hematology/Oncology
  • Infectious Disease
  • Nephrology
  • Neurology
  • Palliative Care
  • Perioperative Medicine
  • Pulmonary Medicine
  • Sleep Medicine
  • Rheumatology
  • Women’s Health
Procedures and Point of Care Ultrasound (POCUS)

We offer elective and required experiences in procedures and POCUS:

  • Interns participate in a required Procedures and POCUS workshop during our Core Skills program in July or August.
  • Interns/residents participate in a procedures refresher workshop that occurs before the MICU rotation.
  • Procedures elective: Residents are able to develop their skills in procedures such as central line placement, lumbar punctures, thoracentesis and paracentesis among others.
  • POCUS elective: This 2 week experience allows residents to develop their skills in POCUS such as lung, heart and abdomen.
Emergency Medicine Experience

PGY1 ED rotation

  • Required for categorical interns, elective for preliminary year interns
  • Includes VA Medical Center Emergency Department (where they work directly with ED faculty), the Froedtert Hospital level 1 Trauma Center or a combination of both
  • VA Medical Center ED experience includes dedicated POCUS teaching

PGY2-3 ED rotation

  • Residents rotate through the VA Medical Center Emergency Department 
  • VA Medical Center ED experience includes dedicated POCUS teaching
Ambulatory Immersion

Residents complete a 1-month ambulatory block in each year of residency. 

Specially designed curriculum includes a combination of clinical activities (internal medicine and other specialties), conferences (such as evidence-based medicine sessions), online modules and independent study time. 

Residents can tailor the clinical activities based on their own interests.

Clinical opportunities include the following:

  • Allergy
  • ALS Clinic
  • Asthma/COPD/Smoking Cessation (seniors only)
  • Breast Care Clinic (seniors only)
  • Cardiology
  • Cardiology Arrhythmia
  • Cardiology Cath Lab
  • Heart Failure
  • Echo Lab
  • Dementia
  • Dermatology
  • EMG
  • Endocrine
  • ENT
  • GI
  • General Internal Medicine
  • Headache Clinic
  • Hematology-Oncology
  • Infectious Disease
  • Infectious Disease/STD Community | Brady Street clinic hours are 6-9 p.m. (seniors only)
  • Nephrology
  • Neurology
  • Neurosurgery
  • Orthopedics
  • Pain Clinic
  • Palliative Care
  • Physical Medicine Rehabilitation
  • Physical Medicine Stroke, Musculoskeletal
  • Pre-op Anesthesia shadowing
  • PIM Patient Intensive Management Team (home-based care experience for complex chronic disease management)
  • PFT Lab (observe PFT testing)
  • Pulmonary
  • Radiation Oncology
  • Rheumatology
  • Sleep Clinic
  • Spinal Cord Injury
  • Stress Lab
  • Substance Use Disorder
  • Surgery
  • Vascular Medicine (seniors only)
  • Vein Clinic (seniors only)
  • Women’s Health/OB GYN

View sample PGY1 Ambulatory Schedule (PDF)

Academic Half-Day
  • Protected educational time for formal didactic curriculum (pagers signed out to others)
    • Core clinical knowledge
    • Teaching skills
    • Case discussions
    • Journal club
    • Diagnostic reasoning skills
    • Reflection exercises
    • Simulation sessions
    • Lectures on financial/life planning
  • Occurs on Wednesday mornings for the PGY2/3s and Wednesday afternoons for the PGY1s
  • Everyone together at one location (in non-pandemic times)

View sample academic half-day schedule (PDF)

