Internal Medicine Residency 

General Info

Tripler Army Medical Center is a vibrant tertiary care medical center with a primary mission of ensuring military readiness through the delivery of quality health care. Tripler’s campus is the primary teaching site for our residency’s core inpatient and outpatient rotations.

The Internal Medicine Residency at Tripler is accredited to train 39 residents. Our program is a combined military and Veterans Affairs (VA) program. Our trainees are approximately an even mixture of active duty Army resident physicians and civilian VA-sponsored physicians. There are six VA-sponsored civilian positions per year. US citizenship is required for all trainees.

Tripler serves a beneficiary population of nearly 500,000 people. There are about 75,000 active duty soldiers, sailors, airmen, and marines assigned to Hawaii. In addition to active duty service members and their families, Tripler serves a large population of military retirees and their family members. Additionally, the Spark Matsunaga VA Medical Center is co-located at Tripler. Tripler serves as the inpatient facility for this population of VA beneficiaries.

The Pacific Island Health Care Program is a consultative service for underserved Pacific Islanders living in such places as the Republic of the Marshall Islands, the Republic of Palau, or the Federated States of Micronesia. Select patients who uniquely benefit graduate medical education are accepted into the program and transported to Tripler Army Medical Center for definitive care.

Our facility, the largest military medical treatment facility in the Pacific Basin, has a catchment area of approximately 52 percent of the earth’s surface. In addition to Hawaii, Tripler is the tertiary medical center for military beneficiaries in Japan, Korea, Guam, American Samoa, and other Asia and Pacific Island nations.

Tripler has about 225 inpatient beds. In addition to internal medicine, there are graduate education programs in general surgery, otolaryngology, orthopedic surgery, psychology, psychiatry, pediatrics, neonatology, obstetrics and gynecology, radiology, urology, transitional year, oral surgery, pharmacy, and health care administration. In a typical day, more than 2,000 patients are seen in outpatient clinic visits, more than 1,500 prescriptions are filled, more than 30 surgical procedures are performed, and more than 30 patients are admitted. There are more than 200 births each month.

Curriculum & Schedule

The academic year is built around a 4+1 schedule, which means that all four-week blocks are followed by one week of ambulatory continuity clinic. All inpatients on medicine teams are covered by separate day and night shifts.

A typical schedule for PGY-1 residents includes:

• 3-4 inpatient ward blocks
• 1 night float block
• 1 cardiology outpatient block
• 2-3 intensive care unit blocks
• 1 emergency department block
• 1 geriatric medicine block
• 1-2 outpatient elective blocks

   A typical schedule for PGY-2 residents includes:

• 2-3 inpatient ward blocks
• 1-2 ICU blocks
• 2 blocks of MOD (admitting resident)
• 1 neurology block
• 4 elective blocks

   A typical schedule for PGY-3 residents includes:

• 2 inpatient ward blocks
• 1-2 ICU blocks
• 2 blocks of MOD (admitting resident)
• 1 dermatology block
• 5 elective blocks

Medical Student Rotation

• Objectives

  • Introduction to the scope of Internal Medicine as it applies to acutely ill patients hospitalized on the wards or in the ICU
  • Introduction to the focused care of patients in the subspecialty clinics
  • Exposure to the team dynamics of Internal Medicine. Medical students should develop communication skills necessary to communicate with patients, families, and other members of the care team in a professional manner
  • Develop strategies to synthesize data into differential diagnoses, working diagnoses, and plans
  • Review the pathophysiology and management of the disease states and clinical presentations encountered during the rotation

• Rotation

  • Rotating medical students are assigned to either an inpatient rotation, Wards or ICU, or an internal medicine subspecialty depending on availability
  • Medical students will work closely with the interns, resident, and staff attending on the team and will receive feedback periodically throughout the rotation
  • We expect medical students to be an active member of the team, performing history and physicals, developing care plans, presenting on rounds, writing notes, and assisting with procedures
  • On inpatient rotations, the medical students will work six days per week and have one day off on a weekend
  • On subspecialty rotations, the medical students will work week days
  • Our hope is that rotating medical students have a chance to explore all that Hawaii has to offer on their days off

• Didactics

  • Medical students will attend all didactics available to residents to include morning reports, the academic half day, board reviews, and grand rounds
  • The chief residents will have medical student only lectures on Wednesdays at noon