Metropolitan Hospital CenterProgram DescriptionAcademic ProgramMajor RotationsPrimary CareFacultyCIR Benefits

Brief Description Of The Major Rotations

Medical Service

The inpatient Medical Service has over 4,000 admissions per year and deals with a wide spectrum of clinical problems. There are 5 general Medical. Each team consists of a supervisory attending physician, a PGY-2, two or three PGY-1 interns, and three medical students. The attending physician, who works with the same ward team for a month, conducts combined teaching and management Rounds six days a week. Attendings are available on-call by pager 24-hours a day. Working hours are from 7:00 AM to 5:00 PM and house officers are on-call for admissions every fourth day, from 7:00 AM to 9:00 PM. After 9:00 PM, the night float team takes all admissions. There is one 24-hour period during the weekend, free from any patient care or administrative responsibilities.

Medical/Cardiac Intensive Care Unit

Metropolitan has a modern 17-bed ICU, where each trainee will extensively learn how to manage complex, critically ill patients. A full-time Board certified Pulmonary/Critical Care Medicine Attending physician rounds everyday and is available on-call 24 hours. The attending leads a team that consists of a Critical Care Fellow, a PGY-3, a PGY-2, two to three PGY-1s. The MICU team works six 12-hour shifts per week, with one 24-hour period free from any patient care or administrative responsibilities.

The Cardiac Intensive Care Unit shares the 17-bed ICU; however, a separate CCU team is assigned to manage the cardiac patients. This team consists of an Attending Cardiologist, a PGY-3, and a PGY-1. Likewise, the CCU team, works 6 12-hour shifts per week, with one 24-hour period free from patient care or administrative responsibilities


Night Float Service

The Wards night float team consists of 2 PGY-2 residents and 2 PGY-1 interns, who start their shift at 9:00 PM each night until 7:00 AM the next day. They continue from 7 to 9:00 AM with academic activities, which include Night Float Intake and Morning Report. The Night Float team handles admissions after 9:00 PM and handles all in-patients during the said period.

The MICU night float team consists of two PGY-3, who start their shift at 7:00 PM until 7:00 AM. They handle all MICU and CCU consults and admissions as well as in patient emergencies. There is also one 24-hour period, free from any patient care and administrative responsibilities.

Emergency Room

This month's rotation revolves around the hospital's busy Emergency Room. There is a broad exposure to a wide range of acute clinical problems, including emergencies in Gynecology, Surgery, Ophthalmology and ENT. This rotation promotes a healthy interaction between the Medicine and the Emergency Medicine house staff. All patients are evaluated first hand by the house staff, with the direct supervision of Emergency Medicine faculty.

Ambulatory Care Block Rotation

From internship until the third post graduate year, house officers rotate through Ambulatory Medicine, where they are exposed to out-patient management of chronic medical illnesses, as well as overlapping diseases encountered in other specialties.
During this rotation, there are specific exposures in Dermatology, GYN, Orthopedics, Family Planning, Allergy-Immunology, Ophthalmology, ENT, Psychiatry, Adolescent Medicine and Rehabilitation Medicine clinics where house officers can perform procedures relative to the specialty like PAP smears, skin biopsies, casting, pain management, use of different methods of contraception and evaluate and treat common psychiatric ailments like depression, anxiety and polysubstance abuse.

Continuity Medicine Clinic

Residents are assigned to an ambulatory care team (one precepting Attending and three residents) which is kept during their three years. Also this ambulatory clinic is maintained throughout the year during other rotations (once or twice a week) so that residents can have continuity of care with their patients.

Medical Consultation Service

The assigned PGY-3 responds to consultations from other services (i.e. Psychiatry, OB-GYN, etc), whose patients develop significant Medicine-related problems. An Attending Physician faculty member reviews every case with the resident. The rotation also includes an opportunity to evaluate ambulatory patients for preoperative medical evaluation.


This rotation provides residents opportunities to enhance skills and knowledge in Neurology, in both the in-patient and Ambulatory Care settings. Metropolitan Hospital is a stroke center which gives opportunity to learn the acute management of stroke.


Our Geriatric department has a newly built state of art Geriatric clinic located separately from the general medical clinics, and located very conveniently for access by our geriatric population. There is also an in-house Geriatric consults rotation where the resident will have sufficient opportunities to evaluate older adults under supervision of Board certified Geriatricians.


Electives may be taken in any of the medical subspecialties. The resident trainee will be a full participant in all clinical and academic activities of the subspecialty service during the period of the rotation. Subspecialties include Cardiology, Gastroenterology, Geriatrics, Pulmonary, Nephrology, Hematology/Oncology, Infectious Diseases, Rheumatology and Endocrinology.

In most of the rotations, the residents will work with the fellows with in-patient consults and in the respective subspecialty clinic. Residents will also attend to their own Medicine continuity clinic twice a week. Subspecialty exposure is scheduled to provide opportunity to rotate in all medical subspecialties during the three years.

- Internal Medicine Residency Program - Metropolitan Hospital Center -
Updated December 2014 - Web design Esteban Franco, MD-