The FIRM System
The IM program organizes its general medicine inpatient and outpatient services into a "Firm" system. A "Firm" consists of a group of residents and faculty that function as a cooperative group practice throughout the 3 years of training. The Firm system enhances the continuity of care of patients in and out of the hospital. There are two large Firm Teams: White and Green (the MSU colors). The White and Green Teams are further divided into 3 clinic teams, forming a total of 6 resident clinics, each with 5 residents.Each resident clinic team works together as an ambulatory group practice. Whenever possible, a member of each clinic team is assigned to the inpatient general medicine service, so that continuity clinic patients requiring admission can be cared for by a team colleague in the hospital.
While assigned to the inpatient general medicine wards, residents work with their White or Green Team colleagues, in order to maintain continuity of patient care and to build strong collegial relationships. Because these general medicine wards are cared for with the Firm structure, the inpatient ward rotations are also called "Firm rotations."
The inpatient Firm rotation rounding groups are therefore composed of representatives from the resident clinic groups. Inpatient Firm rounding groups consist of:
- 1 attending
- 1 PGY-2 or PGY-3
- 2 PGY-1
