Internal medicine residency
Download the "Welcome to Marshfield Clinic Health System Internal Medicine Residency" video.
Residents describe our program as “the best of both worlds” – a large tertiary care center in a rural American city.
State-of-the-art facilities and knowledgeable faculty and fellow residents support a balanced curriculum. Marshfield Clinic expands medical student and resident training opportunities from your first day to graduation.
Marshfield, Wis., is a cozy community with affordable housing. Enjoy short commutes, little-to-no traffic and various arts, entertainment and recreation.
Application Requirements
The primary aim of the Marshfield Clinic Health System (MCHS) Internal Medicine Residency Program is to advance the knowledge base and skill level of our residents in all aspects of patient care. We reinforce curiosity and advocate for critical thinking among our residents. We also believe that any resident physician will be in a better position to advocate for his or her patient when that resident possesses an advanced and positive sense of well-being.
Having entered this third decade of the 21st century, we recognize that our residents must become proficient in best practice, with patient safety always at the forefront of healthcare delivery. Additionally, we acknowledge that system quality improvement has become the responsibility of all members of the healthcare team, and we recognize the necessity of a leadership role for physicians, including resident learners. We foster these opportunities early on in each resident’s training.
As physicians, we have learned that the best outcomes for our patients occur when a highly functioning, mutually respectful team is utilized to its fullest extent. Within the Internal Medicine Residency of the Marshfield Clinic Health System, there is evidence of multidisciplinary team integration within didactic instruction, small group interactions, and feedback processes. We encourage this practice from the onset in order to set the precedent of importance.
Moving forward, we also look back and identify that it was a desire for affective altruism that led many of us to a career within internal medicine. Whether an individual resident decides to pursue primary care or hospital medicine or subspecialty training after residency, the MCHS Internal Medicine Residency Program will not only provide an experience leading to proficiency in all areas of individual competency but an experience that is also mutually satisfying for our resident physicians and the patients they serve.
We invite you to explore our site and learn more about training opportunities in Internal Medicine:
Meet our faculty
View profiles of the individuals who make our program extraordinary.
Meet our residents
Learn about our current residents and their medical education backgrounds.
Resident resource guide
Find tour and travel information, links to area schools and access to our full resident guide.
Day of Interview
After the COVID-19 pandemic, the program is exclusively conducting virtual interviews for residency recruitment. We do not offer onsite visits to our facility.
Navigating the campus
A virtual tour program and facility are shared with the interview candidates. The Marshfield Clinic campus consists of six inter-connected buildings including the main clinic building and our hospital, the Marshfield Medical Center. For more information about the campus layout, please visit the following links:
Get Directions to Marshfield Clinic > https://www.google.com/maps/dir//44.67822,-90.176528/@44.6780444,-90.1792305,17z/data=!3m1!4b1
Campus Map > https://www.marshfieldclinic.org/ClinicLocations/PublishingImages/Marshfield_Campus_8.5x11.jpg
Parking and Entrance Map > https://www.marshfieldclinic.org/ClinicLocations/PublishingImages/Hospital_3D_map.pdf
We are participating in ERAS Program Signaling. A program signal may be used by the applicant to express interest in the residency program at the time of application. If you are interested in our program, we welcome you to use Program Signaling to indicate your interest.
Contact Us > https://www.marshfieldclinic.org/education/residents-and-fellows/internal-medicine-residency/program/contact-us
Thank you for your interest in Marshfield Clinic Health System Internal Medicine Residency program. If you have further questions about our program, please contact us.
Ateeq Rehman, M.D., FACP
Program Director
Internal Medicine Residency Program
Marshfield Medical Center
Phone: 1-800-541-2895 or 715-387-5260
Victoria Rodriguez
Program Coordinator
Internal Medicine Residency Program
Phone: 1-800-541-2895 or 715-387-5260
Fax: 715-387-5434
E-mail: rodriguez.victoria@marshfieldclinic.org
Program Information
Application Requirements
1. USMLE test scores
You must pass Step 1, you need a 225 or more on Step 2, and a passed Step 3 is preferred.
2. Four months or more of recent "hands-on" U.S. clinical experience
Research and observing are not hands-on clinical experience.
3. Eight (8) years or less since medical school graduation
We make exceptions for candidates who were in U.S. residencies during this time.
4. Apply through Electronic Residency Application Service (ERAS).
Include:
- Transcripts from USMLE and ECFMG
- At least three letters of recommendation
- Your Dean's Letter
We do not accept paper or email applications.
