Carolinas HealthCare System
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ICUs and ED

Where Residents Spend Their Time
  Medicine Wards Medical ICU Coronary Care Unit

Electives/
Subspecialty consults*

ER blocks Night float rotations*
PGY1 5 1 0 4 1 0.5-1
PGY2 3 1 1 0 0.5
PGY3 3 1 1 0 0.5

* = Night float rotation amounts do not include weekends and are Sun – Thurs. On average the number of weekend days will be six to eight (6-8) for PGY 1’s and 3-5 for PGY2/3 residents.

Emergency Department

Emergency Department Internal Medicine ResidentsInterns have the opportunity to work with faculty and residents in the Department of Emergency Medicine, which has a strong national reputation for excellence. They will work under the supervision of board-certified Emergency Medicine attendings, seeing adults with major and minor emergencies. There will be ample opportunities for a variety of minor procedures, including suturing and incision and drainage, as well as more invasive procedures. This rotation is four weeks in length; vacation cannot be taken during this experience. During the month, interns typically work twenty 10-hour shifts.

Coronary Care Unit (CCU)

Second- and third-year residents are assigned to one-month rotations on this 20-bed unit, also known as the Dickson Heart Unit (DHU). They work with cardiologists from the Sanger Clinic, a very large multi-specialty cardiology practice that is part of Carolinas HealthCare System. A very select number of the group's partners are extended the opportunity to attend on the resident teaching service; residents assist the cardiologists in the care of patients with acute cardiac illnesses. Residents are also part of the CODE STEMI team, which is the early response team for ST-elevation Myocardial Infarctions. Residents will have the opportunity to hear about these patients en route, see them as they arrive in the Emergency Department and then follow them through the cardiac catheterization lab to the CCU. This is a very unique opportunity - typically residents do not get to be part of the initial evaluation of patients with acute ST elevation MI's. Residents will also be part of the CODE BLUE team and assist with responding to all cardiac arrests in the hospital. The CCU is a completely daytime rotation experience with no overnight call, and shifts are no longer than 16 hours duration.  A typical shift runs from 6 a.m. - 8 p.m.  Additionally, a board-certified faculty cardiologist is assigned full-time to the CCU for teaching purposes. There are always attending level cardiologists to access (24 hours a day, seven days a week) for residents to discuss patient issues with as needed. A doctor of pharmacology and a registered critical care dietitian are part of the CCU team as well.

Medical Intensive Care Unit (MICU)

The ICU is a 30-bed unit supervised by full-time faculty; all of our faculty are certified in critical care. A formal lecture curriculum also exists, with lectures a minimum of three times a week. The curriculum always includes an introduction to ventilators, reviews of critical articles on the management of sepsis and instruction with performing invasive procedures. We own our own Sono-Site™ machine, so we can use this for line placement without needing to involve the radiology department. We also own our own GlideScope™, and this is used to help residents become trained in intubation skills. First, second- and third-year residents assigned to one-month ICU rotations assist in the care of both private and staff patients. During a given month, on average, an upper level resident will work seven (7) night shifts, eight (8) day shifts, and nine (9) "short" shifts of nine (9) hours duration. During a given month, on average, an intern will work 10 day shifts, 10 short shifts of nine (9) hours duration, and five (5) night shifts. Day and night shifts are 16 hours long; none of the MICU shifts are longer than 16 hours duration. A doctor of pharmacology and a registered critical care dietitian are part of the ICU team. We also have board-certified Critical Care attendings in-house 24 hours a day for assistance with critically ill patients.

Carolinas Medical Center recently completed construction of an ICU Tower. This state-of-the art 30-bed Medical Intensive Care Unit facility opened in January 2008, allowing an even higher quality of care for our patients.

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