the medical university of south carolina internal medicine residency program
TRANSCRIPT
The Medical University of South The Medical University of South CarolinaCarolina
Internal Medicine Residency Internal Medicine Residency ProgramProgram
Tertiary care university hospital and research center
596 beds with >30,000 inpatients per year
13 MICU beds / 10 CCU beds
Level 1 trauma center, 24 hour Service
VETERAN’S AFFAIRS MEDICAL CENTER90 acute care beds and 28 nursing home beds
40 Internal Medicine beds and 8 MICU beds
Geriatrics Service
Full, 24 hour ancillary services
Full outpatient clinic care and Urgent Care walk-in clinic
CHARLESTON MEMORIAL HOSPITAL
Transitional Care Unit managed by Hospitalist Team
Emergency Department site for ER rotation and electives
Medicine HousestaffMedicine Housestaff
87 Medicine Housestaff
PGY-1: 21 Categ, 4 Prelim, 2 Med/Peds, 1 Med/Psych
PGY-2: 20 Categ, 2 Med/Peds, 3 Med/Psych
PGY-3: 21 Categ, 3 Med/Peds,
3 Med/Psych
PGY-4: 2 Med Peds, 2 Med/Psych
PGY-5: 1 Med/Psych
Chief residents: 2
2007-2008: 24 Categ, 7 Prelim, 2 Med/Peds, 2 Med/Psych
Intern ScheduleIntern Schedule
► Ward months: 8-9Ward months: 8-9
► Call RotationsCall Rotations
Gen Med (4-5 mo) Gen Med (4-5 mo)
Specialties (3-4 mo)Specialties (3-4 mo)
MICU (1 month)MICU (1 month)
► Non-Call Rotations: Non-Call Rotations: ambulatory, ERambulatory, ER
► Continuity clinic ½ day a Continuity clinic ½ day a weekweek
Inpatient ServicesInpatient Services
► VA wards (3 teams)VA wards (3 teams)► General Medicine wards General Medicine wards
(4 teams)(4 teams)
► Cardiology (2 teams)Cardiology (2 teams)► GI (2 teams)GI (2 teams)► PulmonaryPulmonary► NephrologyNephrology► HematologyHematology► OncologyOncology► MICUMICU► VICUVICU► CCUCCU
Example Intern ScheduleExample Intern Schedule
July VA wardAugust Renal wardSeptember MICUOctober Ambulatory ClinicNovember VA wardDecember VA Urgent Care* January Cards wardFebruary Oncology wardMarch Gen Med wardApril ERMay Gen Med wardJune Pulmonary ward
*Holiday off
Resident ScheduleResident Schedule
► Ward monthsWard months
PGY-2: 5 months + 2 ICUPGY-2: 5 months + 2 ICU
PGY-3: 3-4 months + 1-PGY-3: 3-4 months + 1-2 ICU2 ICU
► Night Float 1 Night Float 1 month/yearmonth/year
► AmbulatoryAmbulatory
► ConsultConsult
► Elective & researchElective & research
Call Service DesignCall Service Design
Short/Long callShort/Long call MUH GM wardsMUH GM wards VA wardsVA wards
►Specialty servicesSpecialty services Onc/Pulm/Renal/HemeOnc/Pulm/Renal/Heme GI/CardsGI/Cards
Call at MUHCall at MUH
InternsInterns
q8: General Medicineq8: General Medicine
q6: Renal, Pulmonary, Oncology, Hematologyq6: Renal, Pulmonary, Oncology, Hematology
q6: Cardiology, GI (liver & luminal)q6: Cardiology, GI (liver & luminal)
ResidentsResidentsq4: MICUq4: MICU
Night floatNight float
On ward services 1-2 overnight calls per On ward services 1-2 overnight calls per monthmonth
Call at VAMCCall at VAMC
Intern Call: q6Intern Call: q6Interns stay overnight q6 and Interns stay overnight q6 and
until 8pm q6until 8pm q6Residents stay until 8pm q 3 Residents stay until 8pm q 3
and take 2-3 weekend callsand take 2-3 weekend callsResident Night FloatResident Night Float
MICU: q3MICU: q3Beds: 8Beds: 8Closed unitClosed unit
ACGME ComplianceACGME Compliance
►Admission caps in 24 hoursAdmission caps in 24 hoursInterns 5 patientsInterns 5 patients
Residents 10 patientsResidents 10 patients
►Work hoursWork hoursMaximum 80 hour work weekMaximum 80 hour work week
Days off average 1 in 7Days off average 1 in 7
Maximum shift 30 hours (no post-call Maximum shift 30 hours (no post-call clinic!)clinic!)
