Clinical Rotations for Residents

Internal medicine resident schedule (sample)

The inpatient ward services provide the foundation for the education of our interns and residents in the management of hospitalized patients. These services are exclusively at New Hanover Regional Medical Center – having one centralized teaching hospital, at the same location as our medical clinic, makes it easier for our residents to maneuver through one electronic health record system and obviates the need to travel to different teaching sites. Teaching and supervision on these services is universally performed by our core clinical faculty, who are continuously accessible to our residents and who are experienced and dedicated clinical educators. There is a core faculty member on work rounds every day of the year, providing bedside teaching and frequent team-based didactic sessions. There is no overnight call on the inpatient ward services. Every third day, an inpatient team is "on call" for admissions until 7:30pm, when the night float resident arrives and takes over for admissions. With a key geographic location that serves both urban and rural areas, and that spans across seven counties in southeastern North Carolina, our residents are exposed to a wide array of inpatient diagnoses – from the common to the rare and unusual – and to a socioculturally diverse patient population. The ward experience is frequently supplemented by having medical students and pharmacy students/residents on our inpatient teams.

Critical Care Service

The ICU service provides the basis for the education of our interns and residents in the management of critical care patients. This service is also exclusively held at NHRMC, a Level II trauma center and a regional referral hospital for seven counties in southeastern North Carolina. The hospital houses four intensive care units (ICUs) with 69 total ICU patient beds. Teaching and supervision on the ICU service is universally done by our core clinical faculty, with the consultative support of pulmonary-critical care physicians. There is a core faculty member on work rounds every day of the year, providing bedside teaching and team-based didactic sessions. There is no overnight call on the ICU service. Every third day, an ICU resident is "on call" for admissions until 7:30pm, when the night float resident takes over for admissions.

Night Float

The only time that residents are overnight in the hospital is during night float rotations. There is between 4 and 6 weeks of night float during the internship year, and one 4-week block in each of the PGY-2 and PGY-3 years.

Emergency Medicine

The emergency medicine experience is held during the PGY-2 year, and exposes our residents to patients with a wide array of illnesses as they first arrive to the hospital. Supervision is by dedicated EM physicians who are eager to teach our residents.

Geriatrics

PGY-3 residents rotate for one block with a core faculty member at the Cornelia Nixon Davis nursing facility, where they learn from a specialized geriatric medicine curriculum by members of our core faculty with special interest in geriatrics.

Neurology

Residents will rotate for one 4-week block during one of their training years (the timing is flexible) with our inpatient neurology faculty, obtaining exposure to common and rare neurological diagnoses and fine-tuning their neuro exam skills.

Ambulatory Medicine Block

The Ambulatory Medicine block experience, along with the residents' weekly Continuity Clinics, provide the cornerstone for outpatient general internal medicine education for our residents. There is a dedicated online teaching curriculum for the outpatient service, and a weekly conference dedicated to topics in outpatient medicine. Diagnosis and management of the key problems seen by internists in the outpatient setting is the educational focus of the clinic experience. We have dedicated core faculty members precepting the clinic at all times, which is located in a building adjoined to the main hospital. Interns and residents have a weekly half-day continuity clinic for which they provide longitudinal care to their cadre of patients throughout all three years of their training. There are specific Ambulatory Medicine blocks where residents see patients with acute medical needs. The Ambulatory Medicine block months are additionally supplemented with high-yield learning experiences in various medical subspecialties.

Elective

Elective rotations are available in the community by excellent subspecialty extended faculty, and can be tailored to the needs of individual residents. In addition to internal medicine subspecialties, experiences are available in other areas, including dermatology, ophthalmology, orthopedics, neurology, pathology, medical microbiology, pediatrics, OB/GYN, radiology, anesthesiology, psychiatry, and general surgery. Electives outside of the Wilmington area ("away electives") are possible, with approval from our hospital's Graduate Medical Education Committee (GMEC), during the second and third year of training.

Other aspects of our curriculum

Preliminary year residents

Our program matches two preliminary year internal medicine residents each year. These positions are extremely competitive and tend to draw very strong applicants. The preliminary year is similar in most ways to the categorical internship year. One major difference is that "prelims" do not have a continuity clinic; instead, they participate in a weekly half-day acute care ('AC') clinic. Since this program is one year in length, longitudinal care for a cadre of primary care patients is less possible, and additionally many of our prelims tend to prefer seeing patients for brief visits and with acute medical problems.

Osteopathic residents

Our program is enthusiastically supportive of graduates from osteopathic medical schools. As an AOA-accredited program, our osteopathic residents will complete required 4-week rotations during their residency in: family medicine (this generally replaces one AC month), general surgery (this generally replaces one 2nd year elective), and emergency medicine (which is already a 2nd year rotation). These three rotations ensure that our residents fulfill the AOA Transitional Year requirements, and hence they are able to be licensed throughout the U.S. following completion of residency. We also offer a supplemental didactic series by Barbara Walker, DO (a faculty member in the family medicine residency at NHRMC) in osteopathic manipulative treatment (OMT).

Board Review Education Program

Check out the Facebook page for the NHRMC Internal Medicine Residency Program… become a fan and interact with our current and former residents in the discussion boards.