Categorical Program Description

The Department of Medicine’s Residency Program seeks to educate residents to be outstanding practitioners, lifelong learners, critical thinkers, and patient advocates. We seek to provide an educational environment conducive to a lifetime of study, problem solving, and excellent clinical judgment in the practice of internal medicine. The program provides a well rounded core curriculum that meets the requirements of the ACGME yet is diversified and flexible enough to allow every resident the education which best suits his or her career goals. All residents have the opportunity and are encouraged to do research with clinical and basic science researchers.

Rotation Sites

Our Categorical residents rotate between the University of Kansas Hospital, the Kansas City VA Medical Center, and the Dwight D. Eisenhower VA Medical Center in Leavenworth.

The University of Kansas Hospital (KUMED)

• KUMED offers seven major medical services: four General Medicine services, as well as subspecialty inpatient Hematology, Oncology, and Nephrology teams. The Med IV service is a hospitalist service composed of a staff, senior resident, and a nurse practitioner. All other inpatient services are comprised of a staff, supervising resident, and two interns.
• There are two critical care services: the Coronary Care Unit and the Medical Intensive Care Unit.
• Residents also gain experience on several subspecialty consult services which include Cardiology, Dermatology, Endocrinology, Gastroenterology, General Medicine, Geriatrics, Hematology, Infectious Diseases, Nephrology, Neurology, Palliative Care Medicine, Pulmonary, and Rheumatology. These consult services involve both inpatient consults and ambulatory clinics.

The Kansas City Veterans Affairs Medical Center (KCVAMC)

• KCVAMC offers four major medical services: three General Medicine teams and one CV team.
• There is one critical care unit: the Medical Intensive Care Unit.
• Consult services include Cardiology, Dermatology, Endocrinology, Gastroenterology, Hematology/Oncology, Infectious Diseases, Nephrology, and Pulmonology.

Dwight D. Eisenhower Veterans Affairs Medical Center (DDEVAMC)

• The Dwight D. Eisenhower VAMC is located in Leavenworth, KS approximately 30 miles from KUMED.
• This rural VA hospital offers two inpatient General Medicine teams with an open MICU.
• Residents take no overnight call while rotating through this site.
• Senior residents have the opportunity to gain exposure in long term geriatric care, substance abuse treatment, podiatry as well as cardiac stress testing while at the DDEVAMC.

Typical First Year Resident Schedule (R-1)

• 6-7 blocks of general and subspecialty inpatient services.
• 1-2 blocks of ICU experience.
• 8-12 weeks on non-inpatient experience in the emergency department, outpatient medicine clinics, or consult services.
• 6 weeks of night float.
• Due to the intern night float system, interns have only 1 or 2 overnight calls per inpatient block on the general medicine and subspecialty wards at KUMED and KCVAMC.
• Interns can expect q5 overnight call on the KUMED ICU rotation.
• There is no call while on non-inpatient blocks.
• 7-8 blocks will be at KUMED, 3-4 blocks at the KCVAMC, and 0-1 blocks at Dwight D. Eisenhower VAMC in Leavenworth, KS.

Typical Second and Third Year Resident Schedule (R-2 and R-3)

• INPATIENT SUPERVISING: 6 blocks divided between 2nd and 3rd year. These blocks involve guiding 2-3 interns as well as 2-3 medical students in the care of inpatients.
• NIGHT FLOAT: 4-6 weeks over two years.
• ICU: 3-5 blocks over two years.
• ER: 1-2 blocks total between 2nd and 3rd year.
• SELECTIVES: 10-12 blocks of selective time divided between 2nd and 3rd year.
• The upper level residents (R2/R3) participate in our night float system as detailed below.
• During the 2nd and 3rd years of residency, up to three blocks of elective time can be designated for research.
• International electives can be arranged during the 2nd and 3rd years.

