During the transitional year, each resident receives training in the following areas:

·        One month of inpatient pediatrics
·        One month of surgery
·        Three months of inpatient internal medicine
·        One month of ICU medicine
·        One month of emergency medicine
·        One month of ambulatory medicine clinics
·        Four months of elective rotations

Elective Rotation Options

• Adolescent Medicine
• Ambulatory Pediatrics
• Anesthesiology
• Cardiology
• Dermatology
• Gastroenterology
• Hematology-Oncology
• Hospice/Palliative Care
• ICU - Critical Care, IMMC
• Infectious Disease
• Neonatal ICU
• Nephrology
• Neurology
• Obstetrics-Gynecology/Women's Health
• Ophthalmology
• Orthopedics
• Pathology
• Plastic Surgery
• Pulmonary Medicine
• Radiation Oncology
• Radiology
• Rheumatology
• Sports Medicine
• Urology
• Vascular Surgery

The pediatric, surgery and internal medicine rotations provide the transitional year resident responsibility for the initial evaluation and subsequent care of hospitalized patients under the supervision of senior residents and faculty.  Transitional year residents are responsible for completing intitial history and physical examinations, assessment and treatment plans, daily orders, and daily progress notes in consultation with supervising senior residents and faculty.  More details about each of these training experiences is provided below.

One Month of Inpatient Pediatrics: Residents will work on an inpatient team with a pediatric hospitalist attending physician, a senior pediatrics resident, a pediatrics intern, and two third-year medical students.  Great patient variety is available and the average intern census is 4-6 patients.  Call is every fourth night with excellent supervision and teaching provided by the senior pediatrics resident on call and the full-time pediatric hospitalist staff physicians. -return to top-

One Month of Surgery: Residents have a choice and may complete either a one-month general surgery rotation or a one-month trauma surgery rotation.  The general surgery rotation provides maximal operative experience, with an excellent variety of surgeries and surgical pathology available.  The trauma surgery rotation provides an opportunity to evaluate, triage, stabilize and manage a wide variety of patients presenting after major trauma to Iowa Methodist's Level I Trauma Center.  Call averages every fourth night during this rotation. -return to top-

Three Months of Inpatient Internal Medicine: Residents complete three inpatient general medicine rotations at our three affiliated teaching hospitals: Iowa Methodist, Broadlawns, and the VA Medical Center. The three months provide residents an outstanding variety of patient pathology with excellent senior resident supervision and strong faculty teaching.  Call is every fifth night during these months.  Daily noon conferences, weekly grand rounds conferences, and monthly journal club and morbidity & mortality conferences assure excellent didactics during these experiences. -return to top-

One Month of ICU Medicine: Residents work in the Medical ICU under the direction of a senior medicine resident and board-certified critical care teaching faculty.  Extensive procedural experience is provided.  A variety of patients with multisystem disorders and patients requiring mechanical ventilation and hemodynamic support will be encountered.  Call is every fifth night during the month.  -return to top- 

One Month of Emergency Medicine: Residents work in the emergency room of a very busy Level I Trauma Center at Iowa Methodist Medical Center.  Residents work 4 ten-hour shifts per week and participate in the triage and evaluation of patients presenting with a variety of acute medical and surgical concerns.  This includes assessment and management of patients presenting after minor trauma (lacerations, sprains, strains, fractures, etc.) and care for patients suffering more serious trauma-related injuries.  There is no call required during this month. -return to top-

One Month of Ambulatory Medicine Clinics: Residents work in the outpatient clinics with core ambulatory medicine faculty seeing a wide variety of patients.  Patients presenting for health maintenance, minor acute concerns and more major acute problems will be seen during the month.  There is no call required during this month. -return to top-

Four Months of Elective Rotations: A wide variety of elective rotations are available, depending on a resident's interest and future training plans.  Residents may repeat any of the required experiences described above.  There are also additional experiences available in pediatrics, general surgery plus many surgery specialties, internal medicine and many of the medicine subspecialty areas.  There are no call requirements during these four months.  A brief description of each of the elective rotation options is provided below: 

• Adolescent Medicine:  Residents will participate in a variety of outpatient adolescent medicine clinic experiences, including Blank Children's Hospital adolescent clinic, Polk County Public Health Department and other community-based programs including schoold-based clinics and Planned Parenthood clinics.  -return to top-
  
