The clinical curriculum of the internal medicine residency program is provided in a block format, as four weeks of an inpatient rotations alternate with two weeks of ambulatory medicine throughout the first year of training. We believe that this approach allows us to teach more effectively the principles of inpatient and ambulatory medicine, and reduces unnecessary handoffs and disruptions in care as residents learn the art and science of medicine. However, because we believe that we have an obligation to teach residents to balance competing clinical priorities as they prepare for life in practice or a fellowship, second and third year residents have a traditional schedule and attend continuity clinic once weekly on most clinical rotations throughout the year.
More than one-third of total training time is spent in a variety of outpatient settings. Each categorical resident participates in a continuity clinic experience that is embedded in the ambulatory blocks. This experience gives you an opportunity to see and care for a panel of patients with a variety of medical problems, covering both sexes and a wide spectrum of age and socioeconomic status.
Also included in the curriculum are additional separate rotations in ambulatory care medicine. These community-based ambulatory rotations allow residents to learn about all aspects of clinic operation, including: scheduling, charting, billing, insurance, medical record keeping and patient referrals.
Preceptors in rural settings are available to provide a different kind of general internal medicine training experience. You will also participate regularly in outpatient clinics during various subspecialty rotations.
The ambulatory blocks that are part of our block scheduling provide an exceptional opportunity to learn and refine the principles and practice of ambulatory medicine. Without having to balance multiple competing clinical priorities, the first and second year resident can concentrate on the care of his or her panel of patients without distraction, and take advantage of the abundant learning opportunities that make up this experience. First year residents will have four continuity clinics each week of a two week ambulatory block. In addition, there will be an academic half-day each week, regularly scheduled time in the simulation lab to teach and evaluate critical skills, an adolescent experience, and outpatient gynecology, all regularly scheduled activities during this block. Second year residents will be able to incorporate many electives into this experience.
Our extensive formal education program is structured to cover a broad range of core internal medicine topics and important areas. We have daily noon lectures, weekly Grand Rounds, thrice weekly Morning reports, and various other educational presentations throughout the year.
First Year Schedule
The first year provides a balanced experience and foundation in general internal medicine, both inpatient and ambulatory. The clinical rotations are divided among Iowa Methodist Medical Center (IMMC), the Des Moines VA Medical Center (VAMC), and Broadlawns Medical Center (BMC). Inpatient rotations are generally four weeks in duration and ambulatory blocks are two weeks in duration.
The first year rotation schedule includes:
- Inpatient General Internal Medicine, IMMC, VAMC, and BMC (16 weeks total)
- Inpatient Gastroenterology and Pulmonary Medicine, IMMC (8 weeks total)
- ICU Medicine, IMMC (4 weeks)
- Night Medicine (Mon-Fri) (4 weeks total, divided into 2 week blocks)
- Ambulatory Cardiology (4 weeks, divided into 2 week blocks)
- Emergency Medicine, IMMC (4 weeks, divided into 2 week blocks)
- Ambulatory Blocks (12 weeks, divided into 2 week blocks)
Second Year Schedule
The second year schedule consists of a series of subspecialty and consultative rotations. In addition, second year residents take on a supervisory and teaching role in the ICU.
The second year resident becomes highly proficient in the procedural and clinical skills necessary to manage critically ill and complicated patients, as well as further refine the skills necessary to be a skilled general internist and consultant.
The second year rotation schedule includes:
- General Inpatient Internal Medicine, VAMC (4 weeks)
- Hospitalist Service, IMMC (4 weeks)
- ICU Medicine, IMMC (4 weeks)
- Cardiology Service, Telemetry and CCU (4 weeks)
- Night Medicine (Mon-Fri) (6 weeks, divided into 2 week blocks)
- Infectious Disease (4 weeks)
- Nephrology (4 weeks)
- Neurology (4 weeks)
- Ambulatory Blocks (6 weeks)
- Electives (8 weeks)
- Endocrinology (4 weeks)
Third Year Schedule
The third year provides an opportunity for residents to further refine their knowledge and skills in the management of often complicated patients, and the skills necessary to direct and lead a team. Furthermore, third year residents have the opportunity to further develop and refine their teaching skills, and teach first year residents and medical students on all three of our campuses.
You'll complete the core of subspecialty service rotations during the third year. There is ample elective time available to allow you to pursue a variety of clinical activities of your choosing. The year includes an experience as senior resident consultant to the Broadlawns inpatient medicine service.