Due to a high volume of applications, Gold Signal applications will be reviewed before Silver Signal applications.
International graduates are encouraged to apply. We accept:
- H1 visas (Send Step 3 results by January 31)
Need to link off to Resident Research and Scholarly Activities somewhere.
Resident Benefits
Salary
We offer a competitive salary and benefit package which includes relocation assistance, malpractice coverage and an annual $1,750 travel/education fund available to each resident beginning in PGY1.
Additionally, we provide you with medical transcription support and program coordinator assistance.
Salaries for 2018-2019 (effective July 1, 2018)
When taken in aggregate, the compensation package provided residents, depending on post-graduate year, ranges from $70,000 to $100,000 per resident.
PGY1: $59,024
PGY2: $60,966
PGY3: $62,908
PGY4: $64,850
PGY5: $66,793
Health/dental insurance
Health insurance
Payment of monthly premium for Security Health Plan point of service coverage for:
- Resident
- Spouse
- Qualified dependents
This includes a prescription drug benefit.
Indemnity coverage is available for a nominal premium. Residents are responsible for copays and/or coinsurance.
Dental insurance
Payment of monthly premium for dental insurance.
Time away
- Vacation: You receive 15 workdays per contract year.
- Continuing Medical Education (CME)/Meeting time: You receive up to 7 working days per academic year for scientific meetings (includes travel time). Days vary in program and training years.
- Interviews: You receive up to 10 interview days total during your residency (with proper approval and planning). Interview days are meant for fellowship and/or job-related interviews (prorated for programs less than three years).
- Exams: Exam days are counted as days in training. This includes:
- USMLE
- COMLEX, first time
- Licensure exam
- In-training exam
- Representing the program or Clinic for a business
- Required educational purpose as approved by program director
- Illness: As a resident, you are allotted sick days. You would not be compensated for unused sick time. You are responsible for notifying appropriate individuals of your absence due to illness in accordance with your program specific policy. Residents are eligible for a short and long-disability plan the first of the month following 90 consecutive calendar days of employment within a benefited status.
- Birth/adoption leave: You may take up to six weeks of leave in a 12-month period for birth of a natural child or adoption. Absence from residency beyond six weeks may require an extension of the program to meet board eligibility criteria.
Family and Medical Leave Act (FMLA)
The FMLA is an unpaid, job protected leave. Residents who meet the eligibility criteria will be eligible for unpaid leave under the FMLA. Absences from the residency program may request an extension of the residency to meet board eligibility criteria.
Professional liability, disability & life insurance
- Residents are fully covered under Marshfield Clinic's self-insurance plan for professional liability. This is an occurrence policy. Contribution to the State of Wisconsin Patients Compensation Fund is also made on behalf of each licensed resident, which provides additional protection.
- Each Resident is covered under Worker's Compensation.
- Short and Long term disability insurance is purchased for each Resident. This policy is effective the 1st of the month following 90 days from your hire date in a benefited status.
- Group term accidental death and dismemberment insurance is an option at the Resident's own expense.
- Group term life insurance A $50,000 term life insurance is purchased for each Resident.
Additional perks
- Annual $1,750 travel/educational fund
- Relocation assistance up to $2,500
- Medical transcription support
- Program coordinator assistance
- Wireless tablet
- On-call meal allowance
- Assigned on-call rooms (hospital)
- Paid for Resident's/Fellow's Wisconsin State Medical License
- Paid for USMLE Step 3 fees*
- Lab coats and laundering
- Marshfield Clinic Optical Shop 20-percent discount
- Special funds for resident paper presentations
- Drug and tobacco-free environment
- Planned Resident Association special activities
- Resident all-day workshops
- Resident Well-Being Committee support
*USMLE Step 3 fees are only covered if you take the exam after contracted training begins at Marshfield Clinic.
Housing
Affordable housing is available in Marshfield. Apartment complexes, single houses and duplexes are located within minutes of campus. Average rental cost for a two-bedroom apartment is $425 to $700 per month.
Conferences
We structure our didactic programs with the goal of teaching high-quality, evidence-based curriculum.
- Ambulatory Didactics Half-day
Half day per week activity in ambulatory Clinic week. The small group activities include Yale modules, lectures on obesity, integrative medicine, and group mentoring sessions. This also includes medical Jeopardy sessions.
