Rotation Schedule

Residents have required inpatient and outpatient rotations each year complimented by an array of elective opportunities in general internal medicine, all medical subspecialties, radiology, pathology, anesthesia, dermatology, radiation oncology, ophthalmology, global health and research at both Waterbury and Yale-New Haven Hospitals.

The rotation schedule consists of a “4 x 2” block schedule spread across thirteen four-week blocks. The “4 x 2” block schedule divides the year into alternating 4 week inpatient blocks and 2 week outpatient blocks. During the inpatient blocks, residents will be spending time on the general medical wards, intensive care unit and inpatient electives. During outpatient blocks, residents will be focused on their ambulatory continuity practice, urgent care and outpatient electives.

PGY1 Schedule

PGY-I Preliminary Interns

Inpatient Wards16 weeks
Intensive Care Unit10 weeks
Ambulatory Medicine and Electives20 weeks
Emergency Medicine2 weeks
Vacation4 weeks

PGY-I Categorical Interns (3-year track)

Inpatient Wards22 weeks
Intensive Care Unit4 weeks
Ambulatory Medicine and Electives20 weeks
Emergency Medicine2 weeks
Vacation4 weeks

PGY2 & PGY3 Schedule


Inpatient Wards16 weeks 
Intensive Care Unit 
10 weeks
Ambulatory Medicine and Electives20 weeks
Neurology2 weeks
Vacation4 weeks


Inpatient Wards16 weeks
Intensive Care Unit 
10 weeks
Ambulatory Medicine and Electives18 weeks
Emergency Medicine 2 weeks
Geriatrics 2 weeks
 4 weeks

Ambulatory Education

The residents’ continuity clinic during dedicated ambulatory block rotations represents the cornerstone of their ambulatory experience. In addition, the residents have an opportunity to work with experienced physicians in subspecialty clinics, such as dermatology, psychiatry, diabetes management clinic, and joint injection clinic. About half of the activities on elective rotations take place in community venues in primary care and subspecialty offices.

Skills and Behaviors

Residents will:

  • Evaluate and manage patients with the range of problems encountered by primary care physicians;
  • Address health care maintenance issues for adult patients
  • Cultivate the robust set of physical examination skills essential to the practice of outpatient internal medicine;
  • Perform primary care procedures, such as joint injection, cerumen impaction removal, etc.;
  • Demonstrate communication skills necessary for effective medical interviewing and patient counseling;
  • Orchestrate the longitudinal care of primary care patients, including follow-up, telephone medicine, and collaboration with consultants and various community services;
  • Develop systems to convert their emerging information needs into well-formed clinical questions and to efficiently acquire, appraise, and apply medical information;
  • Exemplify the highest standards of ethics in patient, professional, and interpersonal interactions;
  • Efficiently provide patient-centered care as part of an interprofessional team within a practice microsystem;
  • Accurately document and code for care provided in an electronic medical record.


Residents will:

  • Understand the presentation, evaluation, and management strategies of chronic diseases and acute illnesses encountered by primary care physicians
  • Understand the basic principles for interpreting diagnostic tests, including probability revision and cost-effectiveness
  • Understand the health care system in the United States and Connecticut (and proposed reforms) and its impact on the provision of primary care


Residents will:

  • Appreciate the rewards and responsibilities of assuming the primary care of a group of patients, including the importance of patient advocacy
  • Consider their role as primary care physicians in the larger contexts of medicine in general, society, and their family and social networks

Continuity Clinic

Residents provide ongoing continuity care for their own panel of patients at the Henry S. Chase Outpatient Center under the supervision of experienced faculty. Before each clinic session, residents participate in a pre-clinic conference, led by both a peer teacher and a core faculty member, which utilizes Yale’s internationally renowned Yale Office-Based Medicine Curriculum.

During the residents' continuity session, the faculty devotes their time exclusively to precepting. Typically, each resident will see 3-5 patients as PGY 1s, 4-6 as PGY 2's, and 5-6 as PGY 3's.

The Henry S. Chase Outpatient Center is located across the street from Waterbury Hospital. This practice is efficiently managed by Alliance Medical Group, which manages many other hospital-affiliated practices in the community. An electronic medical record allows for seamless documentation and sharing of patient information among providers. Physical plant resources include built-in audio-video equipment in two examination rooms, proxy server connections to the Yale Medical Library, and facilities for minor procedures. The practice sees greater than 20,000 visits per year, providing care for a large portion of the medically underserved citizens of Waterbury. The payer mix is 62% Medicaid, 14% Medicare, 12% uninsured (self-pay), and 12% commercial insurers.