The third year rotation schedule includes:
- Supervising Resident, Inpatient General Internal Medicine, IMMC, BMC (10 weeks)
- Night Medicine (4 weeks, divided into 2 wk blocks)
- Gynecology/Women's Health (2 weeks)
- ICU (4 weeks)
- Geriatrics (4 weeks)
- Rheumatology (4 weeks)
- Hematology-Oncology (4 weeks)
- Board Study (4 weeks)
- Research/Publications/Presentations (2 weeks)
- Electives (14 weeks)
Electives are available in both the second and third years. This will allow you to tailor your education in a manner that allows you the opportunity to refine your knowledge and skills in order to best meet your professional goals and aspirations.
- Administrative Medicine
- Adolescent Medicine
- Cardiology Diagnostics
- Clinical Pharmacology
- Community-Based General Internal Medicine, Rural and Urban
- Emergency Medicine
- GI Consult
- Gynecology- Intensive (outpatient)
- Hospice and Palliative Care
- Hospitalist Medicine
- International Medicine
- Occupational Medicine
- Physical Medicine and Rehabilitation
- Public Health
- Pulmonary Medicine
- Sleep Medicine
- Sports Medicine
Research rotations are available. A research elective will allow you to become familiar with principles of research, including study design and implementation, analysis of data, biostatistics, and the process of writing and submitting a manuscript for publication.
The University of Iowa - Des Moines Internal Medicine Residency program offers you the opportunity to learn a wide variety of procedures. You will first have the opportunity to learn the indications, contraindications, and complications of commonly performed procedures through engagement with source materials provided by the program. You will first learn and practice many of these invasive procedures in a simulation lab. Close bedside supervision by faculty physicians working one-on-one with you will help you master a number of procedures not ordinarily encompassed in all internal medicine residency programs.
Regularly Mastered Procedure Skills
- Central venous line placement
- Chest tube insertion
- Arterial line insertion
- Mechanical ventilator management
- Lumbar puncture
- Skin biopsy
- Endotracheal intubation
There are many opportunities for involvement in research available to residents in our program. This comprises primarily clinical and outcomes-based research.
There are tremendous opportunities for research available to residents in the program with excellent advisors and mentors to support and encourage those who elect to participate. Each year the program conducts a grand rounds devoted to "Research in Des Moines" where the results of research efforts for the prior year are highlighted. Information is also shared regarding new research opportunities available to residents in the upcoming year.
Residents and faculty publish and present results of this research at regional, national and even international scientific meetings. Several residents have initiated research projects during residency training that they will continue and take with them to their fellowship training site after graduation.
- The Stoddard Cancer Research Center: perform pioneering bench research developing new treatments for cancer and other genetic diseases.
- The Office of Clinical Research: assist residents and faculty with clinical research studies.
- The University of Iowa Preventive Intervention Center: support several research projects enrolling patients from central Iowa.
- The Iowa Oncology Research Association: coordinate a large number of clinical research projects studying prevention, screening and new treatments for cancer.
- Hayden Smith, PhD, M.P.H. Research Coordinator: plays an active role assisting faculty and residents in the design, implementation and analysis of data in clinical research projects, as well as the final writing and submission of manuscripts.
In addition to the above resources, the Department of Research at Iowa Methodist Medical Center has strong ties with Drake University, Iowa State University and the University of Iowa. Researchers from these three major universities may provide collaborative support when needed with such things as grant applications, research study design, statistics and writing manuscripts.
Preliminary Year in Internal Medicine
The University of Iowa - Des Moines Internal Medicine Residency program offers two one-year preliminary internal medicine positions designed to provide a solid year of internal medicine for those preparing to enter other specialties. The preliminary year provides exposure to diverse medical problems that provide a foundation for further training in a variety of different specialties. Note that the preliminary medicine residents have a traditional, not block, schedule.
If after completing the preliminary year, you choose to continue training in internal medicine, this preliminary year meets all requirements of the American Board of Internal Medicine for the first year of training. You would only need to complete two additional years of internal medicine residency training to meet board eligibility requirements.
The Preliminary Year Schedule Consists of...
- Inpatient General Internal Medicine, IMMC, VAMC, BMC (16 weeks)
- Inpatient Pulmonary Medicine, IMMC (4 weeks)
- Inpatient Gastroenterology, IMMC (4 weeks)
- ICU Medicine, IMMC (4 weeks)
- Night Medicine (Mon-Fri) (2 weeks)
- Emergency Medicine, IMMC (4 weeks)
- Ambulatory Medicine (4 weeks)
- Electives (14 weeks)