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Overview of the Transitional Year Program

Fundamental Clinical Disciplines

The Transitional Year Residency Program, consisting of 15 positions annually, is designed to provide a broad clinical experience as preparation for subsequent education in specialty residency programs. This structured yet flexible program is based on three fundamental clinical disciplines: internal medicine, surgery, and pediatrics. Each resident will select one five-month experience in internal medicine, pediatrics, or surgery. This area of concentration will be supplemented with your choice of four one-month selective rotations from any of the three fundamental clinical disciplines and obstetrics and gynecology. Residents will also have one month of supervised emergency room experience and two months of electives from other departments.

Internal Medicine

The major internal medicine rotations are on the inpatient services at the Lyndon Baines Johnson General Hospital and at Memorial Hermann-Texas Medical Center. The majority of services are general internal medicine services, although a few rotations are available on the oncology, nephrology, and cardiology services at Memorial Hermann-Texas Medical Center and on the cardiology service at LBJ General Hospital. Residents who take five months of internal medicine will have a month of ambulatory medicine. The ambulatory month may include rotations at The University of Texas General Internal Medicine clinic; the general internal medicine and subspecialty clinics at LBJ General Hospital. Transitional residents may request rotations in the medical intensive care unit at either LBJ or Hermann Hospital. On all these rotations, the transitional year resident has the same duties and responsibilities as do PG-1 residents in internal medicine. The PG-1 resident acts as a primary care physician for his/her patients, performing the initial examination, as well as planning, diagnostic evaluation and management. On the inpatient services, the PG-1 resident works together with one or more upper level residents and usually with a team of medical students under the supervision of an attending physician. On the ambulatory rotations, the PG-1 resident works directly with the attending physician.

Pediatrics

Rotations at the LBJ General Hospital are well represented with a total of 100 pediatric/neonatal/low risk nursery beds. The 30-bed general ward, which has eight pediatric intermediate care beds, provides care for children with a wide variety of illnesses, and includes pediatric subspecialty care.

At LBJ General Hospital, the neonatal service consists of 50 beds including a Level II unit and a highly sophisticated Level III unit, a hospice room and an isolation unit. All are provided with the latest technology.

A general pediatric clinic has been opened on the second floor, separate from the Emergency Room, where residents see hospital discharges, early neonatal follow-up, and other general pediatric patients as part of their general pediatric and low risk nursery rotations.

The community-based pediatric experience at LBJ General Hospital provides a complementary educational experience to the more tertiary care provided at Memorial Hermann Children's Hospital and The University of Texas MD Anderson Cancer Center.

Surgery

Rotations are on the inpatient services at the LBJ General Hospital and at Memorial Hermann-Texas Medical Center. Two independent surgical “color” services provide a full spectrum of emergency. critical and elective care in general abdominal, vascular, thoracic, pediatric, oncologic and trauma surgery to a predominantly indigent patient population. Due to the large size and diversity of its patient population and the subsequent wide variety of clinical problems encountered, the General Surgery Service affords the resident a rich opportunity to develop and sharpen clinical skills and master fundamental surgical techniques. Rotations through the Hermann Hospital surgical critical care, cardiovascular surgery, transplantation, burns and pediatric surgery services are also available to those who desire further subspecialty exposure.

Required

LBJ Emergency Center

The intern will spend one month rotating in the Emergency Center at LBJ General Hospital, 2 weeks in Adult EC, and 2 weeks in Pedi EC. The schedule will reflect twelve-hour shifts which will encompass all levels of patient acuity. There is 24-hour-per-day attending coverage in the Emergency Center, along with in-house multi-specialty backup. This rotation exposes the intern to a great diversity of emergency medical conditions.

Department Electives

Anesthesiology

The General OR anesthesia rotation is a one month rotation at Memorial Hermann Hospital. Residents are supervised by faculty and clinical residents of the department of Anesthesiology. During this rotation, residents are exposed to various general surgery, gynecological and ambulatory surgical cases.

During this rotation residents will acquire knowledge for safer practice of anesthesia and evaluation of patients preoperatively. Also residents will acquire the necessary skills for safe management of anesthesia in ASA 1-11 patients.

Dermatology

This elective involves a varied experience including eight half-days per week attending outpatient clinics, with additional time spent doing inpatient consultations. A broad exposure to medical and surgical dermatology, as well as dermatopathology, is made possible by attending the following clinics on a rotational basis: Medical School private outpatient clinic, LBJ clinic, San Jose clinic, MD Anderson clinic, and the option of additional time in the private offices of several dermatologists.

The main emphasis of this rotation is on observing and diagnosing the literally hundreds of different lesions and rashes that come through the clinics. There is no night call or weekend duty associated with this elective.

Neurology

This elective provides the resident with the opportunity to participate in clinical rounds with two neurology residents and faculty on a daily basis and exposure to a spectrum of patients. Functions include interpretation of studies, neuro-radiology rounds with emphasis on CT of the brain and spine as well as cerebral angiograms. Night call is required.

Ophthalmology

The goal of this elective, held at the Hermann Eye Center, is to provide the Transitional Year Resident with a broad exposure to general ophthalmology. Particular emphasis will focus on practicing a systematic eye examination, enhancing the resident's skills with the direct ophthalmoscope and slit lamp. The resident will have hands-on experience with hundreds of patients in an outpatient setting, as well as hospital consultation in ophthalmology, and a limited exposure to common ophthalmic surgical procedures.

The ocular manifestations of common systemic diseases is also stressed, including making the diagnosis of diabetic retinopathy, hypertension, and evaluating patients with thyroid disease. The resident also will have experience with ocular emergencies. Subspecialty rotations in glaucoma, retina, pediatric ophthalmology, neuro-ophthalmology, cornea and external disease also are available. The rotation consists of daytime, outpatient clinics, and there is no call required.

Orthopaedic Surgery

During this elective, the resident will develop the skills necessary to practice orthopaedic surgery through patient care. Clinical rotations are available in general and pediatric orthopaedics, trauma and spine surgery, joint reconstruction, and hand and upper extremity surgery. The resident sees new patients, elicits a pertinent history, examines the patient, orders appropriate x-rays, supervises the positioning, prepping and draping of the patient. This elective also involves the diagnosis and treatment of problems that can be managed on a conservative basis.

Pathology

This elective is at LBJ General Hospital or Memorial Hermann-Texas Medical Center. It involves review of current surgical pathology and cytopathology specimens. The elective provides the opportunity to participate in fine needle aspirations and bone marrow biopsies and to examine blood smears and bone marrow of patients with a variety of hemotological disorders. Clinical pathological correlation is emphasized. Transitional residents are required to participate in interdepartmental and departmental conferences. No night call or weekend duty is required.

Radiology

This elective is at the LBJ General Hospital. The resident will be included in observing both inpatient and outpatient general film reading-CT, ultrasound and special procedures. The rotation will be tailored to each resident's special interests. The Radiology Department at LBJ consists of 18 procedure rooms and performs approximately 105,000 examinations per year. This elective is Monday through Friday, offers no weekend duties and no call.

Our Transitional Year Program is not accepting applications for the 2012–2013 academic year due to budgetary constraints.

Please contact us via email for any questions you have.