The Preliminary Program in Internal Medicine is designed to offer a diverse experience in internal medicine for those individuals preparing for subspecialty careers. There are two differences between the categorical Internal Medicine internship and the preliminary internship. The first is that preliminary interns do not have a continuity outpatient practice. The second is that they have three months of elective time. The elective time is extremely flexible. Preliminary interns may choose from the list of categorical medicine electives or they may design independent experiences. Recent independent experiences include research blocks, pathology electives in the discipline of one's choice and away rotations at other institutions. The elective time may be strung together consecutively or split up into multiple blocks. In addition to three months of elective time, each preliminary intern will have one month of critical care and six months on the general medical wards. The general medical ward rotations are divided across HUP, Presbyterian Medical Center and the VA Medical Center. Finally, one month of vacation time is provided as 2 week blocks and six days around Christmas or New Years. The demographics of individuals in our preliminary program include those pursuing careers in Neurology, Dermatology, Radiology and Radiation Oncology.