The Transitional Year Residency Program provides an excellent combination of required experiences and elective rotations that allow residents to tailor the curriculum to meet their needs. All residents will develop the fundamental clinical skills that are the core of transitional year residency training.
Required Pediatric, Internal Medicine, Surgery, Critical Care, Ambulatory Medicine and Emergency Medicine experiences provide the transitional year resident the opportunity:
- To evaluate patients with a vast array of pathology
- To direct assessment and treatment of patients under the supervision of senior residents and faculty
- To learn proper documentation of patient care in the medical record system
- To work in interdisciplinary teams
- To contribute to hospital quality and patient safety improvement efforts
Well-Rounded Individualized Curriculum
Basic Curriculum Structure
Transitional Year Residency Program Curriculum
(13 four-week block rotations)
1. Inpatient General Pediatrics, Blank Children's Hospital 4 weeks
2. Surgery Service, Iowa Methodist Medical Center 4 weeks
3. Critical Care, Iowa Methodist Medical Center 4 weeks
4. Inpatient Internal Medicine (IMMC, BMC, VAMC) 12 weeks
5. Ambulatory Internal Medicine, Iowa Methodist Medical Ctr 6 weeks
6. Emergency Medicine, Iowa Methodist Medical Center 4 weeks
7. Night Medicine, Iowa Methodist Medical Center 2 weeks
8. Elective rotations: Great opportunities and flexibility 16 weeks
4 Weeks - Inpatient Pediatrics
Residents will work on an inpatient team with a pediatric hospitalist attending physician, a senior pediatrics resident, a pediatrics intern, and two medical students at Blank Children's Hospital. Great patient variety is available and the average intern census is 4-6 patients.
On call experience: One week night coverage (five nights); three weeks day only coverage.
4 Weeks - Surgery
Residents complete a surgery rotation at Iowa Methodist Medical Center, that includes both trauma and general surgery components. The general surgery component provides operative experience with an excellent variety of surgeries and surgical pathology available. The trauma surgery component provides an opportunity to evaluate, triage, stabilize and manage a wide variety of patients presenting after major trauma to Iowa Methodist's Level 1 Trauma Center.
On call experience: No overnight call. Rounds two weekends during the block.
4 Weeks - Critical Care
Residents work in the Medical ICU at Iowa Methodist Medical Center Medical, under the direction of a board-certified critical care teaching faculty. The team consists of a senior IM resident and a junior IM resident ans one senior medical student. Extensive procedural experience is provided. A variety of patients with multisystem disorders and patients requiring mechanical ventilation and hemodynamic support will be encountered.
On call experience: No overnight call. Rounds one weekend day each weekend during the block.
12 Weeks - Inpatient Internal Medicine
Residents complete three inpatient general medicine rotations at our three affiliated teaching hospitals: Iowa Methodist, Broadlawns, and the VA Medical Center. These experiences provide residents an outstanding variety of patient pathology with excellent senior resident supervision and strong faculty teaching. Daily noon conferences, weekly grand rounds conferences, and monthly journal club and morbidity and mortality conferences assure excellent didactics during these experiences.
On call experience: Veterans Affairs Medical Center: 12-hour weekend day shift three weekends during the block.
Broadlawns Medical Center: No nights but mixture of short and long (into evening) call days during the week. Round one weekend day each weekend during block.
Iowa Methodist Medical Center: 12-hour weekend day shift each weekend during the block.
6 Weeks - Ambulatory Internal Medicine
Residents work in the outpatient clinics with core ambulatory medicine faculty seeing a wide variety of patients. Patients presenting for health maintenance, minor acute concerns and more major acute problems will be seen during the month.
4 Weeks - Emergency Medicine
Residents work in the emergency room of the very busy Level 1 Trauma Center at Iowa Methodist Medical Center. Residents work 16 ten-hour shifts during this rotation and participate in the triage, evaluation and treatment of patients presenting with a variety of acute medical and surgical concerns. The rotation includes seeing patients with a wide variety of acute medical and surgical concerns, patients presenting after minor trauma (lacerations, sprains, strains, fractures, etc). and patients suffering more serious trauma-related injuries.
2 Weeks - Night Medicine
Residents will work five nights per week during the night medicine rotation under the direct supervision of hospitalist teaching faculty at Iowa Methodist Medical Center. Responsibilities include providing coverage for patients previously admitted to the inpatient medicine teaching services at Iowa Methodist while also evaluating and treating new patients requiring overnight admission to one of the three inpatient teaching services there.
16 Weeks - Elective Rotations
You can shape the remaining 16-weeks of your residency training through your choice of elective rotations, to help assure that the curriculum meets your individual needs and goals.