Night Float Schedule Night Float Schedule (2nd,3(2nd,3rdrd year year only)only)
Week 1Week 1Float 8pm-8am, Sun-ThursFloat 8pm-8am, Sun-Thurs
Week 2 Week 2 Vacation or VA GM ConsultsVacation or VA GM Consults
Week 3 Week 3 Float 8pm-8am, Sun-ThursFloat 8pm-8am, Sun-Thurs
Week 4Week 4 Float 8pm-8am, Sun-ThursFloat 8pm-8am, Sun-Thurs
Consult OpportunitiesConsult Opportunities
► GastroenterologyGastroenterology► CardiologyCardiology► Pulmonology Pulmonology ► Infectious DiseaseInfectious Disease► HospitalistHospitalist► NephrologyNephrology► RheumatologyRheumatology
► EndocrinologyEndocrinology► Allergy / AsthmaAllergy / Asthma► NeurologyNeurology► Research electivesResearch electives► Others:Others:
DermatologyDermatology
RadiologyRadiology
Surgery, etcSurgery, etc
Ambulatory SitesAmbulatory Sites
► Continuity clinics Continuity clinics University Internal MedicineUniversity Internal Medicine VA Primary Care Clinics and Urgent CareVA Primary Care Clinics and Urgent Care
► Each location with social workers, diabetes Each location with social workers, diabetes educators, dieticians, and clinical educators, dieticians, and clinical pharmacistspharmacists
► General Internal Medicine and sub-specialty General Internal Medicine and sub-specialty clinics for referralclinics for referral
8th floor Rutledge Tower
Primarily Medicare, Medicaid and Private patients
Full service subspecialty referrals
Pharmacy
Laboratory
Radiology
PT/OT
University Internal Medicine (UIM)
Rutledge Tower
>310,000 square feet
265,000 patient visits/yr
Connected to MUSC
Patient regional attachment area >175,000 in NC, SC, and GA
Three primary care teams
Urgent Care walk-in clinic
Full Medical and Surgical specialties
Complete electronic medical record
VA Primary Care Clinics
Conferences & EducationConferences & Education
Morning ReportMorning ReportMonday, Wednesday, FridayMonday, Wednesday, Friday
VAMC MUH
Conferences & EducationConferences & Education
Attending RoundsAttending RoundsDaily, following morning report Daily, following morning report
Bedside teachingBedside teaching
Medical studentsMedical students
Pharmacists, Care Pharmacists, Care
Managers, etc. Managers, etc.
Conferences & EducationConferences & Education
Noon ConferencesNoon ConferencesAttending DirectedAttending Directed
►Emergency Lecture SeriesEmergency Lecture Series►Division LecturesDivision Lectures
Resident DirectedResident Directed►Morbidity and MortalityMorbidity and Mortality►Clinical Pathology ConferenceClinical Pathology Conference►Journal ClubJournal Club►Medicine in the NewsMedicine in the News►Senior TalksSenior Talks
Conferences & EducationConferences & Education
Medicine Grand RoundsMedicine Grand Rounds Outside speakersOutside speakers Patient case Grand RoundsPatient case Grand Rounds
Intern ConferenceIntern ConferenceBoard Review SessionsBoard Review SessionsSecond Year Leadership ConferenceSecond Year Leadership ConferenceDivision Conferences Division Conferences
Cardiology Grand RoundsCardiology Grand Rounds Pulmonary Case Conference, etcPulmonary Case Conference, etc
Average 40% graduates enter General Internal Medicine practice and 60%
enter sub-specialty fellowships
Practice Where?Practice Where?
