Schedules and Firm System

To strengthen the sense of community and family at UTSW, residents are sorted into five "firms" who rotate through their inpatient rotations and +1 clinic weeks together. This continuity, along with having your golden weekends off together, helps you form deep relationships over the three years of residency and allows for relaxing activities with your firm.

Five overlapping circles labeled Firm A, Firm B, etc

4 + 1 Highlights

  • The academic year is made up of 10 blocks of five weeks each.
  • The five weeks are broken up into a 4-week rotation followed by a +1 Continuity Clinic week. The 4-week rotations are made up of inpatient wards, ICU, and hybrid rotations.
  • You rotate through the 4-week rotations with your firm and will always be on the +1 clinic weeks with your entire firm.
  • You do not need to worry about seeing your clinic panel during inpatient rotations; Your colleagues in a shared practice will do that for you.
  • The weekend before your +1 clinic week is always off (“Golden weekend”). This allows you to plan all your weekends off for the full three years of residency!
  • Preliminary interns follow the same schedule as categorical interns. They get the same amount of elective and vacation time. The only difference is that preliminary interns get a few dedicated half days for career-specific clinic experience of the their choice during their +1 clinic week.

Hybrid Rotations

We have combined the strengths of our inpatient and outpatient services in each of the major subspecialties at all three of our hospitals into a single, uninterrupted experience. This will give every resident and intern a 4-week immersion in Nephrology, Gastroenterology, Geriatrics, Infectious Disease, Hematology/Oncology, Neurology, Rheumatology, Endocrinology, Cardiology, and Pulmonary Medicine.​

These hybrid rotations are scheduled throughout your three years here, creating a strong and valuable general-medicine experience for each of our residents. In addition, you'll have most weekends off during hybrid rotations.

Sample Block Schedule

 Block 1Block 2Block 3Block 4Block 5
PGY 1 PMH Wards +1 Elective +1 VA Wards +1 PMH MICU +1 PMH Wards +1
PGY 2 Hem/Onc Hybrid +1 Elective +1 Nephro Hybrid +1 CUH CHF +1 PMH MICU +1
PGY 3 PMH MICU +1 ID Hybrid +1 VA CPICU +1 Primary Care +1 GI Hybrid +1


 Block 6Block 7Block 8Block 9Block 10
PGY 1 Nephro Hybrid +1 CUH MICU +1 PMH CCU +1 Geriatrics/ Vacation +1 CUH Wards +1
PGY 3 Cardio/ Pulm Hybrid +1 Elective +1 QI +1 PMH Wards +1 Rheum/ Endo Hybrid +1

PMH: Parkland Memorial Hospital
CUH: Clements University Hospital
VA: Dallas Veterans Affair Medical Center

Rotations available for each block

General Wards
Combined MICU/CCU    
Adv Heart Failure    
Hybrid Rotations Nephrology
Infectious Disease

PMH: Parkland Memorial Hospital
CUH: UT Southwestern William P. Clements Jr. University Hospital
VA: Dallas Veterans Affairs Medical Center