  
• Ambulatory Pediatrics: Residents will participate in outpatient pediatric clinics in the Blank Children's Clinic area and in the Blank emergency room area working with general pediatric and pediatric emergency room faculty.  -return to top-
  
  
• Anesthesiology.  Residents will participate in a wide variety of operative cases.  Residents may choose to participate in pediatric cases, general surgery cases, or a variety of specialty surgery cases including cardiac, vascular, thoracic, orthopedic, urologic and neurosurgical cases.  There will definitely be opportunities to perform procedures such as endotracheal intubations, central line placements, arterial line placements, etc.  -return to top-
  
  
• Cardiology.  Residents can work with cardiology faculty participating in a variety of paitent care activities including office evaluations, hospital admissions and consultations, and review of non-invasive cardiac studies including EKGs, Holter monitor studies, nuclear cardiology studies and echocardiograms.  -return to top-
  
  
• Dermatology.  Residents can work with dermatology faculty participating in a variety of activities.  This includes evaluation of new patients seeking dermatology consultation, seeing patients returning for follow-up care of chronic dermatology concerns, and participating in a variety of minor surgical procedures conducted in the office setting.  There is also an opportunity to participate in review of dermatopathology studies during this rotation.  -return to top-
  
• Gastroenterology.  Residents can work with The Iowa Clinic gastroenterologists on a busy hospital consultation service at Iowa Methodist Medical Center.  There is an opportunity to see a wide variety of patients with gastrointestinal, hepatobiliary and pancreatic concerns.  Patients will be seen and then staffed with a member of the group so there is extensive one-on-one teaching provided, including an opportunity to review multiple radiology studies and to participate in diagnostic and therapeutic endoscopy procedures.-return to top-
  
  
• Hematology-Oncology.  Residents will work one-on-one with one of the hematology-oncology faculty physicians at the John Stoddard Cancer Treatment Center on the campus of IMMC.  There will be an opportunity to see patients with both hematology concerns and patients presenting with a wide varieyt of cancers.  Patients will mostly be seen in the outpatient clinic setting but there will also be an opportunity to see new hospitalized patients referred for hematology-oncology consultation.  -return to top-
  
  
• Hospice/Palliative Care.  Residents will primarily work with Dr. Archer and the members of his palliative care team at Iowa Methodist Medical Center.  There will be opportunities to assist in evaluation and care of both patients referred for palliative care consultation and patients referred for hospice care.  Patients will be seen at Iowa Methodist Medical Center or at the Taylor House hospice facility that is affiliated with IMMC.  Residents will be provided readings on important end-of-life care topics and on hospice eligibility and benefits concerns to review during the rotation.  -return to top-
  
  
• ICU-Critical Care, IMMC.  Residents can choose to participate in an additional elective experience in critical care at IMMC.  Resident will see and care for a wide variety of critical care patient problems.  They will gain additional experience in performing endotracheal intubations, managing ventilators, and completing a wide varieyt of invasive procedures during this rotation.  -return to top-
  
  
• Infectious Disease.  Resident can participate on the Infectious Disease Consult Service at IMMC and will get an opportunity to work one-on-one with the ID Service Consult Staff Physician for the month.  They will see a large number of hospitalized patients presenting with an array of ID-related concerns.  There will also be an opportunity to participate in some outpatient clinics that allow for exposure to chronic ID concerns like the patient with HIV infection and follow-up of patients seen in the hospital who return for post-hospital care.  -return to top-
  
  
• Neonatal ICU.  Residents will learn to care for critically ill newborns, increase their skill in ventilation, and learn application of physiologic principles in critical care.  They will be responsible for the care of selected critically ill neonates under the supervision of senior pediatric residents & staff neonatologists.  Residents will also participate in twice-weekly morning report, daily noon conference, and weekly Grand Rounds conferences.  -return to top- 
  
  
• Nephrology.  Residents can participate on the Nephrology Consult Service at IMMC and will get an opportunity to work one-on-one with the Nephrology Service consult Staff Physician for the month.  They will see a large number of hospitalized patients presenting with a vast array of renal concerns. There will also be an opportunity to participate in some outpatient clinics that allow for exposure to proper diagnosis and treatment of common acute and chronic nephrology concerns.  -return to top-
  
  
• Neurology.  Residents can participate in a rotation where they will see patients presenting to clinic with new neurology concerns or follow-up of known neurology problems, and patients hospitalized at IMMC needing neurologic consultation.  There will be extensive opportunities to review neuroimaging studies and, if requested, an opportunity ot review other neurologic diagnostic studies such as EEG and EMG-NCV studies. -return to top-
  