KUMED and KCVAMC Ward Inpatient Night Coverage

• Our residency program utilizes an intern and senior night float system on the inpatient wards at KUMC and KCVA.
• All interns and upper level residents will rotate in a two week ward night float block. The night float team is made up of two interns and one senior resident.
• The night float rotation runs from 7 pm to 7 am, Monday through Friday, for two consecutive weeks. Weekends are excluded from this coverage schedule.
• An intern can expect to spend 4-6 weeks covering night float while an upper level will spend 2-4 weeks covering night float per year.
• Interns on inpatient blocks have one or two overnight weekend calls per block in order to relieve the night float team.
• Senior resident weekend inpatient ward coverage is divided amongst the senior residents rotating on the inpatient wards and the senior residents on consult rotations. Those seniors on inpatient rotations will cover one to two weekend 12 hour shifts per block while consult senior residents will cover one 12 hour weekend shift per block.

KUMED Unit Night Coverage

• The KUMED ICU and CCU teams are staffed to sufficient levels to allow for residents from within each team to provide night coverage by means of a night shift resident
• Senior residents in the KUMED ICU will spend seven consecutive nights covering the unit from 7pm to 7am during their ICU rotation; senior residents have no other night coverage responsibility while in the KUMED ICU.
• Interns can expect to take q5th overnight call while in the KUMED ICU; interns will take call along side a senior resident.
• All residents in the KUMED CCU will spend 4-5 consecutive nights covering the unit from 7pm to 7am during their CCU rotation; residents will have no other night coverage responsibility while in the KUMED CCU.

Ambulatory Care

• All categorical residents have at least one half day a week of continuity care clinic during their three years of residency.
• Rotation sites for our resident continuity clinic include KUMED, an alternating site clinic at KUMED and the KCVA, Silver City Health Clinic or Swope Park Health Clinic.
• Preliminary residents do not participate in a continuity clinic care experience.
• All interns have 1-2 blocks of ambulatory exposure—in the emergency department or a dedicated ambulatory rotation.
• All upper level residents do 2-4 weeks of Urgent Care Clinic during their 2nd and 3rd year.
• Residents rotate in subspecialty clinics during their rotations on various consult services.
• The urgent care and continuity clinics at KUMED added Logician, an electronic medical record, in January of 2005 in order to improve documentation and patient care in residents’ continuity clinic.

Teaching Conferences

Excellence in both clinical and didactic education has long been a strength of the KU residency program, as evidenced by our April 2000 ABIM evaluation. At that time we were praised for our "Strong commitment to the training of practicing clinicians," the "availability of the faculty to teach the residents to be excellent physicians," and our "commitment to the importance of excellence in medical education."

Teaching conferences are held as follows:

• Grand Rounds is held each Wednesday morning at 8:00 a.m.
• The Core curriculum lecture series takes place 12:00-1:00 p.m. on Monday, Tuesday, and Thursday, and occasionally on Fridays, 12:30-1:30 p.m. These lectures are mandatory for all housestaff and are televised from the University to the KCVA and Leavenworth VA Hospital. Lunch is often provided.
• Morning report is held each weekday morning at 8:00 a.m. except on Wednesdays. The program directors, faculty from all subspecialties, housestaff, and medical students attend and participate in morning report.
• General Housestaff meetings occur once a month as a forum for housestaff to voice opinions of their rotations and the program.
• Journal Club, a literature review conference, occurs once per month in place of a noon conference.
• The Clinicopathologic Conference (CPC) is held the second Monday of the month.
• The Morbidity and Mortality (M&M) conference occurs on the fourth Monday of the month.

Moonlighting Opportunities

Moonlighting opportunities are available for R-2's and R-3's. One week of locum tenens is allowed per year, in addition to the resident’s three weeks of vacation, for 2nd and 3rd year residents in good standing. These are arranged through the University of Kansas School of Medicine Rural Health Education and Services. The University provides malpractice insurance for residents participating in locum tenens arranged by the Rural Health Office.