Rotation Details

Overview

Residents at Exempla Saint Joseph Hospital serve on inpatient rotations in General Internal Medicine, Critical Care, and Oncology.  All first year residents rotate for one month at Denver Health Medical Center for Emergency Medicine.  Elective rotations are available in all specialties, and are offered in each year of training.  Residents in the three-year categorical track also practice ambulatory medicine in the Caritas Clinic, a charitable clinic for the underserved, one half day per week throughout the year.  All rotations strictly adhere to the guidelines and work hour regulations of the American College of Graduate Medical Education.

The numbers of months allotted to each rotation are different for each post-graduate year, and are summarized below:

 

Post-graduate year	Gen. Medical Wards	ICU	EFIT	MIM	Onc	ED	Float	Elective
PGY I (Prelim.)	4-5	1-2	0-1	1	0-1	1	1-2	2
PGY I (Categ.)	4-5	1-2	1	0-1	1	1	1	2
PGY II	3-4	1-2	0-1	0-1	1	0	1	5
PGY III	1-2	1-2	1-2	1-2	0-1	0	0-1	6

 

General Medicine Wards

There are four inpatient Ward teams at Exempla Saint Joseph Hospital. Each house staff team consists of one senior resident (PGYII or III) supervising two interns (PGYI), and possibly a medical student (MSIII or IV). Residents are responsible for the care of patients from admission to discharge, and are the primary providers for the patients. Residents are supervised by both managing attendings who oversee and teach the day-to-day care of individual patients, and a teaching attending who meets with the team regularly throughout the month for more detailed discussion of patients and their diagnoses. Teams take "long call" every fourth night, triaging new admissions to the various Ward teams until 9:00 p.m. Sunday through Thursday, and staying overnight on Friday and Saturday. Overnight admissions during the week are the responsibility of the Night Float team, which transfers the care of these patients to the Ward teams in the morning.

Night Float

There is one Night Float team on service every month, consisting of one supervising resident (PGY II or III), and two interns (PGY I). Residents are responsible for cross-cover management of inpatients on the teaching services, and for new admissions. The team is in the hospital during the week, Sunday through Thursday, from 7:00 p.m. until 7:00 a.m. Supervision of the Night Float team is by the admitting physician for each specific patient. Care of patients admitted overnight is transferred to the Ward teams in the morning.

Exempla Faculty Inpatient Team (EFIT)

One EFIT team is on service each month, consisting of a senior resident (PGY II or III) supervising one intern (PGY I) and frequently a subintern (MS IV). Residents on the EFIT team are responsible for admission and ongoing care of patients from the Caritas Clinic (our resident-run clinic), and "unassigned" patients from the Emergency Department (those patients without a primary care physician or with a primary care physician who does not have privileges at Exempla Saint Joseph Hospital) in rotation with the MiM team (See below). The EFIT service follows these patients in and out of the ICU, and provides medical consultations for other specialties in the hospital. The team is supervised by one of the Internal Medicine Faculty, who serves as both the teaching and managing attending. The EFIT team is in house daily, but has no overnight call. The

Midtown Inpatient Medicine (MiM)

One MiM team is on service each month, consisting of a senior resident (PGY II or III) supervising one intern (PGY I) and frequently a subintern (MS IV). The MiM Group is a private hospital-based physician group that provides inpatient services (admission and consultation) for private physicians in the community. Residents on this team are responsible for admission and management of these patients and unassigned patients from the Emergency Department in rotation with the EFIT team. The MiM team follows patients in and out of the ICU. Residents are supervised by one of the MiM physicians, who serves as both the teaching and managing attending. The MiM team is in house daily without overnight call. The Night Float team covers cross-cover issues and new admissions.  Night Float team covers cross-cover issues and admits new patients.

Critical Care Medicine

Three critical care teams are on service each month at Exempla Saint Joseph Hospital, consisting of a senior resident (PGY II or III) supervising one intern (PGY I), and one subintern (MS IV). Residents are the primary caretakers of patients in the Intensive Care Unit, responsible for admission and ongoing management. Each team is on overnight call every third night, and is responsible for all medical admissions to the ICU, all adult COR-Zero (Cardiac or Respiratory Arrest) calls in the hospital, and all Rapid Assessment Team (RAT) calls in the hospital. When patients transfer out of the ICU, one of the General Medical Ward teams assumes their care. Critical Care teams are supervised by a managing attending for the day-to-day care of each patient. Additionally, the three teams round at the bedside together every weekday with a teaching Pulmonary and Cardiology Critical Care physicians. During this month the residents do not have responsibilities at the Caritas Clinic.

Oncology Medicine

One Oncology team is on service each month, consisting of one senior resident (PGY II or III) supervising one intern (PGY I), and frequently one subintern (MS IV). Residents are responsible for the care of patients admitted to the hospital with hematologic or oncologic illnesses. Residents are supervised by both managing Oncologists who supervise the day-to-day care of individual patients, and a teaching Oncologist who meets with the team regularly throughout the month for more detailed discussion of patients and their diagnoses. The Oncology team is in house daily without overnight call. The Night Float team covers cross-cover issues and new admissions.

Emergency Medicine

Every intern (PGY I) rotates for one month at Denver Health Medical Center, the premier Emergency Medicine training program in the United States. Residents are responsible for assessing patients as they enter the Emergency Department, formulating and implementing the plan of care, and discharging them appropriately. Residents work on a shift schedule, and are supervised by senior Emergency Medicine resident and attending physicians. Residents do not have responsibilities at the Caritas Clinic this month.

Elective Rotations

Elective months are available to all residents in each year of training. Residents have numerous options for their elective months, allowing them to tailor their training to their interests. Elective rotations are available in all specialties, and are offered at Exempla Saint Joseph Hospital, University of Colorado Health Sciences Center, and local private and HMO offices. Additionally, residents may arrange unique elective months to suit their own educational goals. This includes rural, out-of-state, or international settings. Residents have participated in rotations in Europe, Africa, Asia, Central and South America. They have the option to organize the rotation themselves or participate in the overseas programs affiliated with Exempla Saint Joseph Hospital. Residents have rotated all over the United States, and around the world to China, England, Guatemala, India, Nepal, Pakistan, Peru, Tanzania, and Thailand.