Each academic year is structured by 13 rotations, four weeks in length.

FIRST YEAR	SECOND YEAR	THIRD YEAR
Orientation Emergency Medicine Peds Inpatient Service2 Pediatrics Behavioral Medicine Family Med Inpatient Service Family Med Inpatient Service Family Med Inpatient Service Geriatrics Cardiology5 Obstetrics Obstetrics Access Based Care	Emergency Medicine ENT/Urology/Ophthalmology6 Critical Care1 Dermatology Surgery3 Surgery3 NICU1 Family Med Inpatient Service Family Med Inpatient Service Orthopedics4 Obstetrics Gynecology	Elective Elective Elective Elective Medical Subspecialty Sports Medicine Pediatric ER2 Preceptorship Family Med Inpatient Service Family Med Inpatient Service Neurology Obstetrics Access Based Care

¹Truman Medical Center - Hospital Hill
²Children's Mercy Hospital
³ Private practice surgery group, various local hospitals
⁴ Private practice orthopedic group, office orthopedics
⁵ Private practice cardiology group
⁶ Private practice office otorhinolaryngologist/urologist/ophthalmologist

Your First Year

Orientation - The entire first block is orientation month for all first years. You will be completing certification courses, receiving instruction on the processes of the hospital, participating in teambuilding activities with your fellow residents, but mostly gaining hands-on experience. You will begin establishing your continuity patients during this time as well. The first week of July, is typically an 8 a.m. – 5 p.m. schedule; more variability follows throughout the remainder of the block as you work as part of the OB and Medicine Teams.

Access Based Care - Generally there are two residents—one first year and one third year. Patient centered care is at the forefront of this rotation where the focus is closed loop communication and improved handoffs. During this rotation you will help close the communication gap between in- and –out patient, work in concert with the Medicine Team on the more acute care patients, work in the pulmonary clinic, help with medication refills, patient follow up and complete a small quality improvement project. Residents will participate in a home call schedule during this rotation. Hours average 40 per week.

Obstetrics (2 blocks) - Two blocks are spent covering labor and delivery. As the only residents in the hospital, the OB team manages the patients who present to labor and delivery and delivers those patients who do not have a "panel" doctor (a resident who has been following them for continuity care throughout their pregnancy). You will have one continuity clinic scheduled per week. The hours vary depending on how often you are on call (this depends on the size of the service). There are two call possibilities: 7:30 p.m. to the next morning (following rounds) and 6 a.m. – 8 p.m. .

Family Med Inpatient (3 blocks) - Medicine is similar to OB in that the call is divided between all of the 1st and 2nd years on service. One resident (usually a PGY III) serves as RIC - resident in charge while PGY I and II divide call. You will have one continuity clinic scheduled per week. There are four call possibilities: 7:30 p.m. to the next morning (following rounds); 6 a.m. – 7:30 p.m.; weekends 6 a.m. until rounds are over; or 6 a.m. – 8 p.m.

ER - Generally there are two residents—one first year and one third year. Hours are usually scheduled so that shifts do not overlap with the other resident. Shifts vary from 5 to 12 hours.

Geriatrics - During this rotation, you will work in the Long Term Care Center here at Lakewood. Hours are generally 8 a.m. – 5 pm. Residents will see patients alongside one of the geriatric fellows and address any acute issues that need attention. You will also have geriatric assessment clinic, lectures, journal club, or help with whatever admissions might occur during the day. This tends to be a fairly laid back rotation with respect to hours as you are often dismissed early in the afternoon if no admissions are expected and you have completed the acute care for the day.

Peds Outpatient (Newborn Nursery and Clinic) - Residents see all of the babies in the nursery that do not "panel" doctor (a resident who has been following the mom for continuity care throughout her pregnancy). Babies need to be seen by 9 a.m. The remainder of the morning is spent in the pediatric outpatient clinic  which involves seeing the newborn babies for one-week checks and weight checks. Most afternoons in the outpatient pediatrics clinic tend to be well child checks and sick visits for children of any age. During the day, you admit any babies that need admitted to the nursery and perform circumcisions if parents choose this procedure. If any infant becomes ill in the nursery during the day, you respond. There is no call on this rotation and you typically work two of four weekends.

Peds Inpatient (Children's Mercy Hospital) - This is by far our hardest rotation with respect to hours. No one exceeds 80 hours per week, although this is probably where we come the closest to 80 hours. You fill one of the intern spaces that Children's Mercy Hospital has on their inpatient team.

Behavior Health - You will spend time in clinic with the psychiatrist as well as see psychiatric consults on the family medicine inpatient service or long term care center. You are also responsible for medicine consults from the psychiatric floors during this rotation. You will find that you have a lot of time to read during this rotation as the clinic and consult numbers vary significantly throughout the rotation.

Cardiology – During this rotation, you will work alongside a cardiologist in clinic.  You will also see cardiology consults on the family medicine inpatient service. You will find that you have a lot of time to read during this rotation as the clinic and consult numbers vary significantly throughout the rotation.