Department of
Internal Medicine at Highland Hospital
A member of Alameda Health System

Preliminary Medicine Year: Summary of Rotations


Welcome to the Preliminary Medicine Program at Highland Hospital a member of Alameda Health System!
 

We are excited to have you consider Highland for your Internship year. Our Internal Medicine program has significant work and scheduling advantages compared to many preliminary medicine years (see below). Highland‘s environment is best described in AHS’s mission statement: Caring, Healing, Teaching, Serving All. I emphasize this aspect of our program, as our focus goes beyond a desire of simply ‘helping others’ to a level of understanding that requires maturity, patience, insight and humility needed to apply our mission.

In addition to the the diversity the Bay Area provides, the community we serve offers  a complex and challenging framework, rich with learning and practical experiences. We have an excellent house staff contract and a genuinely egalitarian atmosphere. Preliminary residents serving with us regularly report feeling appreciated and fulfilled.

   
Finally, we want to provide you with the most straightforward information regarding your schedule to enable you to make informed decisions. Keep in mind there is some flexibility in our schedule. This includes two weeks of electives, and the option of adding EM and/or extra ICU weeks to accommodate future residency requirements, particularly in anesthesiology.
 

The SCHEDULE:
Our academic year consists of 52 weeks of rotations that vary from one to four weeks. The Intern year begins on June 25th and ends June 24th. The year includes:

  • In-patient medicine (Wards):
    • Typically an average of 20 weeks over the year
    • Two rotating call days: Long and Short call, that are every 6 days respectively
      • Long call: admitting patients from the emergency department
      • Short call: receiving patients admitted overnight
      • Drip system: non-call admitting days reduce the number of overnight patients teams get on any day.
    • No in-house overnight call while on wards
    • Patient caps are 10 per intern; maximum five new patients on long call days per intern
    • Post-call team caps at 17 patients; non-call teams cap at 15. This supports the learning environment by ensuring that each intern is seldom responsible for more than 7 patients.
  • MICU
    • Typically 2-4 week blocks, with either Saturday or Sunday off each week
    • Our ICU has 20 beds, and is an open ICU
    • No call days or overnight ICU call 
    • Procedure training with focus on ultrasound guided procedures
  • Subspecialty Rotations
    • In Gastroenterology, Pulmonary, Cardiology, Neurology, Infectious Disease, Hematology-Oncology and Nephrology. As a subspecialty intern: you will provide consults for inpatients and attend outpatient subspecialty clinics. 
    • No night duties on specialty services; generally one in three weekend days require subspecialty intern work
  • Emergency Department (ED)
    • Typically 4 weeks with 20 shifts of 10 hours (including 5 overnight shifts)
    • EM rotation is optional.
  • Elective time
    • Two weeks for selection of your choice
  • Vacation
    • Four total weeks, in 1 or 2 week blocks
  • BACKUP
    • In house overnight cross coverage for ward and ICU patients. Admitting duties are done by R-2 and R-3 residents.
    • Backup is 6 nights in a row, done 1-2 weeks per year
  • You will not have a general medicine continuity clinic
  • On Jeopardy weeks preliminary interns may be asked to cover both inpatient and outpatient duties. Otherwise Jeopardy weeks are assigned as subspecialty rotations or elective time.

 

On behalf of our Internal Medicine Residency Program, I want to thank you for your interest in our program and congratulate you on the journey upon which you are embarking. If you have any further questions, please contact me.

Nick Nelson, MBBS
Associate Program Director, Preliminary Internship
Attending Physician, Department of Medicine
Email: nnelson@alamedahealthsystem.org