Schedules and Rotations
How it looks: 4+2+2
Our schedule is built on a 4+2+2 framework, but we believe a "one-size-fits-all" approach doesn't work for residency. That's why our rotation structure evolves with you, providing a different experience for interns and senior residents.
This model was designed with direct resident feedback to ensure you get the right structure at the right time in your training.
A note to our prelims: If you are prelim intern, change the ambulatory blocks to subspeciality blocks, plus you get a month of emergency medicine to round out your medicine education before you head off to your chosen field. Not much else changes. We do our best to treat preliminary interns like our categorical interns - part of the family.
Designed for Continuity & Community
We believe that learning, well-being, and patient care thrive on connection. Our entire program is structured to create strong, consistent relationships at every level.
Your Rotational Team: On all core inpatient rotations—Floors, ICU, Nights, and Admissions—an intern is always paired with a senior resident. This ensures you are part of a dedicated, supportive team, providing direct, in-the-moment mentorship where it counts the most.
Your Ambulatory "Home Base": Throughout the year, your 2-week ambulatory blocks are spent with the same small cohort of residents (2 interns, 2 PGY-2s, and 2 PGY-3s). This creates a year-long "peer family" for shared learning, support, and a consistent community outside of the hospital walls.
The Clinical Curriculum: Year by Year
The Intern Year: Building the Foundation
Your first year is focused on building a rock-solid clinical foundation. To provide stability and deep immersion, your schedule is anchored by 4-week medicine ward blocks.
The rest of your 8-week cycle is composed of two 2-week blocks for other core experiences (like ICU, nights, or subspecialty electives) and your protected 2-week ambulatory block. This predictable rhythm helps you master the fundamentals of inpatient medicine.
The Senior Years (PGY-2 & PGY-3): A Path to Autonomy
As a senior resident, your schedule is designed to help you master team leadership and prepare for independent practice. You will build your skills through a variety of leadership roles. As a PGY-3, you will continue to refine these skills while also taking on unique capstone rotations that serve as your final step toward independent practice.
Core Leadership Rotations (PGY-2 & PGY-3)
Both PGY-2 and PGY-3 residents lead and teach on our core services, composed entirely of 2-week blocks.
Leading the Ward Team: On our traditional floor teams, you will lead and mentor two interns, honing your skills in managing team workflow, delegating responsibility, and teaching multiple learners.
The 'Team 3' Model: On this 1-on-1 service, you will directly manage your own patients while simultaneously supervising your intern on their patients. This rotation is designed to help you master the crucial balance between direct patient care and mentorship.
ICU Leadership: All residents on our standard categorical track complete four weeks of ICU training each year. As the senior resident, you will lead a multidisciplinary team in a high-acuity environment, sharpening your clinical decision-making and crisis management skills.
Exclusive PGY-3 Capstone Rotations
These capstone rotations are a key feature of the PGY-3 year, integrated into your schedule by adjusting time spent on the core Wards and Team 3 services. This progression allows you to transition from leading teams to preparing for independent practice.
ACE (Attending Collaborative Experience): You run the team. On a service without interns, you manage all aspects of patient care, with faculty serving as your direct mentors—a true capstone experience that mirrors attending life.
Consultative Medicine: Refine your skills as an expert consultant. You will co-manage a broad range of complex surgical and OB/GYN patients, solidifying your role as a specialist in Internal Medicine.
Advanced Customization: PGY-2/3 Tracks
Beginning in their PGY-2 year, residents can choose to enter a specialized track to align their training more closely with their career goals. These tracks modify the standard curriculum, for example, by providing additional ICU time for those pursuing Critical Care or further shaping the outpatient experience for those in our Primary Care track. This flexibility allows you to begin specializing while still building a strong foundation in general internal medicine.
Typical Day on inpatient in the first year:
7:00 AM – Night float signs out to day team with Nocturnist oversight. Night float goes home.
8:00 AM – Teaching attending checks in with intern about patients – just like a senior resident would do
9:00-10:30 AM – Walk/bedside rounds with Attending and two interns that make up the team
11:30 – 12:30 – Interdisciplinary rounds with entire care team. Seniors present while interns have power-hour to get work done.
