Adult Medicine

Hospital Medicine

Inpatient rotations on the adult medical floors consist of two months in the first, second, and third years—a total of 6 months over the 3-year program. These rotations expose residents to a variety of both common and less common problems in adult medicine and occur in both the urban and rural settings.

In the PGY-1 year, residents do two separate months of hospital medicine. One month occurs on the family medicine continuity service, comprised only of patients from the Highland Family Medicine residency clinic. Care is led by family medicine faculty. The continuity inpatient service has recently initiated a patient census cap to help ensure a balance between work and learning and to help maintain resident wellness. The team is comprised of one first-year resident, one second-year resident, and a third-year supervising resident.

The second month of hospital medicine is on a team of family medicine residents caring for patients from other practices in the community. This team is usually overseen by hospitalists, but some family medicine faculty also oversee this team for several months of the year. This team is comprised of one first-year resident and a third-year supervising resident; in some months there is a second-year resident as well.

In both the PGY-2 and PGY-3 years, rural residents will do one month of inpatient medicine at Noyes Hospital in Dansville and one month at St. James Hospital in Hornell. On both rotations, residents will work directly one-on-one with a hospitalist attending managing new hospital admissions, rounding daily on hospitalized patients,

Intensive Care Unit

The Medical Intensive Care Unit at Highland Hospital is the setting for training in the management of acute cardiac and pulmonary disease and other complex medical illnesses. A pair of family medicine first-year residents covers the service with supervision by pulmonary/critical care attendings, fellows, and APPs working in the 14-bed unit. There is no overnight call. The nursing staff, along with attending physicians from cardiology, pulmonary, and critical care, provide excellent inpatient teaching for residents. It also offers opportunities to perform critical care procedures. The rotation is 4 weeks, done during the first year of residency.

Night Float

First-year residents do not take night float responsibilities. For one week in the second year, a resident provides cross-cover for patients on non-surgical floors, receiving sign out from the day teams at 8:00 pm and covering until 7:00 a.m. Third year residents admit patients during night float for two weeks.

Cardiology

During this two-week rotation, residents work with the cardiology practice at Highland Hospital and other sites within the University of Rochester system. Residents split their time between outpatient cardiology sessions and seeing patients with the inpatient consultation team. In addition to weekly EKG rounds at Noon Conference at Highland, there are cardiology teaching sessions on inpatient medicine rotations.

Geriatrics

Training in geriatrics is a significant strength of the Family Medicine Residency Program and occurs in one of two designated sites with direct supervision by family medicine geriatric faculty. In addition to providing continuity care for patients in nursing homes, a full block of geriatric medicine in the third year provides training in geriatric mental health care, rehabilitation, comprehensive assessment, and end-of-life care as well as a more intensive experience in day-to-day nursing home care. From clinic patient panels, residents participate in functional assessments and home visits for their elderly patients. Highland Hospital has a medicine floor devoted entirely to acute care for the elderly that has become a national model for elder care. A new palliative care unit was also opened in 2024. In addition to these dedicated experiences, residents gain significant experience caring for older adult patients during their inpatient medicine rotations.

Electives are available for residents with an interest in geriatrics and many of our graduates have gone on to the Geriatrics Fellowship available here at URMC.