General Internal Medicine Inpatient Wards
Inpatient months consist of direct care of patients on the medical floors. A resident team is assigned to a geographic floor which includes General Medicine, ICU step down, Oncology, and Cardiology. Daily rounding occurs with your Hospitalist attending at the bedside. Innovative real time rounding with tablets is available. Residents are responsible for all aspects of patient care as well as the efficient use of hospital resources. Daily rounds with Care Coordination help to minimize length of stay.
Continuity Care Clinic/JFK Health Center
Each resident participates in a general internal medicine continuity care clinic two half days per week while on elective rotations. The residents are responsible for the comprehensive management of their panel of patients. This experience is meant to provide a broad based exposure to general internal medicine practice in the ambulatory care setting. The goal is to ensure preparedness for successful clinical practice upon completion of this program. The team based approach includes clinical pharmacists, on site interpreters, clinical social workers, dieticians, dental and counseling services. This provides an outstanding learning environment while caring for at-risk patient populations.
ICU-Medical Surgical Neuro Trauma Intensive Care Units
Residents round daily with Critical Care attendings and fellows in one of the closed Medical, Surgical, Neuro or Trauma Intensive Care Units. Our Mercy Critical Care Program is one of the largest in the country sporting a vigorous Critical Care Fellowship Program. The SEPSIS initiative has improved the mortality of our patients. Dedicated Critical Care attendings lead the team in daily patient care and teaching rounds. Exposure to the country’s largest eICU is available. Residents are able to participate in procedures. Senior residents can choose to do extra elective rotations in their PGY2/3 years.
CVICU-Cardiovascular Intensive Care Unit
This is an intensive care experience in a closed Cardiovascular ICU within the Heart Hospital of Mercy Clinic. The residents are part of a team with a dedicated Hospitalist Cardiologist and Internal Medicine Hospitalist/Critical Care Attending and are responsible for all aspects of patient care. 24 hour in house Critical Care is also available for this unit. Residents are exposed to the full spectrum of hospital based Cardiology services and subspecialties.
Medical Subspecialty Ambulatory Rotations
These occur every other month during elective rotations. Month long electives in a single subspecialty are available and are tailored to the resident’s specific areas of interest. This allows each resident to formulate their career plan. This includes electives in primary care with integrated Mercy primary care physician groups. Some two week electives include, but are not limited to, Urology, Podiatry, Wound Care, Palliative Care, Ophthalmology, PM&R, Orthopedics and Procedures have been introduced based on interest and need.
The Emergency Medicine rotation occurs on an elective month during the intern year. Interns will work average 13 shifts during this month with 2 full days off per week. There is an ER curriculum and lecture series. Patients are staffed with ER attendings who are dedicated to teaching. Residents can choose to do an elective rotation in the ER Urgent Care or offsite Mercy Urgent Care facilities during their senior years.
This elective, typically done in the intern year, is spent in the Neurology Clinic. The resident will see new patient visits in the morning followed by new inpatient consults in the afternoon.
When on the “Stroke Team” the resident will work with the dedicated stroke service. Mercy Clinic Hospital is a Certified Stroke Center and also offers tele-stroke. The resident will be part of the rapid access team evaluating all possible acute strokes in the ER and hospital.
This is a required rotation by the ACGME. This rotation will focus on both long term care and rehabilitation of the elderly in the Geriatric Outpatient Continuity Clinic.
Quality and Safety
This elective focuses on the quality and safety in medical care. Residents will define patient safety and quality improvement terminologies and general strategies to improve QI. They will complete the Institute for Healthcare Improvement's open school basic certificate to demonstrate basic understanding of patient safety and quality. They will also participate in hospital Quality Improvement activities by participating in committee meetings. Residents will complete a Quality Improvement Project over the course of their residency, which will be presented at The Robert Taylor Research Colloquium at the end of the PGY3 year. The residents will demonstrate systems thinking and processes of care in a Morbidity and Mortality format.
Mercy Clinic Experience
All interns rotate through a Mercy primary care private practice in the St Louis medical community. This rotation can be continued into the second and third years for those who are interested in Primary Care or who want more exposure to an office based setting.
Community Based Health Elective (CBH)
The CBH elective is designed to provide residents an understanding around transitions of care at hospital discharge, how healthcare disparities affect specific populations and improve the awareness of social determinants of health. We will provide exponential, interdisciplinary training in different care settings outside of the acute hospital and resident clinic. This will include two Saturday mornings spent at an indigent clinic located in a local mosque.