► Charleston AreaCharleston Area► Orangeburg, SCOrangeburg, SC► Summerville, SCSummerville, SC► Florence, SC Florence, SC ► Yonges Island, SCYonges Island, SC► Columbia, SCColumbia, SC► Denver, CODenver, CO► Galveston, TXGalveston, TX► College Station, TXCollege Station, TX► Ocean Springs, MDOcean Springs, MD► Washington, DCWashington, DC
► Atlanta, GAAtlanta, GA► Tucson, AZTucson, AZ► Raleigh, NCRaleigh, NC► Durham, NCDurham, NC► Savannah, GASavannah, GA► Cleveland, OHCleveland, OH► Philadelphia, PAPhiladelphia, PA► Little Rock, ArkansasLittle Rock, Arkansas► Nashville, TennesseeNashville, Tennessee► Naples, ItalyNaples, Italy
Fellowships Where?Fellowships Where?
► MUSCMUSC► University of Virginia University of Virginia ► University of North CarolinaUniversity of North Carolina► Baylor UniversityBaylor University► Washington University, St. Washington University, St.
LouisLouis► University of ChicagoUniversity of Chicago► Indiana University Indiana University ► Ohio State UniversityOhio State University► Albert Einstein College of Albert Einstein College of
MedicineMedicine► Medical College of VirginiaMedical College of Virginia► University of MichiganUniversity of Michigan
► Temple UniversityTemple University► Louisiana State UniversityLouisiana State University► South AlabamaSouth Alabama► University of Texas, University of Texas,
GalvestonGalveston► University of South FloridaUniversity of South Florida► Wake ForestWake Forest► East Carolina UniversityEast Carolina University► Medical College of GeorgiaMedical College of Georgia► Vanderbilt UniversityVanderbilt University► UC- San DiegoUC- San Diego► Oschner ClinicOschner Clinic► University of ArizonaUniversity of Arizona
Salary and BenefitsSalary and Benefits
► Resident salaries 2006-2007 (10/1/06 – 9/30/07)Resident salaries 2006-2007 (10/1/06 – 9/30/07)PGY-1: $39,169PGY-1: $39,169PGY-2: $40,857PGY-2: $40,857PGY-3: $42,634PGY-3: $42,634PGY-4: $44,481PGY-4: $44,481PGY-5: $46,416PGY-5: $46,416
► Insurance benefitsInsurance benefits HealthHealth DentalDental DisabilityDisability
► Wellness Center membershipWellness Center membership
Salary and BenefitsSalary and Benefits
► 3 weeks paid vacation plus holiday3 weeks paid vacation plus holiday► Paid Paid
SC, DEA, DHEC licensesSC, DEA, DHEC licensesACP membershipACP membershipStep 3 USMLEStep 3 USMLE
► Parking Parking ► Embroidered lab coatsEmbroidered lab coats► On-call meals, weekend take-outOn-call meals, weekend take-out► Conference / presentation fundingConference / presentation funding► Simon-Web paging systemSimon-Web paging system
Charleston HousingCharleston Housing
► Resident living (approximate) Resident living (approximate) 50% rent / 50% own50% rent / 50% own
► Several diverse locations close to MUSCSeveral diverse locations close to MUSC► Rental Costs by location (2 BR apt per Rental Costs by location (2 BR apt per
month):month):DowntownDowntown $1210/mo $1210/mo James IslandJames Island $950/mo$950/moMt. PleasantMt. Pleasant $1045/mo $1045/mo N. Charleston: N. Charleston: $820/mo$820/moWest Ashley: West Ashley: $960/mo$960/mo
Finding a ResidencyFinding a Residency
►““Did I like those people? Can I work Did I like those people? Can I work with them?”with them?”
►““Did I like that city? Can I live there? Did I like that city? Can I live there? Can my spouse/significant other live Can my spouse/significant other live there? How will I enjoy my days off?”there? How will I enjoy my days off?”
►““What did it feel like while I was there?”What did it feel like while I was there?”