  
• Obstetrics-Gynecology/Women's Health:  Residents will participate in a variety of obstetrics, general gynecology, high risk OB and family planning clinics.  There will also be an opportunity to participate in delivery of infants on the Obstetrics service if desired.  -return to top-
  
  
• Ophthalmology.  Residents can choose to work in several different ophthalmology clinic settings.  They can gain experience evaluating patients presenting with a wide variety of eye complaints.  Residents can also choose to gain special experience in proper evaluation and treatment of diseases of the retina, pediatric eye diseases, and even oculoplastic concerns.  A teaching syllabus and various visual aids are available to supplement the learning experience.  -return to top-
  
  
• Orthopedics.  During this rotation, residents will work with orthopedics teaching faculty.  Residents will see patients presenting to the ER with acute musculoskeletal injuries, participate in several half-day general orthopedics clinics, and see hospitalized patients referred for orthopedic evaluation.  A syllabut of assigned readings will be provided for use during the rotation.  -return to top-
  
  
• Pathology.  During this rotation residents can work in several different areas of their choice.  Reviewing hematology studies (peripheral blood smears, bone marrow results, etc.), participating in anatomic pathology studies, reviewing surgicla pathology specimens, and working in different areas of the clinical laboratory are all possible.  Residents will meet with the pathology rotation director prior to this rotation to plan their schedule of activities.  -return to top-
  
  
• Plastic Surgery. During this rotation residents will work with Dr. Reece and his colleagues in The Iowa Clinic Plastic and Reconstructive Surgery group. There will be an opportunity to see and evaluate patients in clinic and to participate in both cosmetic and reconstructive surgeries in the outpatient clinic and OR settings.  -return to top-
  
  
• Pulmonary Medicine. Residents will work with pulmonologists from the The Iowa Clinic Lung Center on a busy hospital specialty service at Iowa Methodist Medical Center. There is a great variety of patients with varied pathology on the service. Supervision and teaching will be provided by one member of the group and there is extensive one-on-one teaching provided. There will be opportunities to review multiple radiology studies, review pulmonary function test results, and participate in diagnostic and therapeutic bronchoscopy procedures.  -return to top-
  
  
• Radiation Oncology. Residents will work one-on-one with one of the staff physicians at the John Stoddard Radiation Oncology Center on the campus of IMMC. There will be an opportunity to see patients presenting for radiation treatment for a wide variety of different cancers. Patients will mostly be seen in the outpatient clinic setting but there will also be an opportunity to see new hospitalized patients referred for consultation. Residents will also participate in the weekly multi-disciplinary Tumor Board Conferences held at IMMC.  -return to top-
  
  
• Radiology.  Residents can choose to concentrate on one area or may choose to complete one-week blocks in several different areas including interventional radiology, body CT/ultrasound, neuroradiology, musculoskeletal radiology, and pediatric radiology. Residents will meet with the radiology rotation director prior to the start of the rotation to plan their schedule for the month. -return to top- 
  
• Rheumatology.  Residents will work in the outpatient clinic setting seeing a great variety of patients presenting with a vast array of rheumatologic concerns.  There will be opportunities to learn about diagnosis and treatment of these concerns, including the review of a great variety of musculoskeletal imaging studies and review of proper laboratory testing of these patients.  Residents will also learn more about the proper role of PT & OT modalities and new infusion therapies in the care of these patients.  -return to top-
  
  
• Sports Medicine.  Residents will meet with the orthopedics-sports medicine rotation director to determine a schedule for the month.  Concentrated training in specific areas like upper extremity, spine or lower extremity injuries can be arranged.  -return to top-
  
  
• Urology.  Residents will participate in an office-based urology rotation seeing patients presenting with a wide variety of genitourinary system complaints.  Experience will be gained in proper physical examination of the prostate and scrotal areas.  Review and interpretation of urologic x-ray studies will be completed during the rotation.  Experience will also be gained in directing diagnostic work-ups and planning medical and/or surgical treatment of acute and chronic genitourinary system disorders.  -return to top-
  
  
• Vascular Surgery.   Residents will work with a senior surgery resident and vascular surgery faculty in the evaluation and treatment of patients presenting with a wide variety of acute and chronic vascular concerns.  Experience will be provided in both the interventional radiology suite and operating room areas of Iowa Methodist Medical Center. -return to top-