Integrated Health System Experience
Learning and practicing high quality, evidence-based, patient-centered medical care through an Integrated Health System.
Curriculum & Rotation Schedule
Residents in the Kaiser Permanente Hawaiʻi Internal Medicine Residency Program receive their training through twelve 4-week blocks each PGY year, rotating within Kaiser Permanente Hawaiʻi’s integrated health system. Residents have the opportunity to participate in multiple elective rotations lasting 2–4 weeks, including rotations on Neighbor Islands. While a categorial IM residency program, our curriculum places a particular emphasis on Ambulatory Medicine.
*Three-year Program Curriculum subject to change, per recommendations of the Program Evaluation Committee (PEC).
Rotation Schedule
| Rotation | PGY1 (Weeks) |
PGY2 (Weeks) |
PGY3 (Weeks) |
|---|---|---|---|
| Continuity Clinic – Mapunapuna Medical Office | Full day Q2 weeks (24 clinic days) |
Full day Q2 weeks (22 clinic days) |
Full day Q2 weeks (18 clinic days) |
| Primary Care | 12 | 8 | 4 |
| Inpatient Medicine – Wards | 20 | 12 | - |
| Inpatient Medicine – Night Float | - | 4 | 4 |
| Inpatient Medicine – Jr Hospitalist | - | - | 4 |
| MICU / CCU | 4 | 4 | 4 |
| Subspecialty Selectives | 12 | 8 | 20 |
| Individualized Experience (IE) – Resident Selection | - | - | 4 |
| Electives | - | 12 | 8 |
What Makes Our Ambulatory Curriculum Unique
Our ambulatory curriculum is designed to mirror real-world primary care—providing continuity, mentorship, and hands-on training in an integrated care setting.
Protected Continuity Clinic Time
Uninterrupted education during Continuity Clinic structured through two dedicated clinic days per block with no competing clinical responsibilities
Expanded Ambulatory Subspecialty Exposure
Rotations through additional ambulatory focused subspecialties during Primary Care blocks for enhanced training in Primary Care
Longitudinal Mentorship & EMR Training
1:1 mentorship and supervision by a single Continuity Clinic preceptor over 3 years with a gradual ramp up of scheduled visits, allowing for dedicated upfront training of the EMR system and clinic workflow and the practice of graduated autonomy
Preparation for Independent Practice
Excellent preparation towards independent practice through personal patient panel management and In Basket management. Residents are provided the opportunity to link to patients that they may follow for 3 years and are subsequently passed along to incoming PGY1.
Faculty Collaboration & Goal Setting
Space for collaboration with faculty on personal goal setting and quality improvement
Supportive Learning Culture
Supportive learning community with an open culture receptive to feedback
Clinic Community & Teamwork
Inclusion as an integral part of a clinic that values the partnership between physicians and nursing staff, and cares for each other like family
Program Emphasis on Support Through Transition Periods
Transitions are pivotal in residency. Our program offers focused support to help residents grow with confidence at every stage.
- PGY1 residents receive in-depth training during orientation, covering essential Primary Care topics with a strong emphasis on EMR proficiency. They are also paired with a PGY3 mentor to guide them through Continuity Clinic.
- PGY1 residents are paired 1:1 with a PGY2 resident for their first inpatient block and have reduced patient caps for their first two weeks. This helps the PGY1 resident orient to the inpatient space but also allows PGY2 residents to have their first supervising block with only 1 PGY1 resident and a smaller service.
- PGY3 residents can participate in the Inpatient Individualized Experience rotation, gaining exposure to other facets of the hospitalist workflow, including triage, cross cover, ICU step down unit, and time as a dedicated admitter to help them prepare for a career in hospital medicine.
Curriculum Features & Individualized Learning
Our residents are provided with a robust curriculum that guarantees significant exposure and training in a variety of specialty experiences, helping them to build the confidence to manage a wide variety of diseases. Through our carefully sculpted individualized learning opportunities, we strive to set up our residents for success towards independent practice in the career path of their choice.
