Educational Experience

The Med-Peds Residency is structured to provide increasing responsibility and autonomy in both patient care and teaching supervision over the four years. Additionally, residents have progressively more elective time throughout the program to allow for an individualized overall experience.

Our training program combines direct patient care with both formal and informal educational experiences. Our principal aim is to provide an education to residents which enables them to render superlative medical care to patients of all ages. At the completion of their training, our residents are able to provide excellent primary care and, if so desired, are outstanding candidates for fellowship training. Overall, approximately 50% of the graduates of our program pursue general medicine and primary care while 50% elect to pursue fellowship training.

Goals

Our goal is to train highly skilled and compassionate professionals, and we provide an environment for those physicians to achieve this goal. Our residents are responsible for the care of patients with a wide variety of medical illnesses, ranging from those routinely encountered in primary care practice to those seen only in the tertiary care setting. The Ohio State University Wexner Medical Center (OSUWMC) hospitals and Nationwide Children's Hospital (NCH) serve the combined roles of urban community hospitals, indigent care providers and referral centers for central and Southeastern Ohio. Residents have carefully supervised and graded patient care responsibility in a variety of educational settings at these hospitals and in faculty-staffed outpatient care offices.

Additional primary care and ambulatory care experiences are offered during rotations in the outpatient Veterans Administration Clinic and at several rural community clinics. The greater Columbus area has ten med-peds private practices, many of the physicians being graduates of this program. Many of these practices participate in an educational program called Internal Medicine-Pediatric Education in Community Sites (IM-PECS) where PGY2 to PGY4 residents spend a half day per week caring for patients in the private office.

Inpatient Experience

InnovativeFacilities

Both Ohio State and Nationwide inpatient services include sub-specialty wards as well as general internal medicine and general pediatric wards. Patients admitted to sub-specialty wards require both a specialized approach to their medical problems and attention to their general health. Ward rounds are conducted daily with an attending physician who maintains the academic forum for patient care. Resident contact with faculty physicians is an integral component of our program.

Outpatient Experience

The ambulatory patient care educational experience in internal medicine includes the general internal medicine and specialty clinics at Ohio State Wexner Medical Center, outpatient veteran's affairs experience, dedicated geriatric rotation and the emergency department. A two block longitudinal experience known as the Senior Ambulatory Block affords PGY4 residents the opportunity to tailor their outpatient curricula and provides them a longitudinal care experience in multiple specialty clinics of their choosing.

The outpatient component at Nationwide Children's includes the Sports Medicine Clinic, Adolescent Clinic, Behavioral/Developmental Clinic, sub-specialty and surgical clinics and the emergency department. At least six blocks are spent in the various pediatric clinics. Med-Peds residents provide continuing medical care to their own population of patients through continuity clinic throughout their four years of training. During the final three years, weekly clinic rotations in a private Med-Peds practice (IM-PECS) enhance the exposure to "real world" ambulatory medicine.

Primary Care Experience

The Departments of Internal Medicine at Nationwide Children's Hospital and Ohio State have partnered to create The South High Center for Primary Care. The center provides health care to the under-servedsouth side community of Columbus, while also providing an outstanding outpatient training center for the Med-Peds residents.

The South High Center for Primary Care

The South High Primary Care Center is located in a medically underserved area on the South side of town and provides comprehensive care to patients of all ages from newborns to adults. South High has achieved National Committee for Quality Assurance (NCQA) – Patient Centered Medical Home Level three status. The clinic is staffed by physicians board certified in both internal medicine and pediatrics, as well as nursing staff, a social worker, dietician and pharmacists all dedicated to resident education and improving the health of the community. The expanded facility that opened in June of 2013 has a large resident work area, 12 patient rooms, on-site laboratory and up-to-date equipment. This innovative clinic gives you the foundation in ambulatory medicine and patient experience you need to succeed.

In general, residents spend one half day per week in clinic. They develop their own patient panel and follow those patients throughout their four years of residency. Patient encounters encompass all aspects of primary care from well pediatric visits, adult health maintenance visits, acute ill visits, care of the medically complex and those with special health care needs.

The clinic has a targeted ambulatory curriculum with a weekly lecture series for residents. Residents develop and participate in quality improvement projects, continually enhancing how we provide optimal, evidence-based care to our community.

