Internal Medicine Residency

Medicine outpatient is the core ambulatory rotation of the residency program, occurring every two weeks in the X+Y structure. Residents work with a panel of patients in the Hillsboro Internal Medicine clinic and learn key principles of primary care.

Residents typically have half days of primary care clinics, where they care for their own panel of patients working in collaboration with a multidisciplinary team that includes behavioral health specialists, panel coordinators, nurses and pharmacists.

The rotation also supports experiences in Internal Medicine subspecialty training, including Cardiology, Endocrinology, GI, Geriatric Medicine, Sleep Medicine and more. Subspecialty experiences are different based on the year of training.

Residents also have protected time for ambulatory didactics, practice-based learning and population health curriculum. They also have a protected half day of admin time to manage their in-basket, quality improvement projects and research.

Our unique Rural Underserved and Social Determinants of Health (RUSH) curriculum is integrated in ambulatory blocks throughout the three-year training period. It includes opportunities to work with:

• ¡Salud! Services to bring health care to seasonal vineyard stewards
• Virginia Garcia Memorial Health Center, a Federally Qualified Health Center for underserved populations
• Behavioral health in several different settings
• Hepatitis C and HIV clinic

Residents will also have access to an asynchronous medical Spanish course and will receive training in culturally responsive care, the management of healthcare disparities and implicit bias.

Hillsboro Medical Center patient entrance

Residents will have a robust inpatient experience at Hillsboro Medical Center. They will work closely with hospitalists, gaining invaluable experience caring for a broad spectrum of clinical conditions and serving a diverse patient population.

Residents also have the opportunity to work with medical students, which enables them to enrich the learning environment and hone their teaching skills. The inpatient experience is bolstered by a strong interprofessional approach, including collaboration with care management, nursing, rehabilitation and social work.

Inpatient hospital medicine experiences include:

• Opportunities to work as part of a traditional team structure (1 senior/1 intern or 1 senior/2 intern teams)
• Working directly with the attending as a PGY2 or PGY3 resident
• Night float and swing rotations

The opportunity to craft rotations to fit a resident’s interests is a core tenet of the program. Residents can choose among a number of rural electives or local experiences.

Residents have time to elect experiences that align with career goals in various focus areas and subspecialties.

Current elective offerings include:

• Consult rotations
• Subspecialty clinics
• Hospital Medicine co-attending
• Swing
• Skilled Nursing Facility
• Astoria Primary Care (rural and coastal site)
• Astoria Inpatient Medicine (rural and coastal site)
• Washington County Jail
• Point-of-care Ultrasound (POCUS)
• Cardiovascular ICU (at OHSU)
• Neurosurgical ICU (at OHSU)
• Research elective
• Medical education elective
• Lifestyle medicine
• Clinical Informatics
• Palliative Care
• American Indian/Alaska Native Elective

Residents will have experiences in various internal medicine subspecialties including:

• Addiction Medicine
• Cardiology
• Endocrinology
• Hematology-oncology
• Palliative Care
• Pulmonology
• Infectious disease
• Gastroenterology
• Rheumatology
• Nephrology

The rotations are a combination of inpatient and outpatient clinical experiences that are supervised by experienced subspecialists. Residents receive mentorship tailored to align with their career goals, particularly if they are interested in pursuing fellowship.

In their second year, residents complete a two-week Emergency Medicine (EM) rotation at Hillsboro Medical Center, where they work with experienced EM physicians. During this rotation, residents will care for adult patients with broad clinical presentations.

Each academic year, residents will care for critically ill patients during two separate two-week blocks of intensive care.  They will take an active role in our ICU interprofessional team that includes an intensivist, nursing staff, care management, and others.

Hillsboro Medical Center Education Center

Residents on ambulatory blocks have protected time for didactics for a half day each week.

Our didactics include:

• Resident Case Conference
  • Weekly resident-led, case-based presentations focused on developing clinical reasoning skills
• Noon Conference
  • Twice weekly presentations covering general internal medicine and subspecialty topics
• Grand Rounds Sessions
  • Weekly presentations every Wednesday
• Mastering Tough Conversations Workshops
  • In collaboration with VitalTalk
• Resident Morbidity and Mortality Conference
• Practice-Based Learning and Improvement
• Resident Journal Club
• Board Review
• Combined Internal Medicine, Family Medicine, and Transitional Year Curriculum

Evaluations will be tracked on-line and shared with residents.  Together with your advisor and our faculty team, we will collaborate over the three years of your training to graduate you as a competent internist who is ready to practice independently upon completion of the program.