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Primary Care
Residents have the opportunity to rotate with various ambulatory-focused subspecialties and multi-disciplinary team members during their Primary Care blocks.
Focused Subspecialties
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- Allergy
- Dermatology
- Endocrinology
- Gynecology
- Integrated Behavioral Health (IBH)
- Integrated Physical Rehabilitation (IPR)
- Obesity Medicine
- Ophthalmology
- Otolaryngology (ENT)
- PASC (Post-Acute Sequelae of COVID)
- Procedures (General Surgery; Advanced Wound Care)
- PSS (Patient Support Services)
- PT / OT / Speech
- Quality Improvement / Admin
- Urology
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Inpatient Medicine - Wards
- Team Structure: 1 teaching hospitalist with 1 upper level resident, 2 PGY1s and 2 MS3s from the John A Burns School of Medicine
- Caps: 8 per PGY1, 16 per Senior Resident
- Admits: Long call twice/week from 9am-4pm (admit up to 3 patients/PGY1), Short call on 1 weekend day from 9am-1pm (admit up to 2 patients/PGY1). PGY1s may also pick up newly admitted patients in the morning on non-admit days to ensure census numbers remain appropriate for learning
- Hours: 7am-7pm (with options to leave early in certain circumstances)
- Days off: 1 day off/week free of clinical responsibilities
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Inpatient Medicine - Night Float
- Team Structure: 1 PGY2/3 paired with 2 nocturnist hospitalists overnight
- Admits: up to 5/night
- Attends RRTs, code blues, and assists with cross cover overnight, in addition to admitting new patients
- Hours: 7pm-7am, 5 nights/week
- Days off: 2 days off/week free of clinical responsibilities.
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Inpatient Medicine - Jr Hospitalist
- Team Structure: 1 teaching hospitalist with 1 PGY3 resident, and possibly one MS4 sub-intern
- Caps: 12 total (10 if also supervising an MS4 sub-intern)
- Admits/pickups: in general, this rotation is intended to mirror a hospitalist work flow, so the majority of patients will be assigned to the resident in the morning, having been admitted the night before by hospitalist admitters.
- Hours: 6am-7pm (with options to leave early in certain circumstances)
- Days off: 1.5 days off/week free of clinical responsibilities
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MICU / CCU
- Team Structure: 1 PGY3 with 1 PGY1 +/- 1 MS4, or 1 PGY2 working solo
- Goal patient census: PGY1 3-5, PGY2: 5-7, PGY3: 6-9 (if supervising both PGY1 and MS4)
- Hours: 630am-7pm
- Days off: 1 day off/week free of clinical responsibilities
- The ICU at KP is a mixed ICU, including medical ICU patients, cardiac patients, post-operative cardiothoracic patients, neuro-ICU patients, and surgical ICU patients; residents may have the opportunity to work with all of these patients
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Subspecialty Selectives
- Cardiology
- Emergency Medicine
- Gastroenterology
- Geriatric Medicine / Palliative Care
- Hematology / Oncology
- Infectious Disease
- Musculoskeletal (Orthopedics, Podiatry, Sports Medicine)
- Nephrology
- Neurology / Addiction Medicine
- Pulmonology
- Rheumatology
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Individualized Experience (IE) – Resident Selection
PGY3s have the option to choose between an Inpatient and Outpatient IE rotation to better prepare them for their future career plans. During this rotation, residents will gain additional exposure and training to various career-specific work.
Inpatient
- Transitional Care Clinic
- Inpatient Medical Triage
- Clinical Decision Unit
- Inpatient Admitter
Outpatient
- PCP-Focused Training
- On-Call and In-basket Cross Coverage
- Outpatient Procedures
- Provider Shadowing
- Nurse Treatment Center and Wound Care
- Social Work
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Electives
Resident Section
- Care Pathway Center (Gender Affirming Care / HIV)
- Hawaii H.O.M.E. Project (Homeless Outreach & Medical Education)
- Native Hawaiian Health
- Neighbor Island
- POCUS (Maui)
- Procedures (Inpatient/ Outpatient)
- Research
- Subspecialty(s)
- Urgent care (Maui)