Allergy & Immunology
Residents spend most of their time in the patient setting but do have the opportunity to staff inpatient consults.
Residents are exposed to up to date non-invasive and invasive Cardiology in the setting of the new Mercy Heart Hospital. The residents work with a Hospital Cardiologist staffing all inpatient Cardiology.
This elective rotation includes hands on learning in the Dermatologist’s office as well as consultations in the hospital.
Endocrinology & Metabolism
Outpatient Services and inpatient consults are an integral part of this rotation. Residents will be exposed to the management of diabetes, thyroid disease (with procedures such as biopsies) and other adult metabolic conditions.
Residents participate in a combined ambulatory and inpatient clinical service. The residents will participate in a wide variety of procedures as well as consultative services. A 2-week Hepatology elective has been introduced for those interested. Mercy has also partnered with the St. Louis Veterans Administration to provide residents with an opportunity to work with Washington University or faculty at the VA. There is opportunity to perform and learn procedures during this elective.
Residents will spend time at the David C. Pratt Cancer Center practicing outpatient Oncology. Inpatient consultations will also be staffed during this elective. Residents will gain exposure to Radiation Oncology if they are interested.
Hospice & Palliative Care
Mercy Clinic Hospital is a leader in Palliative Care and Hospice. Mercy Hospital is one of only 23 hospitals in the U.S. to receive the Advanced Palliative Care Certification by The Joint Commission. Palliative Care addresses a patient’s physical, emotional, social and spiritual needs and facilitates patient independence, access to information and choice. The team includes physicians, nurse practitioners, licensed clinical social workers, chaplains, dietitians, physical therapy, integrative medicine such as music therapy and massage therapy. This team works alongside a patient’s primary care physician or specialist to provide an extra layer of support. Patients experience firsthand the benefits of Mercy’s team-based approach. Mercy now has a Palliative Care Fellowship, so residents will be working alongside a fellow during this rotation.
Available in PGY-3 year for interested residents. The goal of this elective is to expose residents who may be considering a career in hospital medicine to our hospitalist model. Residents will work one-on-one with an assigned hospitalist faculty caring for patients on a high volume service without interns or medical students. This is a patient care model that accurately reflects what a practicing hospitalist will experience.
Both an inpatient and outpatient rotation. Due to the large and diverse population Mercy Hospital serves, residents are exposed to many ID conditions including HIV, wound care, neutropenic fever and fever of unknown origin. The inpatient ID team has a dedicated ID pharmacist that augments the ongoing quest to chose the right antibiotics.
International Health Elective
A GME led elective where residents can gain experience in International Health. Mercy GME offers 2 International Health scholarships annually.
Residents work with an excellent and enthusiastic hospital based Nephrology group staffing both inpatient and outpatient needs. Mercy has a dedicated hemodialysis unit on site.
Residents will experience Ophthalmology in a private office and in the JFK clinic. Emphasis will be on the diagnosis and treatment of common eye conditions.
Residents may be exposed to orthopedics during their intern year. A 2-week elective is also available to the senior residents. This experience includes both inpatient and outpatient orthopedic care.
Emphasis will be on common conditions that the internist will encounter in Internal Medicine.
Physical Medicine and Rehabilitation
Residents can spend time at the Mercy Rehabilitation Hospital and outpatient offices of attending physicians.
This is a 2-week elective rotation that focuses on management of conditions seen in the primary care setting.
This is a 2-week elective to gain competency in LP’s, Thoracentesis and Paracentesis. A POCUS curriculum is currently being developed.
Residents may spend time during their intern elective months working with Psychiatrists in order to gain exposure to their field.
Pulmonary and Sleep Medicine
Time is spent in the clinic as well as doing inpatient consultations. Time is also available for residents seeking additional exposure in Sleep Medicine and Pulmonary Function Testing.
The main focus is on office Rheumatology with an occasional opportunity for inpatient consultation.
Urgent Care - JFK
This is a 2 week elective designed to provide the resident with a greater understanding of the diagnosis and management of the acutely ill patient in their residency clinic.
This is a 2-week elective focused on primary internal medicine related Urological conditions.
Wound Care Elective
This is a 2-week elective. 1 week will be spent at an off-campus Hyperbaric Wound Care Center which offers complete diagnosis, evaluation and care for chronic and/or complicated wounds that have not responded to conventional treatments. This is led by a plastic surgeon. The other week is spent with Wound Care nurses on the inpatient floors learning the evaluation and management of wounds.