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.

Subspecialty clinics in the internal medicine subspecialties (e.g., endocrinology) support a broad-based internal medicine curriculum. During the rotation, residents also have protected time to participate in quality improvement, scholarship projects, and population health.

PGY-1 residents rotate through ambulatory theme blocks throughout the year in the following specialities:

• Dermatology
• Ear, Nose and Throat & Allergy
• Geriatrics
• Hematology
• Orthopedics
• Women’s Health

Dermatology Block Schedule Example

PGY-2 residents rotate through internal medicine subspecialty clinics throughout the year in the following specialities:

• Cardiology
• Endocrinology
• Gastroenterology
• Pulmonary
• Rheumatology

Cardiology/Pulmonary Schedule Example

Hillsboro Medical Center patient entrance

Residents core inpatient experience is at Hillsboro Medical Center where they work closely with internists in the management of a wide variety of patients in terms of complexity, payor mix and severity. The team structure includes an attending physician, an upper level resident and an intern. The experience is bolstered by a strong interprofessional approach including collaboration with care management, nursing, rehabilitation, and social work.

¡Salud! medical team providing on-site COVID-19 screening to a vineyard worker.

The RUSH rotation is a 2-week experience that is part of a program-wide curriculum on the social and structural determinants of health. In addition to Spanish language training, residents will work with:

• ¡Salud! Program to bring health care to seasonal, migrant workers
• Virginia Garcia Memorial Health Center, a Federally Qualified Health Center for the underserved
• Behavioral health in several different settings

Residents will also work in our Hepatitis C and HIV practices to learn how to meet the needs of this specific patient population. Residents will also receive training in culturally responsive care, the management of healthcare disparities and implicit bias.

The opportunity to craft rotations to fit a resident’s interests is a core tenet of the program. Residents have one month of elective time in their 2nd year and two months in their 3rd year. 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 at HMC or OHSU
• Subspecialty clinics at HMC or OHSU
• Hospital Medicine co-attending
• Astoria Primary Care (rural and coastal site)
• Astoria Inpatient Medicine (rural and coastal site)
• Washington County Jail
• Point-of-care Ultrasound (POCUS)
• Cardiovascular ICU
• Research elective
• Medical education elective
• Lifestyle medicine
• Clinical Informatics
• Swing
• Palliative
• American Indian/Alaska Native Elective
• Rural Underserved and Social Determinants of Health (PGY-2/3 version of PGY-1 RUSH)
• Neuro ICU at OHSU
• Global Health in Botswana (for second half of PGY-2 or PGY-3 only)

Residents work closely with subspecialists in the internal medicine subspecialties. They include:

• Cardiology
• Endocrinology
• Hematology-oncology
• Pulmonology
• Infectious disease
• Gastroenterology
• Rheumatology
• Nephrology

The rotations are a mix of inpatient and outpatient care that are supervised by experienced subspecialists. Residents have the opportunity for mentorship if a plan for fellowship aligns with their career interests.

Residents work with emergency medicine physicians at Hillsboro Medical Center’s Emergency Department to care for adult patients of a diverse patient population. Rotations are two weeks in duration and split between the 2nd and 3rd year.

In collaboration with our colleagues at Kaiser Permanente, residents gain experience in neurology through inpatient and outpatient diagnosis and management. Experiences include the care of admitted patients with complicated neurological diseases (e.g., cerebrovascular accidents, multiple sclerosis) and common outpatient neurological disorders.

Residents will care for critically ill patients on interprofessional teams that include an intensivist, nursing staff, care management, and others. Resident teams will consist of one intern and one resident.

Hillsboro Medical Center Education Center

Residents have protected time for didactics for a half day each week covering a breadth of hospital, primary care and specialty medicine with an emphasis on experiential learning. Didactics include a focus on structural competency, population health and practice-based improvement. A foundational curriculum is covered in the first 6 months of the intern year to provide core skills and knowledge for success in rotations.

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.