- Clinical Refreshers – July - August
Residents and faculty meetings with a focus on teaching and training of PGY1 residents to deal with common challenges they face as new interns. This is a part of the intern orientation process.
- MKSAP Board Review Sessions – Mondays from 12:15 to 1:30 p.m.
This is an extensive program based on test sessions and review lectures by experienced faculty members. The program uses MKSAP Tracker to monitor the progress of our residents.
- Core Lectures – 12:15 p.m. to 1:00 p.m. Tuesdays
These are evidence-based lectures delivered by our subspecialist faculty members.
- Outpatient Morning Report – 12:30 p.m. to 1:15 p.m. Wednesdays
- Morning Report – 12:15 p.m. to 1:15 p.m. Thursdays
The mainstay remains case-based learning. This varies from a team presenting a case from medical service to a case from ambulatory clinic or a subspecialty case.
- Grand Rounds – 12:15 to 1 p.m.; select Fridays
A mix of internationally-renowned experts and Marshfield Clinic faculty present state-of-the-art updates on a variety of topics with global appeal.
- ICU presentations– 12:30 p.m. to 1:15 p.m. on select Fridays
- Morbidity and Mortality with root cause analysis - monthly on a rotating basis
- Journal Club learning with dedicated faculty - monthly on a rotating basis
- Medical Jeopardy game activity for learning: seasonal - July- September
- Yale Outpatient Conference – Wednesdays while in Outpatient Clinic
Resident Evaluations
By definition, any educational process must include assessment. Without evaluation, we can't assure we are providing you skills and knowledge necessary for successful clinical practice.
We regularly assess your progress, advise you in areas of strength and areas for improvement and direct you in ongoing efforts to continuously improve.
A variety of sources evaluate you during residency to form a "360 Degree Assessment." In addition to completing self evaluations, you'll be evaluated by nurses, medical assistants, medical students and peers.
ACGME's Six Competencies
In an ever-growing shift toward training to competency, ACGME has stated the following: "The residency program must require its residents to develop the competencies in the six areas below to the level expected in a new practitioner."
These competencies include:
- Patient Care
- Medical Knowledge
- Practice-Based Knowledge and Improvement
- Interpersonal and Communication Skills
- Professionalism
- Systems-Based Practice
Learn more about competencies at ACGME's site
With these competencies in mind, we have recently embraced the Milestone Evaluation System to further enhance your training.
Insert MCHS Internal Medicine Resident Evaluation video?
Your evaluations of us
We value your evaluations of your residency experience and us. Your feedback allows for continuous improvement.
- Evaluate your attending and rotation at each end of rotation.
- Review your experiences over the past six months ta your biannual composite evaluation.
- Complete an anonymous survey on an annual basis.
Resident Rotation Schedule
PGY1 Year
- 3-4 months: General Medical Ward Service*
- 1 month: Critical Care (ICU)
- 2 weeks: Cardiology
- 2 weeks: Neurology
- 1 month: Night Float
- 2 weeks (5-6 times/year): Outpatient Ambulatory Block
- 2-3 months: Electives
PGY2 Year
- 3-4 months: General Medical Ward Service*
- 2 months: Critical Care (ICU)
- 1 month: Emergency Medicine
- 2 weeks: Inpatient Consult/Hospitalist
- 1 month: Night Float
- 4-5 months: Electives
- 2 weeks (5 times/year): Outpatient Ambulatory Block
*PGY2 and PGY3 residents normally do three months of wards. However, this increases or decreases depending on how many senior residents are in the program.
PGY3 Year
- 3-4 months: General Medical Ward Service*
- 2 months: Critical Care (ICU)
- 2 weeks: Geriatrics
- 1 month: Night Float
- 3-4 months: Electives
- 2 weeks (6 times/year): Outpatient Ambulatory Block
*PGY2 and PGY3 residents normally do three months of wards. However, this increases or decreases depending on how many senior residents are in the program.
Electives
Our program offers a variety of electives:
- Anesthesia
- Cardiology
- Dermatology
- Endocrinology
- Infection disease
- Health screening
- Hematology
- ICU electives (in addition to your required month)
- Nephrology
- Oncology
- Physical medicine and rehabilitation
- Plastic surgery
- Psychiatry
- Pulmonology
- Radiology
- Research
- Rheumatology
- Sports medicine
- Total parenteral nutrition (TPN)
- Urgent care
ACGME Standards
In keeping with ACGME standards, each resident has one day free of patient related activities per week (on average). An average week on Medical Service is approximately 65-70 hours of patient care. An average week on ICU is approximately 70-75 hours of patient care.
