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Programs of postgraduate training in internal medicine at The University of Texas Southwestern Medical School are under the aegis of The University of Texas Southwestern Medical Center at Dallas (UT Southwestern). House officers rotate through Parkland Health and Hospital System (PHHS), the Dallas Veterans Affairs Medical Center (DVAMC), Zale Lipshy University Hospital (ZLUH), and St. Paul University Hospital (SPUH).
The program provides a stimulating and challenging internship during which the fundamental skills of a primary care physician are acquired. The intern takes the major responsibility for the care of the patient with the continuing counsel of the resident. Generally, only the intern writes orders on patients. Interns perform the majority of invasive procedures, under supervision, and rapidly become adept at intubation, arterial and central line placement, thoracentesis and chest-tube placement, abdominal paracentesis, arthrocentesis, lumbar puncture, and; pericardiocentesis. The skills requirements set forth by the American Board of Internal Medicine for a three-year residency are usually met by our interns within six months.
The remaining two years allow consolidation of these skills, the opportunity for more extensive exposure to selected subspecialties, and more time to pursue extracurricular activities. The resident on a ward rotation serves as an advisor and instructor to the intern. The resident evaluates each patient daily with the intern and attending physician to make decisions regarding patient care. The resident also provides literature regarding patients on the service and plays a major role in the education of medical students assigned to the team. In the last two years of residency, about half of one's time is spent on subspecialty rotations at Parkland and the DVAMC. The resident handles most of the consultations on each service and staffs these with the attending physician;for that subspecialty. Nights and weekends are generally free time for the resident; on consultation services residents do not have night-call. In addition to these duties in an inpatient setting, emphasis is placed on developing the skills needed to deliver expert care in an outpatient ambulatory setting.
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