Rotation Schedule

Rotations for second and third year residents consist of medical floors, intensive care units, subspecialty electives, general medicine ambulatory care blocks, emergency room, and a variety of other outpatient experiences.

Elective research rotations are encouraged. Prior approval from the chief residents and the program director/s is required. A written description of the project and its objectives must be submitted 8 weeks prior to the start of the rotation. Residents are expected to submit summaries of their research work in the form of abstracts, publications, and/or letters.

Elective rotations may be done at outside institutions provided such experiences are not available at the main campus and are done at a teaching hospital with an approved training program. Prior approval from the program director is mandatory. An evaluation form must be completed at the end of the rotation by the supervising attending physician.

Outpatient Experiences

In addition to continuity clinic and the month-long ambulatory block, outpatient clinic experiences are included on most subspecialty rotations. Other ambulatory electives include Preventive Medicine, Geriatrics, Gynecology, Sports Medicine, Palliative Care, Neurology, and Dermatology. In addition, outpatient clinic experiences are included on most subspecialty rotations.

R2 and R3 In-Training Examination

In cooperation with the National Board of Medical Examiners and the American Board of Internal Medicine, an in-training examination is given to all second and third year residents during the fourth or fifth month of the academic year. This exam is solely a self-assessment exercise and is not used to judge a resident’s performance in the program.

Clinicopathologic Conference

Each third year resident is expected to discuss an unknown case in detail. The case is given to the resident one week prior to the presentation. The emphasis of the presentation is on the differential diagnosis and overall approach to the case.

Evaluation and Promotion

Residents are evaluated at the end of each floor rotation by their respective teaching ward attending physicians, first year residents, sub-interns, and medical students. They are evaluated by the supervising attending physician during an elective or ambulatory care rotation. Evaluations are reviewed during meetings with faculty advisors and program directors. After the second year of training, residents will have acquired the leadership, teaching and analytical skills necessary to effectively manage an in-hospital ward team and their group of ambulatory patients. By the end of the third year, residents are expected to be ready to assume responsibility as fully independent internists.

Every third year resident must perform a satisfactory history and physical examination under the observation of an attending physician during the second half of the academic year. This exercise is a requirement for the completion of the residency.

Moonlighting

Moonlighting is a privilege given to second and third year residents who maintain a satisfactory performance in the training program. It is available to second year residents only in an “in-house” capacity due to state licensing regulations. Opportunities are available at the Rush North Shore Medical Center and the Johnston R. Bowman Center. The department views these activities to be voluntary educational experiences.

Third year residents who have received their permanent licenses are able to work outside of the hospital. As previously mentioned, their residency performance must be at a satisfactory level. Moonlighting to such an extent that it impairs their work performance at Rush is not allowed. Malpractice insurance for outside activities is provided under the hospital’s malpractice policy only if that moonlighting activity is sponsored by the department at an affiliated institution and prospectively approved. Residents who moonlight in outside institutions are advised to inquire about the coverage provided for them, including “tail” coverage after they leave that job, to avoid any potential future problems. Moonlighting is not allowed during regular work hours and the hours spent in in-house moonlighting are counted towards the 80 hour limit. It is also prohibited during inpatient floor rotations or when a resident has on call responsibilities to another service.