General Medical Ward Service
This is a classical ward medicine inpatient medical service.
Four lettered teams (A-B-C-D) are composed of:
- An attending physician
- A senior resident
- A PGY1 resident
Each team is on call every third day from 7 a.m. to 8 p.m.
The average number of admissions per team per 24-hour call day is 6-8.
You are expected to be available by pager 07:00-17:00 weekdays.
Medical Intensive Care Unit (ICU)
Each resident spends at least one month per year in ICU.
These teams are composed of:
- A Critical Care Boarded Intensivist
- A senior resident
- A PGY1 resident
The average number of admissions per team per 24-hour call day is 1.8, with average census of 4.3 patients.
As ICU rotation is quite demanding, and patient care requirements preclude predictability, your ambulatory clinic is held during your ICU months.
Subspecialty Rotations
These months emphasize detailed study of the specialty at hand while allowing time for scholarly and personal pursuits.
Call days may require evening/nighttime presence in the hospital (at a much lower intensity than Medical Service and ICU). Many rotations do not have call.
FAQs
What are your application requirements?
Our home page details application requirements.
What makes Marshfield special?
Marshfield has advantages of big-city medicine with a small-town lifestyle. Cultural opportunities abound in not-so-far away Minneapolis, Madison, Milwaukee and Chicago.
We practice cutting-edge medicine in state-of-the-art facilities (including our extensively funded Research Institute) and have outstanding faculty and staff.
At Marshfield Clinic, great medical care is definitely a team effort. You will be treated as an integral part of the team and enjoy close working relationships with faculty. Many residents even participate in leisure activities with faculty and staff members. Attendings are very approachable and are available for teaching and consultation.
With the entire medical center under one roof, it's easy to shift from hospital to clinic or library, catch a hallway consultation, or schedule one of your continuity patients for a same-day sick visit.
How would you describe your residents?
We have a rather diverse group of residents and view this as a great strength of our program.
M.D./Ph.D.s elevate the academic mien while individuals who have raised families, farmed, or worked in the private sector add depth and maturity.
Simply put, you will not find a more collegial, affable group of eager, motivated learners. Many long-term friendships are forged during months spent on wards or in the ICU.
How would you describe your faculty?
We have an all-voluntary teaching staff. These clinicians come to us from across the country and around the world. Many have research interests or areas of special expertise and all are well-recognized clinicians.
Most of our faculty hold clinical appointments at UW-Madison School of Medicine and Public Health, and a majority of them have been recognized as Clinical Teacher of the Year by graduating UW fourth-year medical students.
Will I see a broad enough spectrum of disease states and pathology?
Our facility is unique in that we are the premier referral/tertiary care center for northern Wisconsin and the upper peninsula of Michigan. This allows our residents to care for both common and rare diseases.
Our ambulatory experience offers the opportunity to provide longitudinal ambulatory care to a population that mirrors a real world practice as well as seeing esoteric subspecialty referrals.
Will I have enough autonomy?
You will be the first point of contact for all the patients on your team and provide the entirety of their care with progressive responsibility.
What about private patients and their multiple attendings?
We structure all our ward and ICU rotations around an academic model, where a close-knit cadre of health care providers care for all patients. Only the primary service residents write orders, save for subspecialty orders directly related to special procedures/treatments, for their patients.
Will I be able to do enough procedures?
Following a simulation lab experience in orientation, residents perform multiple diagnostic and therapeutic procedures with the aid of bedside ultrasound (routinely used in ICU and Wards for diagnostic purposes).
Additionally, residents are trained to become competent in multiple procedures that include – but are not limited to – the following:
- Arterial line insertion
- Central venous line placement
- Endotracheal intubation
- Exercise treadmill testing
- Joint aspiration and injection
- Lumbar puncture
- Mechanical ventilator management
- Paracentesis
- Thoracentesis
How academic/scholarly is your program?
We take our responsibility of nurturing scholarship quite seriously. We approach this challenge via two main venues: structured learning opportunities, and scholarly activity requirements.
In brief, we teach you via a classical model of core curricular lectures, morning case conference, journal club, board review, EKG series, Radiology conference, etc. We also nurture your own ability to teach yourself and others via engendering intellectual curiosity and building scholarly attributes through our “Scholarly Activity Requirement.”
