Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Residency Rotations

Transitional Year -- Residency Rotations

The fixed requirements of this PGY1 residency consist first of two blocks of ICU/CCU duty. The resident will be rotating on CCU, CVICU, MICU and/or SICU, During these rotations, the PGY1 resident becomes familiar with the care of patients with acute respiratory failure, myocardial infarction, septic shock and other situations in which patients are best treated in the intensive care setting. The PGY1 resident will learn how to place various types of catheters, including subclavian and Swan-Ganz catheters and interpret the data. The PGY1 resident will also learn intubation procedures and become familiar with critical care medicine. During this rotation, the PGY1 resident will interact with Family Medicine residents, Internal Medicine residents, as well as residents involved in the The Methodist (Houston) General Surgery Training Program.

The second required rotations consist of three blocks of Ward medicine. During these rotations, the PGY1 resident will become familiar with general internal medicine patients, as well as those requiring specialized care, such as oncology, nephrology or gastroenterology. The PGY1 resident will work together 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. There are daily teaching conferences during this rotation.

The third required rotation is a four-week tour in the Emergency Department. This rotation is supervised by board certified emergency medicine physicians and consists of 16 10-hour shifts. A series of didactic lessons and lectures are planned.

The fourth requirement for the Transitional Year resident is the completion of one 4-week ambulatory care rotation. This rotation takes place in the Family Medicine clinic at Denver Harbor.

Those who will be entering Anesthesiology or Neurology will have first year requirements that are set out by those programs. These requirements differ from the core requirements for the Transitional Year. Please review your program requirements on the ACGME website, www.acgme.org. In addition to these requirements,the Transitional Year core rotatation requirements must be met. The remainder of the rotations are electives. These can be structured depending on the interest of the PGY1 resident. Typical rotations may include some of the following:

Radiology: During this rotation, the PGY1 resident spends time with upper level University of Texas radiology residents and The Methodist Hospital (Houston) radiology staff and learns fundamentals of radiology. This month may also be spent in radiation therapy if this is the particular field the candidate is interested in. Other sub-selective rotations such as nuclear medicine and MRI and CAT scan interpretation may also be structured.

Dermatology: Three separate rotations are offered. The PGY1 resident may spend time with an active general dermatology practice, a dematopathologist or a MOH's surgeon.

Infectious Diseases: On this rotation, the PGY1 resident will be involved in the care of inpatients and outpatients receiving antibiotic therapy. The PGY1 resident will learn how to deal with a number of unusual infections, including problems involved with AIDS.

Oncology: The PGY1 resident will experience an inpatient rotation, admitting patients in the hospital, seeing patients with various types of hematologic and solid tumor malignancies. The PGY1 resident will learn how to perform bone marrow examinations and how to evaluate patients with various forms of malignancy.

Pulmonary Diseases: The PGY1 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 both in the hospital and in the ambulatory care facilities.

Ophthalmology: The PGY1 resident becomes familiar with the care of the general ophthalmic patient. Much of this is done in an office setting, but the PGY1 resident does spend time in the operating room observing the various surgery techniques and learning their indication.

Occulopathology: The resident will be instructed in principles of pathology and interpretation of findings in specimens obtained during ophthalmic procedures, prepare specimens, work directly with the pathologist and observe procedures used in the acquisition of specimens.

Surgery: The PGY1 resident may choose to take a month in the surgical area. During the rotations, the PGY1 resident will interact with the various surgery residents, as well as the staff physicians.

Obstetrics/Gynecology: The PGY1 resident will learn how to evaluate routine gynecological and obstetrical 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 our residents wanting to specialize in radiology.

Rheumatology: The PGY1 resident spends time with board certified rheumatologists examining patients in both the inpatient and outpatient setting.

Anesthesiology: The house officer 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 house officer. The above elective list is not necessarily complete, but does represent a majority of rotations that have been sought in the past several years.