Curriculum

The UVA Internal Medicine Residency Program transitioned in 2014 to a 3+1 model. This change resulted from extensive planning by several generations of chief residents. Our academic year is divided into 13 four-week blocks: each resident has a three-week block rotation (either an inpatient ward/ICU rotation or a three-week elective) followed by an ambulatory week (the “+1 week”). This separates inpatient and outpatient time for our residents to focus on each domain.

During three-week inpatient rotations, residents rotate through General Medicine, the Medical Intensive Care Unit, Hematology, Oncology, Acute Cardiology, and the Coronary Care Unit. Our second-year residents also do an Emergency Medicine rotation. As mentioned above, the time spent on an inpatient service is entirely devoted to education and inpatient care, without interruption, for outpatient clinics in the afternoons. For categorical interns, one of the thirteen 3-week blocks is available as a consult elective, while the remainder are spent on inpatient time. For PGY2s and PGY3s, 4-5 of the 3-week blocks are used for elective rotations each year, while the remainder of the thirteen 3-week blocks are inpatient rotations.

Every fourth week is the ambulatory +1 week, which consists of 4-5 half-days in a resident-run continuity clinic, University Medical Associates (UMA); 3-4 half-days in an elective subspecialty clinic to augment exposure to outpatient subspecialty medicine; 1 half-day of protected administrative time to keep up with documentation, evaluations, or personal appointments; and one half-day of protected ambulatory didactics and seminars. After the education half-day, time is set aside for the plus-one groups to get lunch together before heading back for the afternoon clinic. The +1 week is a nice break from the busy inpatient service, allowing residents to focus on their clinic patients and education. At the end of the +1 week, every resident has a guaranteed “golden” weekend. Our mission with the 3+1 system is to allow our residents to be 100% devoted to the task at hand, whether in the inpatient or ambulatory setting, and to optimize the educational experience.