Physicians Collaborate Whiteboard

Department of Medicine Curriculum & Schedule

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, the VA 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
  • Transplant Medicine
  • 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

View sample PGY1 schedule (PDF)

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 Emergency Department (where they work directly with ED faculty), the FH level 1 Trauma Center or a combination of both
  • VA ED experience includes dedicated POCUS teaching

PGY2-3 ED rotation

  • Residents rotate through the VA Emergency Department at the VA
  • VA 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:

  • Adolescent Medicine
  • Allergy
  • Asthma/COPD/ Smoking Cessation
  • Behavioral Medicine/Neurosciences
  • Cardiology/General/Arrhythmia/Cath Lab
  • Dementia
  • Dermatology
  • Endocrine/General/Diabetes/Osteoporosis/Surgery
  • ENT
  • GI/General/Hepatology/Advanced/IBD
  • Gynecology
  • Headache Clinic
  • Infectious Disease/General/Global/Brady Street Clinic
  • Nephrology
  • Neurology
  • Oncology/Hematology/Breast/Prostate/Urologic/Gynecologic/Thoracic, etc.
  • Outpatient Procedures (shoulder and knee injections, toenail removal, wound care)
  • Palliative Care
  • PM&R
  • PFT Lab (observe PFT testing)
  • Pre-Op
  • Pregnancy Coagulation
  • Pulmonary
  • Vascular Medicine
  • Vein Clinic
  • Women’s Health

View sample PGY1 ambulatory schedule (PDF)

View sample ambulatory exploration lecture 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 FH, VA 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 monthly at both FH and the VA
  • 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 monthly at both FH and the VA
  • 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 at FH
  • Attendees
    • Interns and residents
    • Faculty members
    • Students rotating on internal medicine services
Core Skills Program
  • One week of protected learning 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
  • Insurance-covered neurocognitive testing is available for residents seeking special accommodations for the ABIM certification exam

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®

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  1 time per month  Every 4th night 
General Medicine FH  Every 10th night  Every 5th night 
General Medicine St. Joseph  NA  Every 4th night 
Cardiology VA  NA None 
Cardiology FH  None  None** 
Heme-Onc VA  Night float (~7 nights)*  None 
Heme-Onc FH  None  None 
MICU VA  NA  Every 4th night 
MICU  FH  Internal night float (~6 nights)  Internal night float (~6 nights) 
Transplant  FH  None  None** 
*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: Night Float is an O month. Each resident has approximately 8 days off during the month.

PGY1s: VA 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  1 resident, 2 interns
General Medicine FH  1 resident, 2 interns 
General Medicine St. Joseph  4 1 resident, 2 interns (St. Joe transitional year interns)
Cardiology VA  1 4 residents 
Cardiology FH  2 residents, 3-4 interns 
Heme-Onc VA  1 resident, 3 interns
Heme-Onc FH  2 residents 
MICU VA  1 4 residents 
MICU  FH  2-3 residents, 2-3 interns
Transplant  FH  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.

View Rotation Descriptions (PDF)

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 HONC wards
FH leukemia wards 
 VA HONC wards
PGY2  FH Leukemia wards
FH/VA HONC consults
VA HONC wards
Research elective (Onc project)
FH leukemia wards
FH HONC consults
Research elective (Heme project) 
PGY3  VA HONC wards
Bone marrow transplant wards
FH/VA HONC consults
Research elective (Onc project) 
FH 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