Curriculum

We are so happy to announce that our Med-Peds program implemented an innovative schedule that started in July 2022 called the X+Y schedule. Only a small number of Med-Peds programs have embarked on this innovation and even a smaller number of Med-Peds programs have both categorical Internal Medicine and categorical Pediatrics on an X+Y schedule.

The X+Y schedule difference

The previous schedule

Our previous (traditional) model adds a weekly Med-Peds continuity clinic into most of your block rotations and duties throughout the year (26- 2 week blocks per year). Therefore on most rotations you must leave your rotation (inpatient and outpatient) to go to your own combined Med-Peds continuity clinic practice session for ½ to 1 full day.

The new Schedule (X+Y)

Our new model, “X + Y” separates your Med-Peds continuity clinic into a separate rotation that is predictably repeated longitudinally throughout the year.

The “X” block is 6 weeks in duration, which can be broken into 3 different 2-week rotations or a 4-week rotation with a 2-week rotation and contains your inpatient floor rotations, ICU rotations, specialty electives (inpatient and outpatient like Pulmonary or Cardiology), emergency medicine, customized rotations with all the required academics like morning reports, noon lectures, Grand Rounds, journal clubs, safety report, etc.

The “Y” block, is 2 weeks in duration and includes 8 Med-Peds continuity clinic sessions, 4 Ambulatory Academic Half Days (2 in Medicine and 2 in Pediatrics), and protected time for administrative work, wellness, Quality Improvement, self-directed learning and personalized experiences that differ by PGY year. Our “Y” schedule will focus more on direct patient care and foundational skills in PGY-1 and PGY-2 years and focus more on advanced skills and career personalization in PGY-3 and PGY-4 years.

There are 4 Med-Peds cohorts with residents rotating into their “Y” block every 8 weeks so there is always one cohort on “Y” led by a Med-Peds senior resident.

X+Y schedule benefits

• Decrease conflicting inpatient and outpatient concurrent responsibilities; thereby reducing resident distractions, handoffs and coverage issues
• Better ability for longitudinal experiences, self-directed learning and personalized experiences
• Increase the total number of Med-Peds continuity clinic sessions each year
• Each “Y” cohort will contain all years of Med-Peds residents to allow for group identity, group interests and mentoring to occur more easily
• Better integration with the categorical programs while allowing Med-Peds culture and identity to flourish
• Deliver academic content (Pediatrics and Internal Medicine academic half day) consistently

Our Med-Peds curriculum is an example of our ability to integrate with core programs (now we are all   X + Y) utilizing critical aspects of both Internal Medicine and Pediatrics sets of rotations, educational platforms and materials while also providing identity for additional skills and experiences, team building, reinforcement of concepts and to provide the depth and breadth of training that has become associated with our combined Med-Peds training. We are a Capital “M” and Capital “P” residency program.

The design of our four year Med-Peds program and schedule is to provide you with a cohesive and organized learning curriculum with a focus on increased independence and self-directed learning skills to be a valuable Med-Peds physician and leader.  The goal of our schedule is to provide a sequence of experiences and not a random set of rotations.

Our Med-Peds schedule of rotations has several unique features. After the first or second block, our interns all switch to the other specialty so early each intern has rotated in both internal medicine and pediatrics. After that first transition, transitions between specialties occurs every 3-4 blocks with the ability to transition more or less frequently in years 3 and 4 depending on your interests. Our schedule of rotations has a deliberate order to the inpatient rotations to better allow for increased responsibility over the 4 years of training.

Sample Schedule “Y” Template (Does not represent any PGY year specifically):

The “X”: We rotate between specialties in general every 4 – 12 weeks on inpatient and outpatient rotations

PGY-1

• Peds: Inpatient- General, Inpatient- Heme/Onc, NICU, Delivery Room, Newborn Nursery
• Internal Medicine– Inpatient- General, MICU, teaching Cardiology, Inpatient- Night Float, Emergency Medicine, Elective

PGY-2

• Peds: NICU- Senior, Emergency Medicine, PICU, Admitting Resident- Senior, Outpatient- Behavioral-Development, Inpatient- Senior Nights, Inpatient- Subspecialty
• Internal Medicine: CICU- Senior, Inpatient- Res-intern General, Geriatrics, Inpatient- Senior Night Float, Inpatient- Senior Rapid Response Team, Elective(s)

PGY-3

• Peds: Emergency Medicine, Outpatient- Cardiology, Outpatient- General Peds, Inpatient- Senior General or Medically Complicated or Heme/Onc, Elective(s)
• Internal Medicine: MICU- Senior, Inpatient- Senior Geriatrics, Inpatient- Senior General, Leadership Elective, Elective(s)

PGY-4

• Peds: College Health (University Delaware), Outpatient- Adolescent Medicine, Emergency Medicine, Outpatient- Behavioral-Development, Inpatient- Senior General, Inpatient- Senior General Nights, Elective(s)
• Internal Medicine: MICU- Senior Nights, Inpatient- Senior General, Med-Peds inpatient service, elective(s)

The “Y” Focus (also incorporated in the “X”)

Themes Across the “Y”

• Quality Improvement, Research, Committee work, Curriculum work
• Panel Management, Population Health, Billing/Coding, Patient Care administrative work
• Med-Peds Academics including Board Review, EBM, Journal Club
• Diversity, Equity, Inclusion and Anti-Racism

Build Your Own Curriculum Adventure as an individual, PGY class or across your “Y” cohort

• Resident as Teacher, Senior Talk and Med-Peds Precepting
• Advocacy and Community Engagement
• Policy Skills
• Leadership Skills and leadership roles
• Financial (Self and System Finances)
• Global Health
• Advanced Outpatient Skills including Center for Virtual Care
• Simulation and Procedures
• Personalized Rotations

Keep Your Life in Order

• Wellness days
• Mandatory Modules
• Evaluations
• Resume and Career Counseling
• Certifications (ACLS etc.)