Ideally, we want you to spend most of your training on the steep part of your learning curve where you are adequately challenged and supported, however, not overwhelmed. When exercising you want the treadmill going fast enough to get a good workout, but not so fast that
you get tired too quickly or fall off! We think of your residency experience in the same way!
In July 2021 all of the University of Cincinnati Medical Center and Cincinnati Children’s Hospital Medical Center moved to a 13 4-week block schedule. This schedule will allow ALL residency programs to rotate together and become in sync with the medical students. Moving to this new format (from our previous 12 month block schedule) now allows all of our residents to have an additional block each year for an exciting learning opportunity.
First two years - Maintain 4/5/4 schedule rotating through IM and peds with the rest of your class. (Intern year - 4 blocks IM, 5 blocks peds, 4 blocks IM. Second year - 4 blocks peds, 5 blocks IM, 4 blocks peds)
Final two years - Can move between IM and peds in a block-to-block fashion as the schedule permits.
All of our residency classes stay together on the same discipline for the first two years of training. All residents start together in internal medicine and rotate together on a 4-5-4 4-week block schedule for the first two years of residency. Why is this important?
It allows each class to forge close bonds early in residency because you are always on the same side together. Early bonding = Friends for life!
It makes switches easier and less stressful because you are never alone, especially with the first one from internal medicine to pediatrics.
Once our residents hit their 3rd year they have grown in clinical confidence and we allow them to rotate on a more frequent basis as the schedule allows. In fact, we believe that having every class stay together during those critical first two years is a very important part of why we have such a low drop-out rate and high residency satisfaction.
During the first two years of residency we switch on a 4-5-4 block schedule. We refer to this as the “Goldie Locks” approach. Why Goldie Locks? Because 4-5 block switches are "not too long, and not too short". We have found this frequency of switching in the first two years allows for:
Development of a sense mastery after 4-5 blocks (hard to achieve in a combined specialty!) where you can relax a bit by the final block.
Optimal learning the first two years of residency for you stay at the steep part of your learning curve and avoid becoming bored or overwhelmed.
Seasonal variation in pediatrics – Think bronchiolitis and flu here, you want two winters of exposure, but not four.
Evening out of your conference series attendance in internal medicine and pediatrics, both of which have a series of early conferences for the incoming residents.
Providing our residents with a world-class ambulatory training experience is a major focus of our residency program. Since 2006 our internal medicine residency program has centered their ambulatory training experience around a long block model (starting in month 16 of residency) which allows for a concentrated ambulatory experience separated from the inpatient training experience. In order to align our ambulatory training experience with our internal medicine colleagues, we instituted an X+Y clinic block schedule while on inpatient internal medicine rotations in July 2022. In this model our residents do not have clinic half days while on internal medicine inpatient rotations, and instead, have their clinic for these rotations combined into 2-week clinic blocks. This allows for ease of internal medicine inpatient schedules and provides our residents with a concentrated ambulatory experience while on these blocks. During these clinic blocks our residents have two to four half days of continuity clinic over a week (depending upon level of resident), other clinical experiences related to ambulatory medicine, one half-day for administrative time, and one wellness half-day over a two-week period.
Our pediatric colleagues still function on a schedule that allows them to have clinic for one half day per week while on inpatient rotations. As such, our residents continue to have clinic for one half day per week while on pediatric rotations and do not have clinic blocks during these experiences.
An example of our block schedule and how clinic block experiences are arranged can be found here.
This cements the rigorous approach to differential diagnosis and independent decision making. The switch to pediatrics in October is easier than the reverse would be. You still start team leading in both internal medicine and pediatrics in the second year, easily keeping pace with your categorical counterparts.
There are 10.5 blocks of elective time during residency during which our residents get to select from over 100 different electives across our academic health center, including 11 combined, Med-Peds electives.
Our residents are never “supervised” by categorical residents at the same training year during residency. We are able to structure the schedule so that rotations early in the second year are “second year only” rotations and our residents are team leading with their peers by the middle part of their second year. As a result, there are only a few months of call in the third and fourth years. This is due to the “front loaded” design of our curriculum, in order to keep you up to speed with the categorical residents.