Florence Internal Medicine Residency Curriculum

The schedule of rotations has been developed on the foundation of balancing robust training and exposure across the Internal Medicine specialties with resident and faculty well-being and achieving an appropriate work-life balance. Various scheduling models exist to achieve this goal. We believe the “four by four” model best suits our program and organizational culture. Four-week blocks of inpatient experiences are alternated with four-week blocks of outpatient/continuity clinic experiences. This model is associated with reduced resident burnout, improving continuity of care with patients, and fostering greater professional engagement. This model also allows for weekends off during all outpatient and elective outpatient rotations.

All required inpatient rotations occur at MUSC Health Florence Medical Center. The inpatient medicine teaching services and ICU rotations are always comprised of both upper and lower residents throughout the year with attending physicians on site. Day Admission Service and Night Float occur at Florence Medical Center, these services are staffed by upper- level residents.

All required outpatient/ambulatory rotations are held at MUSC Health Florence Medical Center, Medical Pavilion specialty practices located on the campus of Florence Medical Center. The Behavioral Health rotation is held at MUSC Health Jean and Hugh K. Leatherman Behavioral Health Pavilion, a short drive from the Florence Medical Center campus. A resident may select an elective outpatient rotation which may be located off the Florence Medical Center campus, at the resident’s discretion.

These rotations are based on your educational goals and interests and can include the following:

• Cardiology
• Dermatology
• Endocrinology
• Gastroenterology
• Hematology/Oncology
• Infectious Disease
• Nephrology
• OP GIM
• Pulmonology
• Psychiatry
• Rheumatology

The Yale Outpatient Curriculum is an evidence-based program designed to help residents assess and manage common ambulatory conditions with confidence. It also covers several practical, real-world topics that are necessary in daily medical practice, such as coding, documentation, and systems-based care, to ensure trainees are well prepared for clinical and professional responsibilities in the outpatient environment.

Interactive case- based discussion of unique and or challenging cases to develop clinical reasoning and decision making. Cases are either based at Florence Medical Center or Charleston MUSC but always have a faculty member from FMC to facilitate the discussion in-person.

This series is held weekly and initially will be in conjunction with the MUSC Department of Internal Medicine. Topics and speakers are selected to provide faculty and trainees with up-to-date knowledge about timely issues in internal medicine.

This 18-month curriculum is designed to cover the core topics in internal medicine and intentionally uses repetition to allow learners to interact with the content at the introductory and more advanced levels and the opportunity to revisit and consolidate knowledge as they grow in clinical experiences and exposure. This series is run primarily by the core faculty and augments learning in the clinical setting.

This series encompasses simulation training in central lines, arterial lines, suturing, intubation, and other critical procedural skills, with an accompanying comprehensive curriculum in POCUS and mock code sessions.

POCUS training is integrated throughout the residency. In addition to didactics, residents receive hands-on experience in the ICU, inpatient teams, ED, PM&R, outpatient General internal medicine and continuity clinic. These rotations are equipped with Butterfly ultrasound probes, allowing residents to perform bedside ultrasound.

This series looks at new and seminal articles relevant to the practice of internal medicine. The presentations are focused on appraisal of the medical evidence and the ramifications for practice.

These peer review sessions are non-punitive and focused on improving patient care through a comprehensive analysis of adverse outcomes or “near misses”. The reviews take a system level approach to identify opportunities for improvement.

This resident guided series is held monthly with lunch provided are a chance to enjoy food and time together with content and activities around all aspects of wellbeing including.

Using clinical pearls and board style questions these interactive sessions aim to regularly assess and improve medical knowledge at all levels. Using the Medical Knowledge Self-Assessment Program (MKSAP) tools, these sessions allow for residents and faculty to help each other prepare for the certifying/recertifying examinations and maintenance of certification (MOC) in internal medicine.

Our longitudinal curricular threads incorporate MUSC Health expertise and local and national resources with fundamental content with the aim to equip residents with a strong understanding of health systems science.

Learn more about Longitudinal Curricular Threads.

MUSC Health FMC IMRP in partnership with MUSC-RN provides and allocates various resources to encourage and facilitate Resident and Faculty participation and completion of scholarly activities. Throughout the three years of training Residents are required to participate in various quality improvement and patient safety initiatives to advance their knowledge of and implement a scholarly approach to evidence-based patient care.

Residents are provided, annually, educational travel allowances to present their findings at local, regional, and national conferences.

Faculty, many of whom already participate in such activities are required to complete at least three domains as defined by the ACGME and will serve separately as a mentor or supervising physician for at least one Resident activity annually.

Faculty Scholarly Activity Participation:
MUSC Health FMC IMRP Core Faculty are afforded resources to participate in scholarly activities and will demonstrate participation in:

• Research in basic science, education, translational science, patient care, or population health
• •Peer-reviewed grants
• Quality improvement and/or patient safety initiatives
• Systematic reviews, meta-analyses, review articles, chapters in medical textbooks, or case reports
• Creation of curricula, evaluation tools, didactic educational activities, or electronic educational materials
• Contribution to hospital and professional committees, educational organizations, or editorial boards
• Innovations in education

Resident Scholarly Activity Participation:
Residents are provided with lectures in research fundamentals to include basic statistics, medical writing, study design, literature review and data collection and interpretation, developed and delivered by the MUSC Department of Population Health faculty, MUSC Medical Librarian and the program faculty.

Each resident is expected to complete one scholarly project as a requirement for graduation. Activities can include quality improvement, clinical/basic science research, review articles, case series, or any presentation at a local, regional or national meeting.The program will ensure the resident completes this requirement using Individualized Learning Plan, with scholarly activity being one of its components. The specific steps to completion such as:

1. identifying a topic,
2. engaging a faculty mentor,
3. submitting an approved plan for scholarly activity,
4. completing a scholarly activity product (article, abstract, presentation slides and evaluations as applicable)
5. ILP completed by the Resident and approved by the Faculty Mentor and tracked in MedHub

Progress and completion of the scholarly activity will be reviewed in the resident meetings with their advisors and the semi-annual meetings with the program director.

PGY-1 Residents will participate in MUSC Value Institute Evidence-Based Quality Improvement (EBQI) curriculum and present project findings to MUSC-RN and MUSC Health Leadership.

All Residents will participate, annually, in one group project for submittal to the MUSC Resident Incentive Program (RIP). Project participants, upon fulfilling the guidelines of the program will be provided a monetary award for successful completion.

MUSC Health FMC IMRP in partnership with MUSC-RN provides other educational resources at no cost to the Resident:

• American College of Physicians (ACP) and Medical Knowledge Self-Assessment Program (MKSAP) annual Memberships
• American Medical Association Health Systems Science Curriculum (AMA HSS) and Institute for Healthcare Improvement (IHI) Modules
• Annual MUSC Mandatory Learning Modules (The Joint Commission/DNV compliant)
• EPIC Learning and Training Modules/MUSC Value Institute Pathways
• Annual In-Training Examination
• MUSC Electronic Medical Library Access
• Individual Learning Plan (ILP)/Elective Rotations (MUSC Charleston only)
• Residents as Teachers Curriculum