The BIDMC Wards Clinical Experience
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 for their patients. Residents lead teams of two interns and oversee management decisions, teach interns and medical students, and guide their team through clinical decision making.
During ward rotations, each team of interns and residents has their own clinical attending and two additional dedicated general internal medicine or subspecialist attendings who lead teaching conferences each day with a particular focus on current medical dilemmas on the wards.
Geographic Admitting and Pod Based System
We recently introduced a novel pod-based care system that aligns work flow in a manner that maximizes efficiency, facilitates multidisciplinary rounds, enhances teamwork and improves patient care. Each pod, consisting of 8-12 beds (see graphic below), represents a team of a resident, 2 interns, 1-2 medical students, 2-3 nurses and an attending. Each resident team admits to their geographically localized pod. The goal of this model is to enhance teaching, teamwork and efficiency and to improve the patient experience and satisfaction.
Quick Facts about Wards at BIDMC
- Day teams work from approximately 7 a.m. - 5:30 p.m., six days per week with one weekend day off per week.
- The team cares for the patients on their pod, admitting patients as beds in their pod open; day teams admit until 4pm each day and a Twilight Team taking over at 4 p.m.
- A Twilight admitting team admits patients from 4 - 10 p.m. to allow the day teams to have a predictable daily schedule.
- Interns typically have three to four wards months per year and residents have one to two wards blocks per year.
- More than 95 percent of the patients are cared for by our academic hospitalist group, usually resulting in one attending per team of patients to enhance teaching, feedback and patient care.
- An intern’s average census is between six to seven patients on any given day.
- Multiple educational opportunities are provided through conferences, formal and informal daily rounds, and afternoon teaching sessions.