The transitional year PGY-1 residency consists of fixed rotation requirements for all participants where they gain experience working in various environments.
ICU and CCU Rotation
During the first two blocks of the program, the resident will rotate on CCU, CVICU, MICU and/or SICU to become familiar with the care of patients with acute respiratory failure, myocardial infarction, septic shock and other situations that require treatment in the intensive care unit. The resident will learn how to place various types of catheters, including subclavian and Swan-Ganz catheters, and interpret the data. They will also learn intubation procedures and become familiar with critical care medicine.
During this rotation, the PGY-1 resident will interact with family medicine residents, internal medicine residents and residents in the Houston Methodist Hospital General Surgery Training Program.
Ward Medicine Rotation
The second required rotation consists of three blocks of ward medicine. During these rotations, the PGY-1 resident will become familiar with general internal medicine patients, as well as those requiring specialized care, such as oncology, nephrology or gastroenterology. The resident will work with family medicine residents and internal medicine residents of the same level. There is also constant communication with a number of staff physicians and senior-level family medicine and internal medicine residents. This rotation includes daily teaching conferences.
Emergency Department Rotation
The third required rotation consists of four weeks in the Emergency Department. During this rotation, the resident will complete 16 shifts, each lasting 10 hours. The rotation is supervised by board-certified emergency medicine physicians. This rotation includes a series of didactic lessons and lectures.
Ambulatory Care Rotation
The fourth required rotation consists of four weeks of ambulatory care in the Family Medicine Clinic at Denver Harbor.
Note: The first year requirements for residents entering anesthesiology or neurology are set by those programs and differ from the core requirements for the Transitional Year. Please review your program requirements on the ACGME website.
Transitional Year Core Rotation Requirements
The PGY-1 resident must also meet the transitional year core rotation requirements. These rotations are electives and can be structured based on the interests of the resident. Below are some typical elective rotations:
- Radiology: The resident spends time with upper-level University of Texas radiology residents and Houston Methodist radiology staff to learn the fundamentals of radiology. They may also work in radiation therapy if this is an area of interest. Other sub-selective rotations, such as nuclear medicine and MRI and CAT scan interpretation, may also be structured.
- Dermatology: The resident spends time on one of three rotations, with an active general dermatology practice, a dematopathologist or a Mohs surgeon.
- Infectious Diseases: The resident will be involved in the care of inpatients and outpatients receiving antibiotic therapy. They will learn how to deal with a number of unusual infections, including problems associated with AIDS.
- Oncology: The resident will gain inpatient experience admitting patients in the hospital and seeing patients with various types of hematologic and solid tumor malignancies. The resident will also learn how to perform bone marrow examinations and how to evaluate patients with various forms of malignancy.
- Pulmonary Diseases: The resident will become familiar with the specialty of pulmonary diseases, and learn how to interpret bronchoscopic data and pulmonary function studies. Patients will be seen in both the hospital and ambulatory care facilities.
- Ophthalmology: The resident will become familiar with the care of general ophthalmic patients. Much of the time is spent in an office setting, but some time is spent in the operating room observing the various surgery techniques and learning their indication.
- Occulopathology: The resident will be instructed in the principles of pathology and interpretation of findings in specimens obtained during ophthalmic procedures. They will also prepare specimens, work directly with the pathologist and observe procedures used in the acquisition of specimens.
- Surgery: The resident will interact with the various surgery residents and staff physicians.
- Obstetrics/Gynecology: The resident will learn how to evaluate routine gynecological and obstetrical (OB) problems and participate with the resident house staff in the care of hospitalized obstetrical and gynecological patients. An OB ultrasound rotation is also available, which has been of interest to residents wanting to specialize in radiology.
- Rheumatology: The resident spends time with board-certified rheumatologists examining patients in both the inpatient and outpatient setting.
- Anesthesiology: The resident becomes familiar with intubation and various anesthetics in the operating room setting, as well as various types of venous and arterial catheters and monitoring equipment.
Additional rotations are available depending on the particular interests expressed by the resident.
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