Noon Report
  • Our main case conference featuring complex or unique cases presented by a senior resident and moderated by a chief resident
    • Includes diagnostic reasoning
    • Clinical pearls
    • Focused teaching on topic pertaining to the case
    • Board review-style questions
  • Occurs on Monday, Tuesday, Thursday and Friday
  • Occurs at Froedtert Hospital, VA Medical Center and St. Joseph
  • Attendees
    • Interns and residents
    • 1-3 faculty members
    • Students rotating on internal medicine services
Clinicopathophysiology Conference (CPC)
  • Expert clinician is presented with the clinical course, relevant laboratory results and radiological findings of a particular patient and asked to develop a case discussion to present to students, residents and faculty.
  • Radiology and Pathology faculty member also present relevant findings
  • Occurs several times a year
  • Attendees
    • Interns and residents
    • Faculty members
    • Students rotating on internal medicine services
Morbidity & Mortality
  • Focused on systems improvement and safety culture, not mistakes made by individuals
  • Occurs regularly at both Froedtert Hospital and the VA Medical Center
  • Led by chief residents
  • Attendees
    • Interns and residents
    • Faculty members
    • Students rotating on internal medicine services
Grand Rounds
  • Invited speakers present relevant information on medical topics, new and innovative research or breakthroughs within medicine.
  • Occurs weekly in a virtual format
  • Attendees
    • Interns and residents
    • Faculty members
    • Students rotating on internal medicine services
Core Skills Program
  • Protected learning time in each residency year
  • Interns: either July or August
    • Must-know clinical content
    • Professional development sessions
    • Procedures/POCUS workshop

View sample core skills schedule (PDF)

Formal ABIM Board Examination Preparation

AHD sessions for PGY2/3s

  • Faculty-led board review sessions 2-3 Wednesdays per month during senior resident Academic Half-Day
  • Utilizes board-style questions and emphasizes general and topic specific test taking strategies
  • Active engagement using of an audience response system

Formal Board Review Course

  • A week-long course held in the spring of each resident’s PGY 3 year
  • Residents are relieved of all other responsibilities to attend
  • All major ABIM certification exam topics covered by faculty with experience leading ACP Recertification Exam Preparation sessions or writing ACP In-Training Exam or ABIM certification exam questions
  • Considered to be very high yield by participants

Personalized Medical Knowledge Improvement Plan

  • All residents take the yearly Internal Medicine in-training examination to help identify areas for improvement and to monitor progress
  • Program leadership assists residents in identifying personal learning styles and guides their selection of the board review resources that best fit their needs
  • Residents with identified test taking difficulties are given individualized assistance with board preparation

Independent Study

A library is kept up to date for residents to borrow the major resources commonly used for board preparation, including MedStudy® and MKSAP®

Arianna Smith, DO, PGY2

Why did you choose MCW for residency?: I wanted to have a fully immersed residency experience in a tertiary care center where I see a wide array of pathologies and work with a diverse patient population during my time of continued medical training. I wanted a residency where I knew I would leave comfortable with managing patients in the most complex care settings. As a wonderful bonus, my family lives in the Milwaukee area so I grew up very familiar with the fact that Wisconsin, and the amazing people who live in this state, make this area one of the most underrated places on the map!

What is your favorite thing to do in Milwaukee?: Milwaukee is a lively and livable city. Nearly every weekend in the summer months, there is a festival to attend if you desire and its sports (and sport fans) are unlike any other. However, my favorite part is that within a 30–45-minute radius in any direction from the downtown bustle, you can find yourself in small towns with character, charm, and abundant outdoor activities to explore.

What is something you like about your residency colleagues?: It sounds cliche, but your colleagues become so much more than colleagues, you build a family here and everyone works together to deliver the best care for our patients, fostering an environment of fun, learning, and one where we elevate those around us. Even in the most challenging times, I look forward to every day with my teams.

What do you like doing in your free time?: For about nine months of the year, I enjoy spending any free time I get on my mountain bike (despite Wisconsin's lack of mountains) or training in the gym to be on my bike. Outside of cycling, I’m enthusiastic about most outdoor adventures.  This may come as a surprise, but in the fall, I will be hunting deer, elk or game birds with my favorite German Shorthair Pointer and then enjoying and sharing this bounty steeped in tradition and family values.  In the winter you can still find me on a mountain doing some skiing.  Outside of adventure, I enjoy reading, challenging puzzles, and escape rooms.

Arianna Smith, MD

Schedule & Inpatient Team Structure

Our overall program structure is a 50/50 system that we call “I’s/O’s.” I’s are inpatient (ward) months, and O’s are elective (with outpatient continuity clinics) months. I months and O months alternate through the year. During O months, residents have weekend days (or an equivalent number of days) off – so this schedule promotes wellness.

