The University of Iowa Hospitals and Clinics (UIHC) is the only academic hospital in the state of Iowa.  Consequently, many of our patients present from across the state with complicated and/or rare medical problems requiring the subspecialty care that only our institution can provide.  UIHC also acts as the “safety net” hospital for the state of Iowa, providing care to the under-served populations.  As such, our residents see a wide range of conditions in a diverse patient population while rotating on the general medicine floor at UIHC.

Three teams, each comprised of a staff hospitalist, one senior resident, three interns, and 2-3 medical students admit, diagnose, and manage these patients.  Two interns take care of patients during the daytime and the third intern provides coverage at night every time their team is on call.  On average, interns take 3-4 nights of call per X-block.

Admission are allocated based on a rotating call cycle of a “pre-call,” “on-call,” and “post-call” team.  No patients are admitted to the “post-call” team.

Recently (as of April 2023), UIHC geo-localized all of the inpatient services.  This means all general medicine teaching team patients are now almost entirely located on the same floor – just a couple steps from the team room.  This also provides for great continuity of care as our residents now work with the same set of nurses, social workers, pharmacist, physical therapists, and occupational therapists, which allows our residents to work together more closely with the support staff and learn from them as they provide outstanding patient care. 

There is also an ultrasound machine on the general medicine floor that is easily accessible and readily available for point-of-care ultrasound exams and performing bedside procedures.

The Iowa City VA Medical Center is a 3 minute walk away from UIHC and it provides a fantastic learning opportunity for residents. Patients come from a wide range of socioeconomic status’ and backgrounds and they present with a wide variety of medical problems, that range from “bread and butter medicine” to the “zebras”.

The ICU at the VA is also an open ICU that is staffed with a pulmonary/critical care staff and fellow, which allow our residents to get experience taking care of all levels of acuity.

Three teams, each comprised of a staff hospitalist, one senior residents, two interns, a pharmacist, and 2-3 medical students admit, diagnose, and manage the patients admitted for primary medicine problems to the VA.  Admissions are allocated based on a rotating call cycle of a pre-call,” “on-call,” and “post-call” team.  No patients are admitted to the “post-call” team.  The interns work schedule is a rotating schedule with interns covering three days in a row on the pre-call, on-call, post-call cycle.  Then the intern transitions to nights and covers the night call shift into the post-call day before starting the call rotation back on days.  Overall, interns do an overnight call every 6th night.

Comprised of a staff Cardiologist, a senior resident, and two interns, the inpatient cardiology team diagnoses and manages patients with acute cardiovascular illness who do not require an ICU admission. Common problems seen on this service include acute coronary syndromes, decompensated heart failure, valvular disease, pulmonary hypertension, pericarditis, and endocarditis. The team admits patients daily. Overnight, cross-coverage and new admissions are managed by our night float team.

The medicine/psychiatry unit at UIHC is a 15 bed unit.  Residents on this rotation get experience managing the complex interactions between psychiatric and medical illnesses.  One team, comprise of a Medicine staff and Psychiatry staff, one senior resident, and two interns care for up to a total of 15 patients who have both a medical indication for hospitalization and a psychiatric indication for hospitalization. The team admits patients daily with no overnight call.  Overnight admissions and cross cover are provided by the night float team.

If you are interested in a combined Internal Medicine and Psychiatry Residency, please visit their residency page:  https://gme.medicine.uiowa.edu/internal-medicine-psychiatry-residency

The UIHC Medical Intensive Care Unit (MICU) is a 26 bed unit.  Common problems managed in the MICU include sepsis/shock, acute and chronic respiratory failure, and other critical conditions.

Two teams, each comprised of a Pulmonary/Critical Care staff, fellow, and 2 senior residents, 1 intern, and 1 APP help provide care to the patients admitted to the MICU.  The intern on the team gains experience taking care of critically ill patients by helping to admit patients and provide cross-coverage every other night.  Interns do not have any day coverage responsibilities in the MICU.  The senior residents take call every fourth night with one day off per week.

Throughout this rotation, residents will have plenty of opportunity to perform beside procedures including central line placement, paracentesis, thoracentesis, lumbar puncture, and arterial line placement.  Point-of-care ultrasound is a highly emphasized aspect of this rotation and residents have ample opportunity to get hands on experience obtaining images and measurements at bedside.

The UIHC Cardiovascular Intensive Care Unit (CVICU) is a 24-bed unit. Common problems seen on this service include cardiogenic shock, STEMIs, severe valvular dysfunction, and life-threatening arrhythmias.

Patients admitted to the CVICU are either admitted to the medical team, if their primary problem is a medical cardiovascular problem, or to the surgery team.  Four senior internal medicine residents help staff the medical team of the CVICU, along with a staff cardiologist and cardiology fellow. Each resident takes call every fourth night with one day off per week. 

During their rotation on the CVICU, residents will become comfortable with the interpretation of hemodynamic monitoring number from PA catheters (Swan-Ganz catheters) and the management of cardiac assist devices including intra-aortic balloon pumps (IABPs) and impellas.

The night float team consists of two pairs of one intern and senior resident.  Each pair works every other night.  This team helps to cross-cover and admit to the Inpatient Cardiology Teaching Service and the Medicine/Psychiatry Unit.  The senior resident also covers Surgical co-management (general medicine) consults.