Resident Work Schedule
The Categorical Programs operate on a "6+2" schedule, in which residents spend a dedicated 2 week block at their ambulatory continuity site, and then complete a 6 week block comprised of 2 or 4 week inpatient rotations, electives, research, vacation or night float.
The Preliminary Program does not have an ambulatory component and thus Preliminary Interns are not on the "6+2" system. However, Preliminary Interns will experience 2 week inpatient rotations.
Advantages of the "6+2" system:
Departing from the traditional "one day a week ambulatory continuity clinic" model, the 6+2 system offers numerous advantages.
If house staff have to go to their ambulatory site once a week, this brings them away from the inpatient ward or from an elective that is important to them. Handoffs are increased, interns and residents have to cover each other while someone is in clinic (on top of their other ward duties), and team cohesiveness is impaired. Under the 6+2 system, the entire team is present every day, with resultant reductions in handoffs and the need for coverage of each other, and an improved team dynamic.
Dedicated two week ambulatory rotations allow our residents to focus on being an ambulatory physician, without the need to juggle ongoing inpatient ward team duties at the same time. Patient scheduling is more flexible and patient-centered, with opportunities for increased continuity.
Although our inpatient rotations are demanding and intense, the 6+2 system gives the Program the ability to schedule residents for the most demanding rotations in 2 week blocks, as opposed to an often more stressful one month block.
Sample House Officer Yearly Schedules
PGY-1 Categorical
Inpatient Medical Wards: 3.5-4.5 months
Ambulatory Continuity Practice: 3 months, spread over 6 recurring 2 week blocks
Cardiac Intensive Care Unit: 1 month
Medical Intensive Care Unit: 1 month
Elective: See below under "Elective Time"
Night Medicine (aka "Night Float"): 4-6 weeks
Geriatrics: 0-1 month
Vacation: 1 month
PGY-1 Preliminary
Inpatient Medical Wards: 5-7 months
Cardiac Intensive Care Unit: 1 month
Medical Intensive Care Unit: 1 month
Elective: 4-6 weeks*
Night Medicine (aka "Night Float"): 4-6 weeks
Vacation: 1 month
Emergency Department: 1 month if required (Anesthesia - see below section on electives)
PGY-2 Categorical
Inpatient Medical Wards: 3-4 months
Ambulatory Continuity Practice: 3 months, spread over 6 recurring 2 week blocks
Medical Intensive Care Unit: 0-1 month
Emergency Department: 1 month
Inpatient Neurology: 0-2 weeks
Elective: See below under "Elective Time"
Night Medicine (aka "Night Float"): 4 weeks
Medical Admitting Resident/In-House Chief Medical Resident: 0-1 month
Geriatrics: 0-1 month
Vacation: 1 month
PGY-3 Categorical
Inpatient Medical Wards: 2-3 months
Ambulatory Continuity Practice: 3 months, spread over 6 recurring 2 week blocks
Medical Intensive Care Unit: 0-1 month
Inpatient Neurology: 0-2 weeks
Medical Consult/Rapid Response Team Leader: 1 month
Cardiac Intensive Care Unit: 1 month
Elective: See below under "Elective Time"
Night Medicine (aka "Night Float"): 4 weeks
Medical Admitting Resident/In-House Chief Medical Resident: 0-1 month
Geriatrics: 0-1 month
Vacation: 1 month
Elective Time
Categorical residents are allotted up to 6 months of elective over the course of their 3 year training.
Two to four weeks may be scheduled in the PGY-1 year. The remainder may be taken over the PGY-2 and PGY-3 years, to suit individual resident preference and to allow for natural variability in the schedule. Two months of elective must be taken in the ambulatory setting. The Geriatrics rotation is a mandatory elective (sometimes known as a "selective") as there is flexiblity in this experience to suit individual resident preference.
*Anesthesia Preliminary Interns: to satisfy advanced program's requirement for Emergency Department rotation, 2 or 4 weeks of your elective time will be used. Exact amount will vary depending on intern class make up.