Preliminary Pathway

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Length of training: 1 year

Setting: University Hospitals Cleveland Medical Center, Louis Stokes Cleveland Veteran Affairs Medical Center

Description and defining characteristics: The Preliminary year offers an outstanding one-year clinical experience in adult medicine for trainees pursuing other long-term careers. We believe the Prelim PGY1 year is a vital year for achieving clinical competence prior to moving to categorical training, and our training achieves this goal through the combination of hands on clinical experience with supervision from outstanding residents and faculty. Prelim interns are considered full members of the Department of Medicine house staff. They have three months of elective time to pursue their academic interests. In our program, there is no weekly continuity clinic requirement for Prelim interns.

Schedule:
2.5 months of Elective
0.5 months of Jeopardy
1 month of vacation
0.5-1 month of night float
0-0.5 months of urgent care at the VA
2-2.5 months of ICU
5-5.5 months of wards

Preliminary pathway experience by Ashley Wentworth, MD

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How did you originally become interested in the pathway?
In applying to an advanced specialty in dermatology, I had the choice between a transitional year and a preliminary year in internal medicine for my internship. I chose to pursue a preliminary year because I wanted a strong foundation in internal medicine before commencing specialization. I felt that the experiences gained would provide the skills required to best serve the medically complex patients I would encounter as a dermatology resident at an academic center.

Why did you think you would be a good fit for it?
As a preliminary year intern, the schedule is divided primarily between inpatient services and elective time. I knew I would appreciate expanding my core medical knowledge via direct participation in the art and practice of internal medicine afforded by ward rotations, while also welcoming any relevant intersections with my future specialty. In addition, I valued electives as opportunities for self-directed learning and anticipated selections could augment my practice of internal medicine throughout this year as well as my future training in dermatology.

What is the single most gratifying thing about training in the Preliminary pathway?
Over the past year, each team of interns, residents, and attending physicians with whom I have worked ensured providing patients with the best care possible was at the forefront of their priorities. Given that we all entered medicine to first and foremost serve patients, it has been such an honor to work at an institution that values this practice at every level.

How has your experience been up until now?
Starting a new phase of medical education is always a challenge, but the extensive network of support offered by residents and attending physicians, as well administrative staff, has guaranteed the assistance and advice needed to ensure patients received excellent care, while also allowing for learning and development as a physician throughout the year. This program stands out for its collegiality both within and among various levels of training, and I have never hesitated before asking a question or requesting help, which fosters not only a remarkable working environment but also the highest quality of patient care.

Can you give an example of the most inspiring thing you witnessed while in the pathway?
Throughout this past year, I have been awed by the resilience of the patients for whom I have had the privilege to care. Despite battling complex medical complaints, and often challenging social situations, their fortitude provides a model of strength in the face of challenges.

Why would you recommend joining the pathway? What sets it apart?
The Preliminary pathway excels at combining excellence in core internal medicine foundational skills and experience required for specialized training, along with almost three months of electives dedicated for exploring one's future specialty, rotating in related fields, conducting research, or engaging in any other electives of benefit. During my electives, I was able to delve into specialties like rheumatology and infectious disease overlapping with my future practice of dermatology, as well as to finish a research project on allergic contact dermatitis.