皇家华人 Department of Medicine Curriculum & Schedule
Arianna Smith, DO, PGY3
Why did you choose MCW for residency?: I wanted to have a fully immersed residency experience in a tertiary care center where I see a wide array of pathologies and work with a diverse patient population during my time of continued medical training. I wanted a residency where I knew I would leave comfortable with managing patients in the most complex care settings. As a wonderful bonus, my family lives in the Milwaukee area so I grew up very familiar with the fact that Wisconsin,鈥痑nd the amazing people who live in this state,鈥痬ake this area one of the most underrated places on the map!
What is your favorite thing to do in Milwaukee?: Milwaukee is a lively鈥痑nd livable鈥痗ity. Nearly every weekend in the summer months, there is a festival to attend if you desire and its sports (and sport fans) are unlike any other. However, my favorite part is that within a 30鈥�45-minute radius in any direction from the downtown bustle, you can find yourself in small鈥痶owns with鈥痗haracter, charm, and鈥痑bundant outdoor activities to explore.
What is something you like about your residency colleagues?: It sounds cliche, but your colleagues become so much more than colleagues, you build a family here and everyone works together to deliver the best care for our patients, fostering鈥痑n environment of fun, learning, and one where we elevate those around us. Even in the most challenging times, I look forward to every day with my teams.
What do you like doing in your free time?:鈥疐or about nine months of the year,鈥疘鈥痚njoy spending any free time I get on my mountain bike鈥�(despite Wisconsin's lack of mountains)鈥痮r training in the gym to be on my bike. Outside of cycling, I鈥檓 enthusiastic about most outdoor adventures.鈥� This may come as a surprise, but in the fall, I will be鈥痟unting鈥痙eer, elk or game birds with my favorite German Shorthair Pointer鈥痑nd鈥痶hen enjoying and sharing this bounty鈥痵teeped in tradition and family values.鈥� In the winter you can still find me鈥痮n a mountain doing some skiing.鈥� Outside of adventure,鈥疘 enjoy鈥痳eading, challenging鈥痯uzzles, and escape rooms.
Schedule & Inpatient Team Structure
Our overall program structure is a 50/50 system that we call “I’s/O’s.” I’s are inpatient (ward) months, and O’s are elective (with outpatient continuity clinics) months. I months and O months alternate through the year. During O months, residents have weekend days (or an equivalent number of days) off – so this schedule promotes wellness.
View sample PGY1 schedule (PDF)
Nighttime Coverage
Some of our inpatient months have overnight call; some have night float. Having overnight call was a purposeful decision. We believe there is educational value in having some training in the hospital at night—you will see things and learn things at night that you wouldn't otherwise.
See the table below for details.
| Rotation (clinical service) | Site | Intern overnight call? | Resident overnight call? |
| General Medicine | VA Medical Center | 1 time per month | 5–6 nights (partial night float coverage) |
| General Medicine | Froedtert Hospital | Every 10th night | Every 5th night |
| General Medicine | St. Joseph | NA | Every 4th night |
| Cardiology | VA Medical Center | NA | Shared night float w/VA MICU (~4 nights) |
| Cardiology | Froedtert Hospital | None | None** |
| Heme-Onc | VA Medical Center | Night float (~7 nights)* | None |
| Heme-Onc | Froedtert Hospital | None | None |
| MICU | VA Medical Center | NA | Shared night float w/VA Cardiology (~5 nights) |
| MICU | Froedtert Hospital | Internal night float (~6 nights) | Internal night float (~6 nights) |
| *When interns are on VA Heme-Onc, they do night float to cover the general medicine team. Night float is M-F, with the weekends off. **A senior resident night float team covers the cardiology and transplant teams at night |
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Night Float
PGY2/3 residents: Cardiology night float is considered to be an I month. PGY2/3 residents do it once per year. Eight other night float shifts per year are scheduled during an O month.
PGY1s: VA Medical Center night float is paired with Heme-Onc wards to provide exposure to overnight cross cover issues. Interns work directly with the on-call team’s senior resident. Night float works Monday-Friday, with the on-call team interns each covering one call night per month (on the weekends).
Team Structure
- MCW residents love working together on teams. The team structure varies, depending on the usual workload of each clinical service (see table below).
- Most of our teams feature PGY2/3 residents supervising interns. Both M3 and M4 students are often on the teams as well.
- All the hospitals have hospitalist services that also admit general medicine patients and are available for overnight supervision as needed.
| Rotation (clinical service) | Site | # of housestaff teams | Housestaff team structure |
| General Medicine | VA Medical Center | 4 | 1 resident, 2 interns |
| General Medicine | Froedtert Hospital | 5 | 1 resident, 2 interns |
| General Medicine | St. Joseph | 4 | 1 resident, 2 interns (St. Joe transitional year interns) |
| Cardiology | VA Medical Center | 1 | 3 residents |
| Cardiology | Froedtert Hospital | 2 | 2 residents, 4 interns |
| Heme-Onc | VA Medical Center | 1 | 1 resident, 3 interns |
| Heme-Onc | Froedtert Hospital | 1 | 2 residents |
| MICU | VA Medical Center | 1 | 4 residents |
| MICU | Froedtert Hospital | 2 | 2-3 residents, 2-3 interns |
| Transplant | Froedtert Hospital | 1 | 1-2 residents, 0-1 intern |
Tailoring Your Schedule
In our program, residents can tailor their experience to their needs. Everyone will graduate with experience in general medicine and subspecialty wards, ICU and ambulatory care. Beyond that, we offer a wide range of electives (from patient safety and POCUS to GI consults and women’s health). We encourage residents to request rotations to help them fill in knowledge gaps, solidify future plans and then prepare them for the subspecialty or practice of their choice. That means that we work with each resident to tailor their experience to their interests and needs.
For example, what if you wanted to pursue a hematology-oncology fellowship? Two of our former residents did just that: Kathleen Monahan and Nicole Held tailored their experiences. See their schedules below.
| Kathleen Monahan Schedule | Nicole Held Schedule | |
| PGY1 | VA Medical Center HONC wards Froedtert Hospital leukemia wards |
VA Medical Center HONC wards |
| PGY2 | Froedtert Hospital Leukemia wards Froedtert Hospital/VA Medical Center HONC consults VA Medical Center HONC wards Research elective (Onc project) |
Froedtert Hospital leukemia wards Froedtert Hospital HONC consults Research elective (Heme project) |
| PGY3 | VA Medical Center HONC wards Bone marrow transplant wards Froedtert Hospital/VA Medical Center HONC consults Research elective (Onc project) |
Froedtert Hospital leukemia wards |
| Products | Presented at the Multinational Association of Supportive Care in Cancer 2019 Publication: accepted |
Presented at American Society of Hematology 2019 |