Elective Rotations

Overview

We offer a variety of elective rotations to help meet your training requirements and career goals.

During your first year of residency, you will have a continuity clinic for one week of every outpatient block. The second week of your outpatient block will include rotations in neurology, essential skills in internal medicine (ESIM), and same-day clinic.

During your second and third year of residency, you can tailor your schedule to help meet your career goals. In addition, some electives are required, including rheumatology, endocrinology, general medicine consults, and a clinic block elective (Geriatrics, outreach, and ambulatory telemedicine).

Below, we have divided the electives based on year of training and potential career interest. If you are not sure what type of career you are interested in pursuing- that’s okay! Your exposure to multiple subspecialties during your first year will help to guide you.

In addition to the electives listed below, we allow for two research months to be taken during your second and third year of training.

First year electives:

Ambulatory clinic block (Patient Centered Team Care): As an immersion experience in the principles of ambulatory medicine in the setting of a Patient Centered Medical Home, this rotation focuses on in-depth essential skills in ambulatory general medicine, management of chronic disease states, and learning the different team member roles (nurses, medical assistants, case managers, and pharmacists) and how a patient navigates within the Patient Centered Medical Home.

Same-Day Clinic: This is an ambulatory experience in which your clinic appointments will be opened the same day to allow for increased resident exposure to acute outpatient complaints.

Essential skills in internal medicine (ESIM): This 1-week rotation, completed early in the internship year, focuses on obtaining procedural skills in our state-of-the-art simulation center to practice on models and gain familiarity with equipment. You also will have POCUS training during this time.

Longitudinal Skills Curriculum: Topics addressed include fundamental communication skills, quality improvement, and research. You will go through a variety of workshops that are interwoven in your intern schedule to give you the confidence to communicate with your patients when it comes to breaking bad news, error disclosure, and hand-offs. You will be exposed to a comprehensive evidence-based medicine and quality improvement curriculum. Many of these sessions will take place during your outpatient blocks.

Neurology: During the Neurology consultative elective, internal medicine residents will learn basic clinical neurology while providing aid to consulting services. Residents will learn anatomy, physiology, clinical presentation, and management of common nervous system disorders, and gain confidence in performing a neurological exam on patients.

Required Second and Third-year electives:

General medicine consults: Inpatient gastrointestinal consults are combined with outpatient management and exposure to scopes. Common conditions include peptic ulcer disease, hepatobiliary disease, liver transplantation, and diverticular diseases. Various endoscopic procedures are also done.

Rheumatology: Not often encountered in the inpatient service, this month-long outpatient rotation offers exposure to diagnosis and treatment of connective tissue disorders.

Endocrinology: Mostly outpatient with some inpatient consultation exposure. This will give you confidence in diagnosis and management of diabetes, thyroid disease, pituitary disease, metabolic bone disease.

Geriatrics, outreach, and ambulatory telemedicine (GOAT) This is a 2-week clinic block rotation that consists of all virtual visits and reaching to patients to help improve cancer screening and chronic disease management paired with our Geriatrics experience.

Emergency Medicine: This is a four-week rotation in the Emergency Department (ED) during your second year that offers a comprehensive immersion in acute care within a fast-paced ED setting. This rotation aims to enhance skills in rapid assessment, diagnosis, and management of emergent and urgent medical conditions. Participants will work alongside EM attendings and senior residents, engaging in initial patient evaluations, performing common procedures, and participating in multidisciplinary team collaborations.

Optional Electives: (divided by subspecialty interest)

Research month: We encourage our residents to take research months during their second and third year. This month will allow up to four weeks of dedicated research time, with the only clinical responsibility being continuity clinic (1 day per week).

Procedural Experience

The Henry Ford Internal Medicine Residency prides itself on training outstanding physicians including the opportunity to develop competence in a variety of invasive procedures. We encourage all of our residents to take advantage of these opportunities especially for those in preparation for their subsequent fellowship or chosen career path. 

Our residents receive extensive training in all standard procedures within the field of Internal Medicine. This includes early simulation center training, direct patient interaction with supervision, and eventual certification with the ability to give back with education during didactics and supervision on the medical wards. The procedures our residents have the ability to perform include, but are not limited to: paracenteses, thoracenteses, lumbar punctures, arterial blood gas collection, arthrocentesis!

Ultrasound

We believe that Point of Care Ultrasound (POCUS) is an important part of your education as an internist. This technology provides the ability to perform procedures under ultrasound guidance for improved patient safety, diagnostic accuracy, assist in clinical decisions and ultimately to become an extension of the physical exam.

We have developed an Ultrasound curriculum with the intent to create a three-year longitudinal curriculum in point of care ultrasound. The curriculum will focus on the basic skills as an intern and will build on those skills over the subsequent years in the Intensive Care Units, Emergency Department, General Medical Units, and Simulation Center. The curriculum will be based on a combination of simulation, didactic, and patient scanning for procedural and diagnostic uses. We have two dedicated Ultrasound machines on our General Medicine Floors with other machines available by request. Our goal is to have our residents graduate with basic skills in POCUS that would take their already outstanding clinical skills to the next level.

Additionally, on our hospitalist floor (F1), we have multiple handheld ultrasounds available for residents to use.

Dr. Rachel Karmally, our POCUS training director.

Procedure rotation

After successfully completing their first year of residency, our residents rotate through the Procedure & Code Blue service. A two-week rotation focused on building core knowledge in procedures (paracenteses, thoracenteses, lumbar punctures, ABGs, etc.) and running Code Blue events on the medical floors builds a unique and hands-on opportunity for our senior residents to fine tune their skills. The training our residents receive during this rotation is a critical part of becoming an expert Internal Medicine clinician, and advancing to the next phase of medical training.

Center for Simulation, Education and Research

Creating an environment that fosters innovation and places emphasis on continuous learning benefits everyone: staff, patients and their families.

The 12,000-square-foot Center for Simulation, Education and Research at Henry Ford Hospital gives our professionals the ability to practice new approaches to health care and refine their clinical skills using state-of-the-art simulations in a risk-free environment.

Fully accredited as a Level 1 Comprehensive Education Institute by the American College of Surgeons, the Center for Simulation, Education and Research at Henry Ford Hospital is the most advanced facility of its kind in Michigan and one of the largest in the United States.

The Center offers procedural simulation technologies using computerized mannequins and other mechanical devices. It also is a venue for advancing education and assessing the competencies of residents, physicians and other health care workers in the areas of inter-professional team communications, patient safety and doctor-patient communication skills. Reconfigurable suites replicate the emergency department, operating room, intensive care unit, labor and delivery suite, and other hospital environments. Mannequins allow staff to realistically challenge their skills, perfect new care protocols and practice code situations. 

Sladen Library

The Sladen Library is the flagship library of the Sladen Libraries of Henry Ford Health System. The library provides professional services to the medical staff, students, and employees of Henry Ford Hospital, Henry Ford West Bloomfield, and the medical centers. The Sladen Library website serves as Henry Ford Health System's gateway to electronic journals, electronic books, and an array of databases that support the teaching, research, and clinical practice missions of Henry Ford Health System.

Located on the 17th floor of Henry Ford Hospital, the Sladen Library offers a beautiful panoramic view of the Detroit and Windsor skylines. Comfortable chairs, study carrels, work tables, a training room, and computer stations provide a variety of options for quiet study and group projects.