A wide variety of additional training experiences are available in a broad mix of specialties including:
- Adolescent Medicine
- Ambulatory Pediatrics
- Anesthesia Pain Management
- Hospice/Palliative Care
- ICU/Critical Care
- Infectious Disease
- Neonatal Intensive Care
- Obstetrics-Gynecology / Women's Health
- Pain Medicine
- Pediatric Orthopedics
- Physical Medicine & Reahbilitation
- Plastic Surgery
- Pulmonary Medicine
- Radiation Oncology
- Radiology (Diagnostic)
- Sports Medicine
- Vascular Surgery.
Elective Rotation Descriptions
A wide variety of elective rotations are available depending on your interest and future career plans. You may repeat any of the required experiences as elective options. There are also a number of additional experiences in pediatrics, general surgery and the surgical specialties, and internal medicine and the medicine subspecialty areas. There are no night or weekend call responsibilities during these elective rotation experiences.
A brief description of each of the elective rotation options is provided below.
Participate in a variety of outpatient adolescent medicine clinic experiences, including Blank Children's Hospital adolescent clinic. Polk County Public Health Department and other community-based programs, including school-based clinics and Planned Parenthood clinics.
Participate in outpatient pediatric clinics in the Blank Children's Clinic area and in the Blank Emergency Room area working with general pediatric and pediatric emergency room faculty.
Participate in a wide variety of operative cases including cardiac, vascular, thoracic, orthopedic, urologic and neurosurgical cases. There will definitely be opportunities to perform procedures such as endotracheal intubations, central line placements, arterial line placements, etc.
Anesthesia Pain Management
Work in a busy outpatient pain management center directed by anesthesiologists board-certified in pain management. Residents will see patients with a wide variety of pain syndromes of different types, locations and etiologies. Residents will learn about medical pain management options and about the many types of interventions available to treat patients with chronic pain syndromes.
Work with cardiology faculty participating in a variety of patient care activities including office evaluations, hospital admissions and consultations, and review of non-invasive cardiac studies including EKGs, Holter monitor studies, nuclear cardiology studies and echocardiograms.
Work with dermatology faculty participating in a variety of activities. This includes evaluation of new patients seeking dermatology consultation, seeing patients returning for follow-up care of chronic dermatology concerns and participating in a variety of dermatologic surgery procedures conducted in the office setting. There is also an opportunity to participate in review of dermatopathology studies during this rotation.
Work with board-certified dermatopathologists reviewing large numbers of specimens submitted for analysis by dermatologists and other physicians from across central Iowa. This will include the opportunity to review skin cancer excisions submitted in real time during Mohs surgical procedures.
Work with gastroenterologists on a busy hospital consultation service at Iowa Methodist Medical Center. There is an opportunity to see a wide variety of patients with gastrointestinal, hepatobiliary and pancreatic concerns. Patients will be seen and then staffed with a member of the group so there is extensive one-on-one teaching provided, including an opportunity to review multiple radiology studies and to participate in diagnostic and therapeutic endoscopy procedures.
Work one-on-one with a hematology-oncology faculty physician at the John Stoddard Cancer Treatment Center on the Iowa Methodist Medical Center campus. There will be an opportunity to see patients with both hematology concerns and patients presenting with a wide variety of cancers. Patients will mostly be seen in the outpatient clinic setting but there will also be an opportunity to see new hospitalized patients referred for hematology-oncology consultation.
Hospice / Palliative Care
Work with members of the palliative care team at Iowa Methodist Medical Center. There will be opportunities to assist in evaluation and care of both patients referred for palliative care consultation and patients referred for hospice care. Patients will be seen at Iowa Methodist Medical Center or at the Taylor house hospice facility that is affiliated with Iowa Methodist Medical Center. Residents will be provided on important end-of-life care topics and on hospice eligibility and benefits concerns to review during the rotation.
ICU / Critical Care IMMC
Participate in an additional elective experience in critical care at Iowa Methodist Medical Center. You will see and care for a wide variety of critical care patient problems. You will gain additional experience in performing endotracheal intubations, managing ventilators and completing a wide variety of invasive procedures during this rotation.
Participate on the Infectious disease Consult Service at Iowa Methodist Medical Center with an opportunity to work one-on-one with the ID Service Consult Staff Physician for the month. You can see a large number of hospitalized patients presenting with an array of ID-related concerns. There will also be an opportunity to participate in some outpatient clinics that allow for exposure to chronic ID concerns like the patient with HIV infection and follow-up of patients seen in the hospital who return for post-hospital care.
Neonatal Intensive Care Unit
Care for critically ill newborns, including neonates needing mechanical ventilation and learn application of physiologic principles in critical care. You will care for selected critically ill neonates under the supervision of senior pediatric residents and staff neonatologists. You will also participate in twice-weekly morning report, daily noon conference and weekly Pediatric Grand Rounds.
You can participate on the Nephrology Consult Service at Iowa Methodist Medical Center and be provided an opportunity to work one-on-one with the Nephrology Service consult Staff Physician for the month. You will see a large number of hospitalized patients presenting with a vast array of renal concerns. There will also be an opportunity to participate in some outpatient clinics that allow for exposure to proper diagnosis and treatment of common acute and chronic nephrology concerns.
