Wards
General medicine ward rotations comprise the core experience of the internal medicine residency. Interns admit, diagnose, and manage patients with a broad range of internal medicine problems, while serving as the primary caregiver of the medical team. Residents lead teams of two interns and oversee management decisions, teach interns and medical students, and guide their team through clinical decision making. There are multiple educational opportunities provided through conferences, formal and informal daily rounds, and afternoon teaching sessions. During ward rotations, each team of interns and residents has two dedicated general internal medicine or subspecialist attendings who lead teaching conferences with particular focus on current medical dilemmas on the ward. Teams are arranged and located geographically by Firms, meaning that most of the team’s patients are located on one or two floors of the hospital.
Quick Facts about Wards at BIDMC
- Five to seven patients per intern, on average.
- Every 4th night on call with no overnight call, with this general sequence:
- On call: admit until 8:30 pm with your team, usually out by 11 pm
- Post call: no admissions
- Short call: accept patients admitted by nightfloat in the morning, up to two per intern
- Pre call: no admissions
- Three attending groups that admit patients:
- HMED hospitalist group: This group of hospital-based physicians attend on any patient without a PCP, or PCPs who have decided to defer inpatient care to this group of hospitalists.
- Affiliated Physician Group (APG) hospitalists: A different group of hospitalists caring for patients whose primary care physicians are affiliated with BIDMC.
- Healthcare Associates & private attendings: Physicians in our own primary care practice at BIDMC or other local primary care physicians who care for their own patients in the hospital, representing the smallest percentage of wards admissions.
- Dedicated teaching attendings with afternoon teaching sessions four times per week, in addition to usual conferences.
- One entire weekend off per month, work both days one weekend per month (no days off), and two weekends with one day off.
- Most interns have three to four ward months during the year, while an average resident may have two to three wards months per year.
- Geographic admitting means that patients are concentrated on one or two floors allowing improved communication among interns, residents, nurses, case management, and ancillary staff.