Inpatient Education

Inpatient education is based primarily at Waterbury Hospital and provides trainees with a broad exposure to the breadth and depth of internal medicine. Our program has a wide range of educational conferences. Each morning residents have the opportunity to participate in chief resident led reports. Each week we have invited Yale speakers at noon conference and Grand Rounds in the Bizzozero Conference Room. Every month we have recurring core faculty led conferences including journal club, tumor board, high-value care, medical jeopardy, emergency medicine and ethics, research and quality improvement, peer teaching, intern support group, board review, Chairman’s Rounds, M&M and multi-disciplinary firm conferences. 

Inpatient Wards

The teaching service is a geographically localized 30 bed unit on the fourth and fifth floor of Waterbury Hospital consisting of four day teams and two night teams divided into two Firms. These Firms are named after Drs. David Podell and Joseph Renda, master clinicians who embody the very best of medicine from clinical excellence to the highest standards of professionalism and devotion to patients. Areas of particular emphasis of the general medicine Firms at Waterbury Hospital include bedside rounding, the role of the physical examination in clinical care, and transitions of care. Each day team consists of an attending physician, resident, intern, and students from Quinnipiac University School of Medicine, Quinnipiac University School of Health Sciences, University of Connecticut School of Medicine, and University of St. Joseph College of Pharmacy. 

Medical Intensive Care Unit

The Medical Intensive Care Unit team is comprised of Pulmonary/Critical Care attendings, interns, PGY II and PGY III residents. Clinical care is complimented with daily case discussions and a core intensive care unit curriculum. The goal of medical training in the intensive care units is to educate residents in the diagnosis, evaluation and management of patients with a wide range of critical illnesses, most commonly sepsis, chronic disease related multi-organ failure, and respiratory failure. The resident is expected to become knowledgeable about the indications, contraindications, risks and benefits of common ICU level procedures. Residents have the opportunity to be trained in a variety of procedures such as arterial puncture and arterial blood gas interpretation, arterial line and central venous line placement, paracentesis, lumbar puncture, and naso-gastric tube placement. Inherent in the care of critically ill patients is the management of psychiatric, social and family concerns which are heightened in these intensive care settings and are addressed by residents as part of a multidisciplinary team. Patients are transferred to the medical ward teams when discharged from the intensive care units.

Research and Scholarship

All residents in the three-year categorical program are required to complete a scholarly activity project during residency. These projects can consist of case reports, literature reviews, curriculum development, or hypothesis driven research.

Aims of the Resident Scholarship Requirement

The primary goals of the resident scholarship requirement are to enhance the critical thinking skills of the residents as bedside clinicians, to facilitate scholarly thinking, creativity, and appreciation of the excitement in creating new knowledge in medicine, and to broaden the scholarly sophistication of all elements of the residency program (i.e., morning report, peer teaching, work rounds, noon conferences, etc.).

Interns will be taught how to write a clinical vignette abstract that they will then submit to the Connecticut Chapter of the American College of Physicians (ACP) annual meeting or to the yearly New England Regional Society of General Internal Medicine (SGIM) meeting. Residents with the highest quality work will also submit their work to the National ACP or the National SGIM meeting.

Residents are also encouraged to develop a more in-depth scholarly project during their PGY-2 and PGY-3 years. Projects can be in hypothesis-driven research, curriculum development, or quality improvement. Residents pursuing hypothesis driven research can designate up to one month per year of elective time for research.

Examples of Prior Research Projects

Abou Ziki MD, Verjee MA. Rare mutation in the SLC26A3 transporter causes life-long diarrhea with metabolic alkalosis. BMJ Case Rep. 2015 Jan 7;2015.

Abou Ziki MD, Strulovici-Barel Y, Hackett NR, Rodriguez-Flores JL, Mezey JG, Salit J, Radisch S, Hollmann C, Chouchane L, Malek J, Zirie MA, Jayyuosi A, Gotto AM Jr, Crystal RG. Prevalence of the apolipoprotein E Arg145Cys dyslipidemia at-risk polymorphism in African-derived populations. Am J Cardiol. 2014 Jan 15, 15;113(2):302-8

Stitham J, Vanichakarn P, Ying L, Hwa J. Cardiovascular pharmacogenetics of anti-thrombotic agents and non-steroidal anti-inflammatory drugs. Curr Mol Med. 2014;14(7):909-31.

Vanichakarn P, Hwa J, Stitham J. Cardiovascular pharmacogenetics of antihypertensive and lipid- lowering therapies. Curr Mol Med. 2014;14(7):849-79. 

Wang L, DeMarco SS, Chen J, Philips CM, Bridgets LC. Retinoids Bias Integrin Expression and Function in Cutaneous T-Cell Lymphoma. J Invest Dermatol. 2015 May 7.