Across two residency programs, intern orientation pilots with DDx revealed something programs don't often get: objective, actionable data on where each resident stands before it matters most.
More than 90% of residents reported they would continue using DDx after completing just five cases integrated into their intern bootcamp.
Why is intern day one readiness so difficult to assess?
The first week of residency is one of the most consequential moments in a physician's career. Interns step into clinical settings carrying the knowledge of medical school, but not always the same hands-on experience. They've studied the same textbooks, but they haven't all seen the same patients.
That gap shows up fast. And residency program directors feel it immediately.
Two programs decided to tackle this problem head-on by embedding DDx into their intern orientation and bootcamp week. What they found is changing how they think about day one readiness.
How did residents improve with DDx during bootcamp?
Over 25 residents between Indiana Ascension St. Vincent Internal Medicine Residency and UC Irvine's Emergency Medicine Residency implemented DDx by Sketchy. These programs had residents complete five residency-level cases where they worked at their own pace to simulate everything from patient interviews and differential diagnosis to test ordering and patient management.
Both pilots shared the same two goals: prepare residents for real clinical encounters, and surface knowledge gaps early before those gaps had a chance to compound in real patient care.
The data told a clear story at both programs. After just one week of DDx cases, residents at Indiana Ascension St. Vincent showed substantial improvements across every measured competency:
- +49% improvement in confidence ordering medications
- +27% improvement in formulating an accurate assessment
UC Irvine showed similarly strong gains in areas where confidence had been lowest at baseline:
- +48% improvement in confidence ordering medications
- +27% improvement in identifying the correct admission setting
And at UC Irvine, 100% of residents agreed that DDx improved their confidence in clinical reasoning. 86% said they believed DDx inclusion during residency would benefit their learning and clinical preparedness throughout training — not just at orientation.
What faculty and residents said
At Indiana Ascension St. Vincent, faculty praised DDx for surfacing what typically stays hidden until much later in training:
"Without a tool like this, we'd only discover those deficits later in the year. This lets us capture them early and tailor our teaching from day one."
The low-stakes environment stood out as a key differentiator from high-fidelity simulation:
"It spurred them back into critical thinking in a very low-risk, safe way — before their first real patient encounter."
At UC Irvine, residents didn't just complete their assigned cases — they asked for more:
"The AI attending conversation really helped them get better at differentials — one of the hardest parts of patient care."
Why bootcamp is the right moment for DDx
DDx is built for exactly this moment in training. The platform delivers realistic, faculty-authored cases aligned to residency-level clinical presentations, structured across clinical reasoning, clinical skills, and communication dimensions. Residents engage at their own pace and receive immediate, automated feedback after each case, reinforcing critical thinking without requiring faculty to be present for every interaction.
Faculty, in turn, get something they rarely have during orientation week: objective, actionable insight into where each resident actually stands — structured data on reasoning patterns, not just right-or-wrong answers. Programs have described DDx as a third pillar alongside bedside teaching and high-fidelity simulation: not a replacement for either, but an essential addition.
Frequently asked questions
What is intern bootcamp in residency programs?
Intern bootcamp (also called orientation week or intern boot camp) is the structured onboarding period at the start of PGY-1 training where new residents build foundational clinical skills before assuming patient care responsibilities. It typically includes simulations, skills stations, didactic sessions, and increasingly, case-based learning tools to establish a baseline of clinical reasoning before rotations begin.
How does DDx differ from traditional intern orientation simulations?
Traditional high-fidelity simulation requires physical space, trained faculty facilitators, and significant scheduling coordination — constraints that limit frequency and scale. DDx allows residents to work asynchronously at their own pace, with automated rubric-based feedback on reasoning quality, giving programs the ability to run every intern through the same structured experience simultaneously without additional faculty time.
What types of clinical reasoning does DDx assess during intern orientation?
DDx cases are structured across three competency domains: clinical reasoning (differential generation, diagnostic prioritization), clinical skills (EKG interpretation, imaging, lab analysis), and communication (patient interactions, handoffs, escalation conversations). This gives programs visibility into intern readiness across all three dimensions, not just medical knowledge recall.
Can DDx replace high-fidelity simulation in residency bootcamp?
DDx is designed to complement, not replace, high-fidelity simulation. Programs describe it as a third pillar alongside bedside teaching and in-person sim — handling the scalable, repeated practice layer so that simulation time can focus on higher-order coaching rather than correcting foundational reasoning errors.