12:30 - 5:00 PM - Care for patients and get work done.
1:30 - 3:30 PM (Tuesdays & Thursday) – Academic half day
4:30 - 5:00 PM – Sign out to swing intern and then go home if not swing intern
5:00 - 9:00 PM – Swing intern manages resident floor patients – Admitting senior and attendings on site
9:00 PM – 7:00 AM – Night Resident and Night Intern cover admitted teaching patients. Resident is focused on admissions while intern is focused on cross-coverage
Call & Nights: A Supported & Sustainable System
Our goal is simple: a night coverage system that prioritizes patient safety, resident education, and sustainable well-being.
But our commitment goes deeper than simply eliminating 24-hour call. The true measure of a sustainable system is how it protects residents when they are off service. At our program, this means residents on ambulatory and elective rotations never cover weekend or night shifts. Your protected time is never borrowed for inpatient needs—a rare guarantee that reflects our deliberate and thoughtful approach to scheduling.
The Swing Shift: Team-Based Cross-Cover
This duty rotates among the five floor interns, 7 days a week. Our swing interns are never alone and benefit from layers of senior support.
Daytime Support: Throughout the day, the three floor seniors are always available to help all on-duty interns manage Rapid Responses and Codes, ensuring you have immediate help when you need it most.
Weekday Evening Support: Support is structured for a seamless handoff to the night team. The intern's day senior typically leaves around 5 PM, at which point the dedicated Medicine Admissions Resident (MAR) becomes the primary senior support. By design, the Swing intern's shift and the MAR's shift both conclude at 9 PM, ensuring a single, clean handoff to the arriving Night Float team and maximizing continuity of care.
Weekend Evening Support: One of the three floor seniors stays late, functioning as the MAR. They work directly with the swing intern, who handles cross-cover but may also assist with admissions (in a Medicine Admissions Intern, or MAI, role).
The Night Float Rotation & The Golden Weekend Guarantee
Night Float is a two-week rotation with a dedicated team and clearly defined roles. This structure is the key to one of our program's most valued features: the guaranteed golden weekend.
The Team & Roles: One intern (Night Float) is paired with one senior resident (Night Resident). The intern focuses on managing admitted patients, while the senior focuses on new admissions.
The Golden Weekend Guarantee: The Night Float team works six nights a week, with Friday nights off guaranteed. This shift is covered by the dedicated MAR/MAI team. By keeping night coverage contained within these two teams (NR/NF and MAR/MAI), we can make a simple promise: residents on ambulatory and elective rotations have a golden weekend (both Saturday and Sunday off) every time. Your protected time will never be interrupted by cross-cover duties.
The Ultimate Safety Net: Layered Support for the Entire Team
This is the most important feature of our night system. While your senior resident is your partner and first line of support, we believe in providing an unparalleled safety net for the entire team.
We have a minimum of two hospitalists/nocturnists on-site and in the hospital, 24/7. This means that if your senior resident needs support, is managing another critical patient, or if you simply need immediate faculty-level guidance, expert help is just steps away. You will never have to call an attending at home or wait for a callback during a critical moment.
This system empowers our residents to take ownership with confidence, knowing they are fully supported at all times.
Rotation Weeks by Program Year
PGY-1:
Wards: 16 weeks
Critical Care: 4 weeks
Night Float: 6 weeks
Ambulatory: 12 weeks
Subspecialty/Elective: 10 weeks
Vacation: 4 weeks
PGY-2:
Wards: 12 weeks
Critical Care: 4 weeks
Night Float: 6 weeks
Ambulatory: 12 weeks
Subspecialty/Elective: 12 weeks
Palliative Care: 2 weeks
Vacation: 4 weeks
PGY-3:
Wards: 8 weeks
Critical Care: 4 weeks
Night Float: 6 weeks
Ambulatory: 12 weeks
Subspecialty/Elective: 12 weeks
Consultative Medicine: 4 weeks
ACE: 2 weeks
Vacation: 4 weeks