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 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

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

New Hospital Building Estimated Completion: 2007

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: : 24 Categ, 7 Prelim, 2 Med/Peds, 2 Med/Psych

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

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

Example Intern Schedule JulyVA ward AugustRenal ward SeptemberMICU OctoberAmbulatory Clinic November VA ward DecemberVA Urgent Care* JanuaryCards ward FebruaryOncology ward MarchGen Med ward April ER MayGen Med ward JunePulmonary ward *Holiday off

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

Call Service Design Short/Long call  MUH GM wards  VA wards ► Specialty services  Onc/Pulm/Renal/Heme  GI/Cards

Call at MUH Interns q8: General Medicine 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

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

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!)

Night Float Schedule (2nd,3 rd 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

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

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

8 th 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 & Education Morning Report Monday, Wednesday, Friday VAMCMUH

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

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

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

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

Practice Where? ► 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

Fellowships Where? ► 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

Salary and Benefits ► Resident salaries (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

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

MUSC

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

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?”

QUESTIONS ???