Fl- Floor, FF- night float, UF- MICU night, CR- Clinic rotation, El- Elective, DF- day float, R/BV- research/Bellevue, Vac- Vacation.
Program Structure
The academic year at Lincoln Medical Center is divided into thirteen, four-week blocks.
Medical Ward Rotation:
There are 8 Medical Ward Teams who care for inpatients in General Medicine. Each ward team consists of one second year resident, two interns, and one or two medical students from Cornell University or SABA. The average number of patients carried by each team is 14-16 (interns are capped at 12 patients). While on the ward rotation, teams admit patients every second day (interns are on-call every fourth day), taking long call until 9 p.m. Four Teams are on call on any given day. There are also two Day Float teams consists of second year residents that admits limited number of patients everyday to relieve the regular floor teams in the busy morning hours. Medical wards are always supervised by an on call Hospitalist during off hours.
ICU and CCU Rotations:
There are 22 ICU beds on the medical service (physically connected 15-bed MICU and 7-bed CCU). The MICU teams consist of two Pulmonary and Critical Care Attending, One senior resident, two second years and three interns. There is an on call critical care attending during off hours. There is a night float team for MICU consist of one third year, one second year and two interns. Day and night teams work in 12 hour shift eliminating overnight calls in MICU during weekdays. The CCU team consists of an Attending Cardiologist and a senior resident. CCU is covered by MICU night float during off hours.
Ambulatory Care:
Quality ambulatory care training is a critical part of our program. We have our Ambulatory Training Program in a state-of-the-art facility. Faculty practices are now completely integrated with the resident practices, and the house staff works side by side with their preceptors. Each resident spends one half day per week in their continuity practice and one to two months in an ambulatory block rotation each year of their residency. This experience allows for an intensification of their continuity of care practice as well as focused learning of the special skills needed for competence in outpatient medicine. These rotations offer ample time to experience and gain skills in medical areas such as gynecology, ENT, ophthalmology, women's health, adolescent medicine and allergy clinic.
On-Call Structure
The program provides 6-days a week float coverage for all ward services. There is no overnight call for interns and residents rotating on ward services. At any given day four teams are on call. They admit patients up till 7 pm. At 8 pm night float comes in and takes over the admitting duties. On call teams finish the remaining work between 8-9 pm and sign out at 9 pm. Interns are on call every fourth day (Each team has 2 interns). Interns and residents are ensured at least one full day off every weekend (either Saturday or Sunday). MICU calls during the weekend are covered by House Officers in the elective rotations
Night Float Rotation
The PGY-2 Night Float Rotation provides an opportunity for residents to admit and manage a broad variety of medical cases, while reducing the work and hours of floor teams. Each night, two PGY-2 night floats admit new patients along with four float interns and provide cross coverage for patients on the medical ward services. All the admissions to the medical wards are supervised by the on call Hospitalist and they are available in case of emergency. The night float shift starts at 8:00 PM and ends at 7:30 am. House officers on the Night Float Rotation work six days per week for a total of two weeks. The remaining two weeks are usually assigned for vacation, elective, or ambulatory rotations. House officers can also choose to work for four weeks instead of two weeks. MICU night team works 5-days a week and covers MICU/CCU patients.
Electives:
For subspecialty rotations, residents divide their time between outpatient clinics and inpatient consultation services. When rotating on the Subspecialty Services, interns and residents work closely with Subspecialty Attending. On average, 33-50% of the elective is devoted to outpatient subspecialty work and the remainder to inpatient (consultation) work. Residents on the elective rotation get one or two MICU weekend calls. Electives are very good rotations to get direct exposure to special procedures and get hands on experience of many outpatient procedures like Bone marrow Biopsy, Arthrocentesis and joint injections, Hemodialysis, EGD/colonoscopy, PAP smear.
MAR (Medical Admitting Resident):
MAR is a unique rotation done by PGY3 residents giving them the opportunity to quickly assess the patient's condition based on available data and triage the patients accordingly. Once patients are admitted by the ED, house staff from ER presents the patient to MAR. MAR will triage the patient based on the severity and assign the patient to one of the on call teams or will consult MICU for admission. Besides supervising all admissions, MARs provide consultation services to all other departments in the hospital. They work in 12 hour shifts for a total of 14 shifts in the month.
Research and Bellevue rotation:
Research is an important part of our residency curriculum. At present, the rotation consists of two weeks provided in th efirst year of training for all residents. Our expert faculty will help house staff to design a protocol or be involved in an ongoing research of their interest. During this rotation residents are taught the basics of clinical research and Biostatistics. For the other two weeks residents rotate in the CCU of Bellevue hospital to get exposure with management of pre and post Cardiac cath patients. As of July 2008, the program offers additional two weeks to all residents in their PGY-II and III year who have demonstrated comitment and willingness to engage in research and scolarly activities.
Residency Program 
