Our cardiology service includes two 1 Resident / 1 Intern teams. Both teams care for patients in both the Coronary Care Unit (CCU) and the Intermediate Cardiac Care Unit (ICCU). Patients admitted to this service have primary cardiac problems, ranging from unstable angina to valvular dysfunction to acute arrhythmias. Critically ill patients are managed in the CCU, a state-of-the-art intensive care facility for patients with acute MI, post-infarction complications, severe pulmonary edema, and life-threatening rhythm disorders. In both the ICCU and the CCU house officers work closely with a cardiology attending and fellow. The team also attends a series of teaching conferences devoted to cardiology topics.
This senior resident rotation at Dartmouth-Hitchcock provides an opportunity to work one-on-one with a skilled general medical consultant. Assessment of medical issues in adult patients throughout the hospital forms the core of the experience, which also includes significant exposure to preoperative medical evaluation.
Inpatient internal medicine
These rotations, at DHMC and the VA, form the core experience for learning how to recognize and care for truly sick, complex internal medicine patients. At DHMC, each team consists of one intern and one resident working directly with a hospitalist. The team admits a steady number of patients every day, with no overnight call. At the VA, one intern and one resident are paired with a designated teaching attending. Interns do not take overnight call. Dartmouth medical students and sub-interns round out the teams at both locations.
As the regional, federally-designated comprehensive cancer center, DHMC maintains a busy inpatient hematology/oncology service. House officers gain experience with every stage of cancer treatment, including initiating chemotherapy, using new transplant protocols, and providing end-of-life and palliative care.
Intensive care unit
The ICU offers medicine residents the opportunity to act as consultants and primary caregivers for medical patients requiring the highest level of care. Interns work day shifts only, transitioning to more independent night shifts as their skills increase in the PGY-2 and PGY-3 years. A specific didactic curriculum is delivered to all interns.
At DHMC, a night float team consisting of an intern paired with a senior resident manages acute overnight care for the general medicine service. This team evaluates and admits new patients to the hospital and provides cross-coverage for other medicine patients.
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