View sample PGY1 schedule (PDF)

Nighttime Coverage

Some of our inpatient months have overnight call; some have night float. Having overnight call was a purposeful decision. We believe there is educational value in having some training in the hospital at night—you will see things and learn things at night that you wouldn't otherwise.

See the table below for details.

Rotation (clinical service)  Site  Intern overnight call?  Resident overnight call? 
General Medicine VA Medical Center 1 time per month  5–6 nights (partial night float coverage)
General Medicine Froedtert Hospital  Every 10th night  Every 5th night 
General Medicine St. Joseph  NA  Every 4th night 
Cardiology VA Medical Center  NA Shared night float w/VA MICU (~4 nights)
Cardiology Froedtert Hospital  None  None** 
Heme-Onc VA Medical Center Night float (~7 nights)*  None 
Heme-Onc Froedtert Hospital  None  None 
MICU VA Medical Center NA  Shared night float w/VA Cardiology (~5 nights)
MICU  Froedtert Hospital  Internal night float (~6 nights)  Internal night float (~6 nights) 
*When interns are on VA Heme-Onc, they do night float to cover the general medicine team. Night float is M-F, with the weekends off.

**A senior resident night float team covers the cardiology and transplant teams at night 

Night Float

PGY2/3 residents: Cardiology night float is considered to be an I month. PGY2/3 residents do it once per year. Eight other night float shifts per year are scheduled during an O month.

PGY1s: VA Medical Center night float is paired with Heme-Onc wards to provide exposure to overnight cross cover issues. Interns work directly with the on-call team’s senior resident. Night float works Monday-Friday, with the on-call team interns each covering one call night per month (on the weekends).

Team Structure

  • MCW residents love working together on teams. The team structure varies, depending on the usual workload of each clinical service (see table below).
  • Most of our teams feature PGY2/3 residents supervising interns. Both M3 and M4 students are often on the teams as well.
  • All the hospitals have hospitalist services that also admit general medicine patients and are available for overnight supervision as needed.
Rotation (clinical service)  Site  # of housestaff teams Housestaff team structure
General Medicine VA Medical Center 1 resident, 2 interns
General Medicine Froedtert Hospital  1 resident, 2 interns 
General Medicine St. Joseph  4 1 resident, 2 interns (St. Joe transitional year interns)
Cardiology VA Medical Center 1 3 residents 
Cardiology Froedtert Hospital  2 residents, 4 interns 
Heme-Onc VA Medical Center 1 resident, 3 interns
Heme-Onc Froedtert Hospital  2 residents 
MICU VA Medical Center 1 4 residents 
MICU  Froedtert Hospital  2-3 residents, 2-3 interns
Transplant  Froedtert Hospital  1-2 residents, 0-1 intern

Tailoring Your Schedule

In our program, residents can tailor their experience to their needs. Everyone will graduate with experience in general medicine and subspecialty wards, ICU and ambulatory care. Beyond that, we offer a wide range of electives (from patient safety and POCUS to GI consults and women’s health). We encourage residents to request rotations to help them fill in knowledge gaps, solidify future plans and then prepare them for the subspecialty or practice of their choice. That means that we work with each resident to tailor their experience to their interests and needs.

For example, what if you wanted to pursue a hematology-oncology fellowship? Two of our former residents did just that: Kathleen Monahan and Nicole Held tailored their experiences. See their schedules below.

  Kathleen Monahan Schedule Nicole Held Schedule
PGY1  VA Medical Center HONC wards
Froedtert Hospital leukemia wards 
 VA Medical Center HONC wards
PGY2  Froedtert Hospital Leukemia wards
Froedtert Hospital/VA Medical Center HONC consults
VA Medical Center HONC wards
Research elective (Onc project)
Froedtert Hospital leukemia wards
Froedtert Hospital HONC consults
Research elective (Heme project) 
PGY3  VA Medical Center HONC wards
Bone marrow transplant wards
Froedtert Hospital/VA Medical Center HONC consults
Research elective (Onc project) 
Froedtert Hospital leukemia wards 
Products Presented at the Multinational Association of Supportive Care in Cancer 2019
Publication: accepted
Presented at American Society of Hematology 2019
Patient Safety Indicator-12 Rarely Identifies Problems with Quality of Care in Perioperative Venous Thromboembolism