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
- Multiple educational opportunities are provided through conferences,
formal and informal daily rounds, and afternoon teaching sessions.