We believe this combination of didactic presentation and nurturing lifelong learning skills, will prepare you for both the ABIM Certifying Examination as well as a lifetime of medical practice.
Our residents have been engaged in numerous scholarly activity projects including posters, published articles, case reports, original research and multiple conference presentations that have been delivered at both state and national venues.
What about your outpatient experience?
We prepare you for ambulatory practice in a variety of ways. You will provide ambulatory care via a number of electives in outpatient settings (Rheumatology, Endocrinology, Gastroenterology, etc.) as well as your own outpatient practice. The electives help nurture your ability to provide consultative care in the ambulatory setting, while your ambulatory block clinic provides the longitudinal care for a panel of patients.
We also embrace the Patient Centered Medical Home model. It is incorporated into your ambulatory training, truly the cutting edge of medicine.
We have implemented the ambulatory mini-block schedule. With this schedule, residents rotate in an outpatient clinic for a 2-week block every 8 weeks. Residents are exposed to a half-day subspecialty or study/QI-related time during this block.
Find more information on our Rotation Schedule page.
Additionally, we use the Hopkins Modules, a series of thorough, evidence-based computer-based education modules dealing with a wide range of outpatient issues.
Residents also utilize the weekly outpatient Yale Learning Modules for didactic learning in conjunction with small group case-based learning.
What about hospitalist experience?
We staff 70 percent of ward teams with hospitalists as attendings. In addition, each PGY3 has a one month focused experience on our hospitalist consult service where you provide consultative care.
Do you offer rural medicine rotations?
You will have an opportunity to spend 1-2 months during your second or third year in our Marshfield Clinic rural centers of Park Falls and/or Minocqua in an inpatient or outpatient setting.
Update location pages to .ORG.
Do you offer international rotations?
Yes, up to 2 weeks during your second or third years in El Salvador, Belize, Honduras or other locations with a faculty member.
What do your graduates do after graduation?
Our residents pursue an equally broad range of professional pursuits after graduation.
Overall, our three-year aggregate graduate data shows one third going into fellowship programs, one third going into primary care and one third becoming hospitalists.
A significant number of graduates remain at Marshfield Medical Center, and many are involved in academic and medical administration.
You can see recent class pursuits on our Alumni Page.
What are your board pass rates?
Per the ABIM website, Marshfield Clinic Internal Medicine Residency Program has a five-year pass rate of 96 percent.
Will I be able to get a fellowship?
Regarding fellowship placement, the following roster indicates where our graduates have pursued fellowship training:
- Allergy / Immunology - Medical College of Wisconsin, Milwaukee, WI
- Cardiology - Baylor University, Houston TX; Ochsner Clinic, New Orleans LA; Health Science Center at Brooklyn, Brooklyn, NY; Mt Sinai Hospital, Milwaukee, WI,
- Medical College of Wisconsin, Milwaukee, WI; Mayo Clinic, Phoenix, AZ
- Pulmonary Medicine/Critical Care - Mayo Clinic, Rochester, MN; University of Wisconsin, Madison, WI; Medical College of Wisconsin, Milwaukee, WI; Cleveland Clinic,
- Cleveland, OH; University of California - Davis, Sacramento, CA; Mercy Medical Center/St Louis University, St Louis, MO; Henry Ford Hospital System, Detroit, MI
- Gastroenterology - McMaster University, Hamilton, ON; Emory University, Atlanta, GA; Medical College of Wisconsin, Milwaukee, WI; Virginia Commonwealth
- University, Richmond, VA
- Nephrology - Medical College of Georgia, Augusta, GA; University of Michigan, Ann Arbor, MI; UCLA, Los Angeles, CA
- Rheumatology - Washington University, St. Louis, MO; University of Wisconsin – Madison, Madison WI; Vanderbilt University, Memphis TN
- Infectious Disease - Cleveland Clinic, Cleveland, OH; Rush/St. Luke’s Presbyterian, Chicago, IL; University of Utah, Salt Lake City, UT; West Virginia University/Health
- Sciences Center, Morgantown, VA; Wayne State University, Detroit, MI; University of Minnesota, Minneapolis, MN
- Hematology/Oncology - University of Wisconsin – Madison, Madison, WI; University of Minnesota, Minneapolis/St. Paul MN; University of Calgary, Calgary, AB
- Geriatric Medicine - University of Wisconsin – Madison, Madison, WI
- Endocrinology - Springfield, IL; Milwaukee, WI
- Palliative Care - Marshfield, WI