Each resident spends 5 rotations on inpatient medical service. Admissions are evaluated by the medicine team which is comprised of the first year and senior resident. The first year resident discusses the patient with the appropriate attending, formulates the differential diagnosis and treatment plan. We care for our own patients in the intensive care units, with specialty consultations available as needed. Emphasis is placed on refining clinical judgement and skill at history-taking, physical examination, appropriate laboratory and x-ray selection as well as interpretation. a senior resident is always on hand for discussion of differential diagnosis and teaching as needed. Supervision of residents is provided by the Internal Medicine Coordinator, faculty and a group of community physicians dedicated to medical education. the medicine teams serve as code leaders for all in-house cardiac arrests, and Advanced Cardiac Life Support certification is provided. Through these experiences the resident becomes quite comfortable with intensive care medicine as well as routine inpatient problems by the end of the first year.