Our program is centered around the four+one model, which is divided into four weeks of general internal medicine inpatient services including night float, subspecialty inpatient services, subspecialty consultant service, subspecialty ambulatory experience, critical care inpatient services, vacation time, and a fifth week of continuity clinic.

As a result, residents are divided into five cohorts that alternate continuity clinic weeks in sequential order. Residents will do these rotations mostly through University of Missouri Health Care but also affiliated hospital Harry S Truman VA.

The yearly schedule is made and revised as necessary by the two chief residents, who are elected by the residents to serve as chiefs during their PGY4. This schedule is usually in the form of an excel sheet that is distributed through email. The schedule can also be found on New Innovations, which is a website where residents document their work hours, fill out evaluations and more.

During the continuity clinic week (the +one) residents get a typical “8-5, M-F” schedule followed by a two-day weekend free of any work duties. These free weekends are known at the start of the program and so residents are able to plan for any personal activities far in advance. There are six half-days of continuity clinic during this time and two half days devoted to board review and scholarly projects/Quality improvement. This leaves two additional free half-days that residents can use for personal study, research, or to attend to personal matters.

During the four weeks of regular rotations, residents are usually scheduled two to three weeks of rotations such as GIM wards, subspecialty inpatient services, night float, or ICU and one to two weeks of rotations such as subspecialty consults or ambulatory experiences.

Residents may take their vacation weeks during the subspecialty rotations as long as they meet ACGME requirements for rotating through all required services by the end of the program. Residents get four weeks of vacation per year.

Rotation Summary

University Hospital

Inpatient teams

  • 4 GIM inpatient resident teams
  • 3 MICU teams
  • 1 CICU team
  • 1 GIM floor night float team
  • 1 cardiology floor team
  • 1 hematology/oncology inpatient service
  • 1 heme/onc-cardiology night float team
  • 1 stroke team (co staffed with neurology residents)
  • 1 general neurology floor team (co staffed with neurology residents)

Consultant services: cardiology, GI, nephrology, endocrine, rheumatology, hematology/oncology, pulmonary, ID, palliative care, geriatrics, general internal medicine

Outpatient/Ambulatory subspecialty rotations: cardiology, GI, nephrology, endocrine, rheumatology, hematology/oncology, pulmonary, ID, geriatrics, dermatology

Other Rotations: procedure team, electives including radiology, anesthesia, research weeks, ER

Harry S. Truman Veteran’s Affairs Hospital

Inpatient teams

  • 3 GIM inpatient resident teams
  • 1 open unit MICU/CICU team
  • 1 GIM night float team
  • Community Living Center (skilled care, long term care, hospice care)