Program Structure

A sample structure of the four-year curriculum is shown in the Table below. One month of vacation has been excluded from the table. Recent residents in the IM/PM program have had this rotation structure:

*Individual resident and schedule may vary.

Year 1

IM/PM interns are encouraged to attend preventive medicine seminars, journal clubs, and research conferences. Every effort is made to encourage the residents to integrate Internal Medicine and Community/Prevention practice.

First Year Curriculum
General Medicine Rotations	4 Months
ICU/CCU Rotations	2 Months
Emergency Medicine	1 Month
Ambulatory Medicine	1 Month
Cardiology Rotations	2 Months
Night Float Rotation	1 Month
Vacation	1 Month
Primary Care Clinic	One half day per week, throughout

Year 2

During the PGY-2 year, residents continue their clinical training to fulfill American Board of Internal Medicine requirements. PGY-2 residents are expected to participate in research meetings, journal club, research activities, and the preventive medicine seminar. In addition, residents are encouraged to pursue clinical electives germane to Internal Medicine, Preventive Medicine and Public Health (e.g., Occupational Health), and to identify population-based issues relevant to clinical rotations.

Second Year Curriculum
General Medicine Rotations1	2 Months
ICU/CCU Rotations1	1 Month
Cardiology Rotation	2 Months
Geriatric Medicine	1 Month
Night Float Rotation	1 Month
Elective-Medicine1,2	2 Months
Medical Consult/Day Float/MOD	1 Month
Vacation	1 Month
Ambulatory Medicine	1 Month
Continuity Care Clinic	One half day per week, throughout
1Rotations representing opportunities for integration exercises (practicum). 2Electives may be taken at the Yale School of Medicine, Yale-New Haven Hospital.

Year 3

In PGY-3 year, residents begin the curriculum leading to the Masters degree in Public Health (MPH). Magority of residents complete their MPH at the Yale School of Public Health, but residents have the option of doing their MPH elsewhere or online once approved by the program dirctor. They complete the fall and spring semester. During the remainder of the PGY-3 year, residents resume clinical activities. Of note, the academic semesters during year three allows the residents to begin and complete MPH course work with a single cohort of classmates, enhancing the development of collaborations and relationships, and cultivating full acculturation to public health. This facilitates compliance with certain requirements: 1) core degree curriculum requirements of the School of Public Health; 2) requirements of the ABPM, which call for breadth of training; and 3) program requirements, which include courses in research protocol development, occupational health, and electives related to the particular resident's career goals, are chosen with faculty supervision. In year three, residents can spend one month with a Public Health Department or other Public Health relevant rotation. Objectives of these rotations are tailored to the interests of the particular resident, but in general include opportunities for outbreak investigation; participation in public health surveillance; participation in research conducted by the Health Department; and participation in the meetings, lectures, and seminars relevant to the particular resident's activities in the Health Department.

Cancer track residents are expected to go to the National Cancer Institute to complete the "Summer Cancer Epidemiology Course" at the beginning of PGY-3.

PGY-3 residents are expected to participate in research meetings, journal club, research activities, and the preventive medicine seminar. Finally, residents in year three are provided the opportunity to apply their new public health training by participating in administrative meetings at the hospital related to case management, quality management initiatives and clinical pathway development.

Third Year Curriculum
General Medicine Rotations	1 Month*
Night Float Rotation	1 Month
Public Health Rotations	1 Month
Vacation	1 Month
MPH Degree	8 months
Continuity Care Clinic	One half day per week
*Clinical rotations during which integration exercises (practicum) may be conducted.

Year 4

Residents complete the practicum and any remaining clinical requirements. The importance is placed on the clinical practice of community-oriented primary care emphasizing continuity practice, screening, preventive service delivery, clinical epidemiology, cost-effectiveness, and decision analysis. Community-based health promotion, including service delivery outside the conventional clinical setting and community-based clinical research; outbreak investigation; participation in activities of the Public Health Department; formulation of and participation in multidisciplinary teams designed to address hospital-wide or community-wide problems in health care status or delivery is emphasized. The program encourages participation in research grant applications and clinical research; manuscript preparation for peer-reviewed medical journals; and hospital administrative meetings that impact on clinical service delivery; and exposure to health care legislation process. Available practicum sites can be found in the Practicum Directory.

Fourth Year Curriculum
General Medicine Rotations	2 Months
MOD/Day Float/Medical Consult	1 Month
Community Health/Public Health	5 months*
Vacation	1 Month
Women Health and other integrated rotations	3 Months
Continuity Care Clinic	One half day per week, throughout
*Integrates Women's Health, Geriatrics, Occupational Health, Research and Yale Cancer Center etc.