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The Medical University of South Carolina Internal Medicine Residency Program

The Medical University of South Carolina Internal Medicine Residency Program. 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 CENTER.

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The Medical University of South Carolina Internal Medicine Residency Program

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  1. The Medical University of South CarolinaInternal Medicine Residency Program

  2. 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

  3. VETERAN’S AFFAIRS MEDICAL CENTER 90 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

  4. CHARLESTON MEMORIAL HOSPITAL Transitional Care Unit managed by Hospitalist Team Emergency Department site for ER rotation and electives

  5. New Hospital BuildingEstimated Completion: 2007

  6. Medicine 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

  7. Intern Schedule • Ward months: 8-9 • Call Rotations Gen Med (4-5 mo) Specialties (3-4 mo) MICU (1 month) • Non-Call Rotations: ambulatory, ER • Continuity clinic ½ day a week

  8. VA wards (3 teams) General Medicine wards (4 teams) Cardiology (2 teams) GI (2 teams) Pulmonary Nephrology Hematology Oncology MICU VICU CCU Inpatient Services

  9. Example Intern Schedule JulyVA ward AugustRenal ward SeptemberMICU OctoberAmbulatory Clinic NovemberVA ward DecemberVA Urgent Care* JanuaryCards ward FebruaryOncology ward March Gen Med ward AprilER MayGen Med ward JunePulmonary ward *Holiday off

  10. Resident Schedule • Ward months PGY-2: 5 months + 2 ICU PGY-3: 3-4 months + 1-2 ICU • Night Float 1 month/year • Ambulatory • Consult • Elective & research

  11. Call Service Design Short/Long call • MUH GM wards • VA wards • Specialty services • Onc/Pulm/Renal/Heme • GI/Cards

  12. Call at MUH Interns q8: General Medicine q6: Renal, Pulmonary, Oncology, Hematology q6: Cardiology, GI (liver & luminal) Residents q4: MICU Night float On ward services 1-2 overnight calls per month

  13. Call at VAMC Intern Call: q6 Interns stay overnight q6 and until 8pm q6 Residents stay until 8pm q 3 and take 2-3 weekend calls Resident Night Float MICU: q3 Beds: 8 Closed unit

  14. ACGME Compliance • Admission caps in 24 hours Interns 5 patients Residents 10 patients • Work hours Maximum 80 hour work week Days off average 1 in 7 Maximum shift 30 hours (no post-call clinic!)

  15. Night Float Schedule (2nd,3rd year only) Week 1 Float 8pm-8am, Sun-Thurs Week 2 Vacation or VA GM Consults Week 3 Float 8pm-8am, Sun-Thurs Week 4 Float 8pm-8am, Sun-Thurs

  16. Gastroenterology Cardiology Pulmonology Infectious Disease Hospitalist Nephrology Rheumatology Endocrinology Allergy / Asthma Neurology Research electives Others: Dermatology Radiology Surgery, etc Consult Opportunities

  17. Ambulatory Sites • Continuity clinics • University Internal Medicine • VA Primary Care Clinics and Urgent Care • Each location with social workers, diabetes educators, dieticians, and clinical pharmacists • General Internal Medicine and sub-specialty clinics for referral

  18. University Internal Medicine (UIM) 8th floor Rutledge Tower Primarily Medicare, Medicaid and Private patients Full service subspecialty referrals Pharmacy Laboratory Radiology PT/OT Rutledge Tower >310,000 square feet 265,000 patient visits/yr Connected to MUSC

  19. VA Primary Care Clinics 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

  20. VAMC MUH Conferences & Education Morning Report Monday, Wednesday, Friday

  21. Conferences & Education Attending Rounds Daily, following morning report Bedside teaching Medical students Pharmacists, Care Managers, etc.

  22. Conferences & Education Noon Conferences Attending Directed • Emergency Lecture Series • Division Lectures Resident Directed • Morbidity and Mortality • Clinical Pathology Conference • Journal Club • Medicine in the News • Senior Talks

  23. Conferences & Education Medicine Grand Rounds • Outside speakers • Patient case Grand Rounds Intern Conference Board Review Sessions Second Year Leadership Conference Division Conferences • Cardiology Grand Rounds • Pulmonary Case Conference, etc

  24. Average 40% graduates enter General Internal Medicine practice and 60% enter sub-specialty fellowships

  25. Charleston Area Orangeburg, SC Summerville, SC Florence, SC Yonges Island, SC Columbia, SC Denver, CO Galveston, TX College Station, TX Ocean Springs, MD Washington, DC Atlanta, GA Tucson, AZ Raleigh, NC Durham, NC Savannah, GA Cleveland, OH Philadelphia, PA Little Rock, Arkansas Nashville, Tennessee Naples, Italy Practice Where?

  26. MUSC University of Virginia University of North Carolina Baylor University Washington University, St. Louis University of Chicago Indiana University Ohio State University Albert Einstein College of Medicine Medical College of Virginia University of Michigan Temple University Louisiana State University South Alabama University of Texas, Galveston University of South Florida Wake Forest East Carolina University Medical College of Georgia Vanderbilt University UC- San Diego Oschner Clinic University of Arizona Fellowships Where?

  27. Salary and Benefits • Resident salaries 2006-2007 (10/1/06 – 9/30/07) PGY-1: $39,169 PGY-2: $40,857 PGY-3: $42,634 PGY-4: $44,481 PGY-5: $46,416 • Insurance benefits • Health • Dental • Disability • Wellness Center membership

  28. Salary and Benefits • 3 weeks paid vacation plus holiday • Paid SC, DEA, DHEC licenses ACP membership Step 3 USMLE • Parking • Embroidered lab coats • On-call meals, weekend take-out • Conference / presentation funding • Simon-Web paging system

  29. MUSC

  30. Charleston Housing • Resident living (approximate) 50% rent / 50% own • Several diverse locations close to MUSC • Rental Costs by location (2 BR apt per month): Downtown $1210/mo James Island $950/mo Mt. Pleasant $1045/mo N. Charleston: $820/mo West Ashley: $960/mo

  31. Finding a Residency • “Did I like those people? Can I work with them?” • “Did I like that city? Can I live there? Can my spouse/significant other live there? How will I enjoy my days off?” • “What did it feel like while I was there?”

  32. QUESTIONS ???

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