Internal Medicine-Pediatric Education in Community Sites (aka IM-PECS)

The IM-PECS experience is designed to provide one of the nation's most distinctive training experiences in community practice. Augmenting the foundation of ambulatory care education provided in resident continuity clinic, each resident is assigned to a preceptor in a community internal medicine-pediatrician's office. Residents attend weekly half-day sessions during select rotations of the second through fourth years of residency. During the second or third year of residency, residents participate in a month-long IM-PECS rotation. This vital, one-of-a-kind training experience:

Reinforces the basics of primary care
Ensures a rich diversity of experience with different patient populations and a variety of practice models
Teaches the business aspect of primary care
Provides mentorship for residents

Didactics

The didactic components of the training program center on a variety of conferences and hands-on simulation experiences. Examples of regular conferences include Resident Report, Resident Didactic Sessions, Emergency Lecture Series, Grand Rounds, Health Equity Rounds, Morbidity and Mortality Conference, Ethics Conference and a large number of weekly subspecialty conferences. Simulation is incorporated and highly valued in both the pediatric and medicine arenas in the form of mock experiences and regularly scheduled simulation sessions. A favorite and hallmark of our program, our Med-Peds Journal Club convenes monthly over dinner to discuss current topics in patient care and research and provides a forum for residents and their families to gather outside of the hospital.

Take a Virtual Tour of Our IM/Pediatrics Residency Learning Spaces and Medical Center Campus

Residency Curriculum

PGY1

The first year curriculum gives practical skill in the management of both common and complex medical issues for adults and children, setting the framework for skills needed in leadership and patient management as a future supervisory resident. The interns have level appropriate clinical experiences designed to expose them to the frequently encountered issues in both specialties. These experiences include inpatient general medicine, inpatient pediatric infectious diseases, an ambulatory acute care month and the newborn nursery. Interns are also taught the management of the very ill and the at-risk patients to help them develop decision making abilities in urgent or acute settings. Activity in areas such as the medical ICU, the neonatal ICU and delivery room, cardiology and oncology wards provide this experience. The intern lecture series focuses on emergent and urgent conditions and their management. These lectures are recorded for later viewing on the occasion that the resident may not be able to attend the session (clinic, post-call, vacation, etc.) or to refresh previously learned material. The intern schedule rotates between internal medicine and pediatrics every three blocks.

Block schedule

1	IM	MICU
2	IM	Gen Med
3	IM	Heme
4	Peds	ID/General
5	Peds	Heme/Onc
6	Peds	Acute Care/Primary Care
7	IM	Heart
8	IM	Night Float
9	IM	Outpatient Elective
10	Peds	Pulm/General
11	Peds	NICU
12	Peds	Well Baby Nursery
13	Peds	Night Float/Elective

PGY2/PGY3

Years two and three are consolidated to provide a ‘second-year equivalent’ for both internal medicine and pediatrics. The education, at this level, is designed to provide our residents with supervisory experience in both specialties. Four-week long rotations through our subspecialty systems, including emergency medicine, allow the residents to get exposure to most of the medical and pediatric subspecialties, while gaining additional practical exposure to potential career paths and mentors. More experiences in ambulatory care for adults and children (including developmental pediatrics, our IM-PECS program and block time in the combined Med-Peds Clinic) and care for the undifferentiated patient provide generalist education in our program. Our residents are also given an elective career development month during this period. This rotation allows a resident to explore a desired career path through both clinical and scholarly activity. Years two and three switch departments every four blocks.

Block Schedule

PGY 2
1	IM	ED
2	IM	Neph/ID Consults
3	IM	Veterans Affairs
4	Peds	Night Float/Elective
5	Peds	ED
6	Peds	Adolescent/Develop Behav
7	Peds	NICU
8	IM	Gen Med
9	IM	Onc or Transplant Med
10	IM	GI/Liver
11	IM	Elective
12	Peds	PICU
13	Peds	Elective/Professional Dev

PGY 3
1	Peds	Primary Care
2	Peds	Outpatient Elective
3	IM	Night Float
4	IM	Outpatient Elective
5	IM	MICU
6	IM	IM-PECS
7	Peds	Subspecialty Elective
8	Peds	General Ward
9	Peds	ICU
10	Peds	Night Float/Elective
11	IM	Heart
12	IM	Elective
13	IM	Transition

PGY4

Year four provides the ability for the senior to utilize ambulatory block time for experience in geriatrics and other outpatient medical subspecialty care. There is a four-week long experience of being the senior resident in the hospital helping manage patient flow, acute care issues and consultations. This experience helps residents feel comfortable in their management abilities while providing support and mentorship to more junior residents. The senior resident can significantly tailor much of the final year in our program to meet his or her specific career-based needs. Year four alternates departments every three blocks. Our schedule overview is graphically depicted below.