Participate in the evaluation of patients presenting to clinic with new neurology concerns or follow-up of known neurology problems, and patients hospitalized at Iowa Methodist Medical Center needing neurologic consultation. There will be extensive opportunities to review neuroimaging studies and, if requested, an opportunity to review other neurologic diagnostic studies such as EEG and EMG-NCV studies.
OB-GYN / Women's Health
Participate in a variety of obstetrics, general gynecology, high risk OB and family planning clinics. There will also be an opportunity to participate in delivery of infants on the Obstetrics service if desired.
Work in several different ophthalmology clinic settings. Gain experience evaluating patients presenting with a wide variety of eye complaints. You can also choose too gain special experience in proper evaluation and treatment of disease of the retina, diseases of the cornea, pediatric eye disease, and even oculoplastic concerns
During this rotation, you will work with orthopedics teaching faculty. See patients presenting to the ER with acute musculoskeletal injuries, participate in several half-day general orthopedic clinics, and see hospitalized patients referred for orthopedic evaluation.
Residents will work with a board-certified pediatric orthopedist and see patients presenting to the clinic and to the ER with a variety of acute musculoskeletal injuries. In addition to clinic work, there will be an opportunity for residents to work in the OR. This rotation involves extensive review of radiology studies and can be a great benefit to radiology-bound TY residents.
During this rotation, you can work in several different areas including: reviewing hematology studies (peripheral blood smears, bone marrow results, etc), participating in anatomic pathology studies, reviewing surgical pathology specimens, and working in different areas of the clinical laboratory.
Physical Medicine and Rehabilitation
Residents will work with board-certified PM&R physician faculty and can work in both the hospital and outpatient clinic setting. In the hospital, resident can admit and manage patients admitted to the inpatient Younkers Rehabilitation Service and see new patient consultations requested for patients on other services. Iowa Methodist Medical Center is both a Level 1 Trauma Center and a Stroke Hospital of Distinction so there are many patients needing PM&R consultation and management services. Residents can also see a wide variety of patients needing outpatient PM&R services.
Work with pulmonologists on a busy hospital specialty service at Iowa Methodist Medical Center. There is a great variety of patients with varied pathology on the service. Supervision and teaching will be provided by one member of the group and there is extensive one-on-one teaching provided. There will be opportunities to review multiple radiology studies, review pulmonary function test results, and participate in diagnostic and therapeutic bronchoscopy procedures.
Work with board-certified radiation oncology physicians at the John Stoddard Cancer Center on the Iowa Methodist Medical Center campus. There will be an opportunity to see patients presenting for radiation treatment for a wide variety of different cancers. Patients will mostly be seen in the outpatient clinic setting but there will also be an opportunity to see new hospitalized patients referred for consultation. Participate in the weekly multi-disciplinary Tumor Board Conferences.
You may choose to concentrate on one area or complete one-week blocks in several different areas, including interventional radiology, body CT / ultrasound, neuroradiology, musculoskeletal radiology and pediatric radiology.
Transitional Year residents may select to use an elective rotation block to work on a research project that they have identified or developed in conjunction with local faculty. Projects may include basic science or clinical research; including writing up case reports, case series, clinical reviews, letters to editors, meta-analyses, or original research manuscripts for subsequent publication or presentation at regional or scientific meetings. The Director of Resident and Faculty Research at UnityPoint Health-Des Moines will provide direction and support for the rotation and can assist the resident in accessing resources needed t assure a successful experience (e.g. institutional approval, data acquisition, as well as statistical and writing assistance).
Work in the outpatient clinic setting seeing a great variety of patients presenting with a vast array of rheumatologic concerns. There will be opportunities to learn about diagnosis and treatment of these concerns, including the review of a great variety of musculoskeletal imaging studies and review of proper laboratory testing of these patients. Learn more about the proper role of PT and OT modalities and new infusion therapies in the care of these patients.
Meet with the orthopedics-sports medicine rotation director to determine a schedule for the month. Concentrated training in specific areas like upper extremity, spine and lower extremity injuries can be arranged. There is also an opportunity to work in the Orthopedic Urgent care Clinic seeing a wide variety of patients presenting with acute sports-related injuries.
Participate in an office-based urology rotation seeing patients presenting with a wide variety of genitourinary system complaints. Experience will be gained in proper physical examination of the prostate and scrotal areas. Review and interpretation of urologic x-ray studies will be completed during the rotation. Experience will also be gained in directing diagnostic work-ups and planning medical and/or surgical treatment of acute and chronic genitourinary system disorders.
Work with vascular surgery faculty and surgery residents in the evaluation and treatment of patients presenting with a wide variety of acute and chronic vascular concerns. Experience will be provided in both the interventional radiology suite and operating room areas of Iowa Methodist Medical Center.