Typically, two residents assist the attending physician on the Internal Medicine Service, a Medicine Chief (second or third-year resident) and an intern. The winter months are covered by three residents.

First year–12 weeks Internal Medicine

Second year–4 weeks Internal Medicine, 4 weeks pulmonology, 4 weeks cardiology, 4 weeks neurology and neurosurgery

Third year–8 weeks Internal Medicine

Total nine months of internal medicine

The service covers both the East and the West Campus of Portneuf Medical Center. Typically there are between ten to twenty patients on the service, so that each resident cares for five to eight patients each. The residency requires that the continuity resident follows their own patients on the service. The Director of the Inpatient Service is Dr. Sandra Hoffmann who has had twelve years of experience teaching an internal program in Kalamazoo prior to joining us in 2003. Senior residents are expected to be involved in the initial stabilization of acute IM patients in the emergency and on the ICU and will be expected to be competent in managing the ventilator on our overdose patients who do not have lung disease. They will participate with the ventilator management of lung disease patients requiring artificial ventilation. Internal medicine cases range from general medical problems to severe problems requiring intensive or coronary care. The second- and third-year medicine and subspecialty rotations are focused on intensive care, cardiology and pulmonology.

The second year Pulmonary ICU rotation is supervised by our intensivists, Drs. Jackson and Christon, who are both committed to teaching. Residents meet with them on a daily basis, provide the initial history workup and problem management of all consultations that are sent to the intensivists, round, write notes and suggest management plans on all the intensive care patients. Personal, one-on-one teaching provides an opportunity for in-depth internal medicine and pulmonary knowledge.

The Cardiology rotation in the second year is spent with Drs. Call and Boehm. The resident is attached to the cardiologist on a one-on-one basis and rounds with them. Included in their time during the weekend, the resident does initial cardiology consultations and presents the patient and their management plans to the cardiologist for review. There is opportunity for intensive EKG training and residents may pre-read a hospital EKG for a month with a faculty member, learning and achieving competence in EKG readings. There is also the potential for learning cardiac stress testing under the guidance of both the cardiologists and our family physician internal medicine faculty who perform this test.

An additional month of neurology and neurosurgery brings the total internal medicine component of the residency up to nine months. The neurologist who teaches this program is Dr. Kennedy and sometimes Dr. Girard. Residents learn a wide variety of outpatient neurological conditions and their management. They perform inpatient consultations for the neurologists and present the patients in consultation.