Transitional Year Schedule

The typical Transitional Year intern schedule is divided into 13 four-week blocks. The other NWH-based interns do some modified schedule based on their specific program requirements. Each TY intern is able to take up to 3 weeks paid vacation per year. However, due to scheduling constraints vacation can only be taken one week at a time and not in 2 or 3 consecutive weeks. Also, there is no terminal vacation at the end of the academic year in June.

Services Typical Number of Blocks for TY Interns
Medicine Ward Service 1 - 2
Surgery Service 3 - 4
ICU 1
Night Medicine 2
Ambulatory Care 1
Emergency Medicine 1
Elective 3 (including a QI elective)


Medicine Service

There are 4 medicine teams that comprise our medical teaching service. Each team is comprised of:

  • MGH senior medicine resident
  • MGH medicine intern
  • NWH-based intern 
  • Tufts MSIII student
  • PA Student
  • NWH Hospitalist

Each medicine intern accepts new patients every other day. Formal pass-off of night medicine admissions to the day teams occurs each morning during Morning Report, which is lead by the MGH Chief Resident. New admissions are accepted by the admitting interns until 6:00 pm. Non-admitting (swing) days are typically much shorter and interns can sign out by 4:00 pm. Admitting interns typically end their days by 8:00-9:00 pm.

We have an extensive hospitalist service attending on the medicine teaching service. Given the communities that NWH draws from, our patient population is typically elderly, well-educated, and compliant with medications and follow-up, though there are certainly exceptions to this. We can admit patients with de novo presentations of common and less common diseases. Patients will come in with a variety of illnesses including coronary artery disease, cardiac arrhythmias, congestive heart failure, valvular heart disease, chronic obstructive pulmonary disease, asthma, diabetes and its complications, renal failure, stroke, seizure disorders, a variety of neoplastic diseases including lymphoma and multiple myeloma, gastrointestinal bleeding, pancreatitis, pneumonia, pyelonephritis, and bacterial endocarditis.

There are many didactic sessions scheduled on the medicine service. Morning report and noon lectures with lunch are scheduled daily. On a weekly basis, journal club, intern report, simulation training and grand rounds are held. The MGH Chief Resident based at Newton-Wellesley leads many of these didactic sessions.

Surgery Service
There is one large surgery team that includes: 

  • MGH senior level surgery resident
  • MGH junior level surgery resident
  • MGH surgery intern
  • NWH-based interns (4)
  • Tufts MSIII students (4-5)
  • PA students

Given that the surgical team has few senior members, interns are often the first assist in one of our many operating rooms. If you enjoy the operating room, you will have plenty of time to hone your skills in surgeries such as laparoscopic and open cholecystectomies, large and small bowel resections, hernia repairs, vascular bypass and endarterectomies, breast biopsies, breast lumpectomies and modified radical mastectomies. We have the largest gastric bypass department in the state and there will often be patients on the surgery service status post gastric bypass.

Due to the resident work hour requirements, we follow a night float system where each intern on the team will take turns working the overnight shift for 4-5 nights at a time. There are weekly didactic lectures and simulation center trainings led by the Associate Chair of Surgery.
 
Intensive Care Unit (ICU)
The ICU is a closed unit of 12 beds comprised of surgical, cardiac and medical patients. The surgery service covers the surgery patients in the ICU. The cardiac and medical patients are covered by the ICU resident team, which is comprised of:  

  • MGH senior medical resident
  • MGH junior residents (2)
  • NWH-based interns (2)

The ICU is staffed by critical care attending physicians during the day and moonlighter attending level physicians at night. The ICU follows a night float system and each intern works one 6-night stretch of overnight shifts. The other two interns are either on short call or long call, leaving the hospital between 3:00 and 8:00pm. Patients suffer from a variety of syndromes requiring intensive care unit treatment including sepsis, respiratory failure, toxic overdoses, acute myocardial infarction, unstable angina, congestive heart failure, and gastrointestinal bleeding. There are daily teaching sessions. The ICU is one of the most enjoyed rotations due to the team structure and excellent teaching.

Emergency Medicine
Each NWH intern will spend 4 weeks rotating in our new Emergency Department. We are not a trauma center but do see a variety of emergency situations such as myocardial infarction and drug overdoses. The interns have first contact with a variety of patients and can often do procedures such as suturing and intubation if desired. The 10 hour shifts are scheduled from 9:00 am - 7:00 pm. In addition, the ED interns are scheduled to be the night medicine interns 4 nights out of the block. There are weekly lectures given by the Chair of the Emergency Medicine Department.

Ambulatory Care
The Transitional Year Review Committee requires a minimum of 140 hours be spent in an ambulatory setting. We schedule the rotation to include some time in an offsite local Urgent Care center and some time in a primary care practice at NWH. The interns have first contact with patients and work alongside 1-2 attendings so teaching is a daily occurrence. This requirement is for the TY interns only but the other NWH-based interns have occasionally chosen this as their elective given the popularity of the rotation especially at the Urgent Care Center.

Night Medicine
Each NWH intern spends approximately 8 weeks being a night medicine intern. There are 2 night medicine interns each night covering 2 different “regions” of the hospital for the 4 medicine teams. The night medicine interns will cross cover the service and admit 3 patients to their “region”. The night medicine interns work 6 nights in a row and interns on their EM rotation provide additional coverage one night a week. Typically, a night medicine intern works only 12 nights total out the 28 day block. The remaining 16 days/nights of the four-week block are scheduled as vacation and as “backup”.

Electives
There are a variety of elective choices at NWH and interns have 2-3 months for electives depending on whether they are TY interns or MGH Anesthesia categorical interns. There is a four-week quality improvement elective that each TY intern is required to complete and other NWH-based interns have the option to do as well. Other electives that residents commonly choose include anesthesiology, cardiology, dermatology, ophthalmology, pulmonology, and radiology. We are very flexible on what electives interns choose and support research opportunities as well.
 

 

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