Carolinas HealthCare System
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Internal Medicine Curriculum

Acute Care Conference Series, Noon Conferences, Departmental Conferences, Inpatient Morning Report, Outpatient Education, Grand Rounds, Innovative Wednesday Curriculum, Journal Club, Symposia, Board Review, In-Training Exam in Internal Medicine, Rising PGY-3 Leadership Seminar, PGY-2 Resident as Teacher Symposium, Simulation Center, Intern Patient Safety Skills OSCE, PGY-1 Common Critical Care Curriculum, Audience Response Technology, Rotation Pre- and Post-Testing, EKG and Cardiology Quizzes, International Activities

The CMC Internal Medicine Residency curriculum includes many different educational opportunities. Please take a moment to learn more about our educational curriculum.

Acute Care Conference Series

Internal Medecine Residents CurriculumLectures are Monday through Friday at 12:30 p.m. from July to mid-August. The series includes core topics relevant to new intern/upper level working on an inpatient service.

Topics include Fluids and Electrolytes, Drug/Alcohol Withdrawal syndromes, Tachyarrhythmias, GI Bleeds, and Antibiotics, among many others.

  • The lecture series culminates with a five-day seminar on EKGs - basics through arrhythmias.
  • Lectures are attended by IM residents and medical students as well as faculty and residents from Family Practice and Emergency Medicine.

Noon Conferences

Internal Medecine Residents Curriculum

Following the completion of the Acute Care Conference Series curriculum, our regular Noon Conference schedule begins. Lectures are held Mondays, Tuesdays, 1st/3rd Wednesdays, Thursdays, and Fridays from 12:30 p.m. – 1:30 p.m. A wide variety of topics are covered throughout the year. Typically, Tuesdays are reserved for ambulatory general medicine topics. The overall topics are relevant to Internal Medicine's RRC requirements, the In-Training Exam, and the ABIM shelf exam, as well as everyday practice.

Our daily didactic curriculum is evaluated anonymously by the house staff and earns excellent ratings because of its relevance, thoroughness, and the outstanding dedication of the faculty.

Departmental Conferences

Each subspecialty division offers its own individual weekly or monthly conferences. Examples include the weekly Tumor Board conference, combined Medical-Surgical GI conference, Pulmonary-Critical Care conference, and Infectious Disease Microbiology Rounds. Individual specialties do a great deal of didactic and bedside teaching on a daily basis in addition to formal lectures.

Inpatient Morning Report

Inpatient Morning Report is held on Mondays, Tuesdays, Thursdays, and Fridays. This conference is open to medical students, interns, residents, and faculty, and we strongly encourage all to attend. The assigned resident selects an interesting case and provides an evidence-based case presentation.  The chief residents facilitate discussion with a focus on defining the skills of differential diagnosis.

INTERN-ONLY Morning Report occurs from July-October on Thursday mornings. These conferences focus on the evaluation of core medicine topics such as chest pain, altered mental status, acute renal failure, etc.  Only interns are invited, and these sessions are led by an upper level resident.  There is a strong emphasis on differential diagnosis and increasing one’s comfort with public speaking.

Outpatient Education

Internal Medecine Residents Curriculum

Ambulatory Morning Report: We adopted Yale University's Ambulatory Clinic Curriculum for use in the Myers Park clinic beginning in the fall of 2009, and we have been thrilled with how it has added to our ability to teach outpatient medicine! We assign resident "leaders" to facilitate the weekly topics in the continuity clinic for each morning session. Thus, the residents facilitate our "Ambulatory Morning Report" with faculty mentorship. The topics change on a weekly basis. At the end of each week, all residents are asked to review the weekly presentation material on their own time if they have not been able to attend the outpatient sessions. All residents are asked to complete a short quiz online for topic review. The curriculum follows a 3-year cycle so that topics do not become redundant.

Ambulatory Noon Conference and Symposia: Tuesday noon conferences are dedicated to ambulatory clinic topics and typically are given by the general medicine faculty.  In addition, there are resident symposia held during the year on specific ambulatory topics.  Some examples of recent ambulatory symposia topics include pain management, the musculoskeletal office exam, systems of care, and shared decision making.

Ambulatory Pain Management Curriculum: Residents receive longitudinal instruction on safe opioid use for chronic pain. www.scopeofpain.com

Grand Rounds

Our Medical Grand Rounds are held on the first and last Wednesdays of every month from 12:30 p.m. – 1:30 p.m in our main auditorium. Presentations are given by Carolinas Medical Center faculty as well as by visiting professors from other institutions. Over the past few years, our Grand Rounds schedule has included many prestigious speakers, including:

  • Ann Bonham, PhD – Chief Scientific Officer: Association of American Medical Colleges
  • Allan S. Brett, MD – Editor-In-Chief, JournalWATCH®, Internal Medicine.
  • Steven Weinberger, MD - Senior Vice President for Medical Knowledge and Education: American College of Physicians, on "An ACP Perspective on the Direction of Medical Training"
  • Gerald Smetana, MD - Associate Professor of Medicine at Harvard Medical School and International leader in the field of perioperative medicine on "The Perioperative Pulmonary Evaluation"
  • Neil MacIntyre, MD - Clinical Chief for the Division of Pulmonary, Allergy, and Critical Care at Duke University on "The NIH ARDS Network"
  • Ruth Berkelman, MD - Director of the Center for Public Health Preparedness and Research, Emory University on "Microbial Threats to Health: More to Come"
  • Brian Wansink, PhD - Professor of Consumer Behavior at Cornell University and former executive director of the USDA's Center for Nutrition Policy and Promotion on "Mindless Eating: Why We Eat More Than We Think"
  • Richard W. Light, MD Vanderbilt University, founder of "Light's Criteria" for classifying pleural effusions
  • Gerald Appel, MD Columbia University, Chairman of the Glomerular and Nephritis Council of the National Kidney Foundation
  • Paul L. Marino, MD The Miriam Hospital, Providence, R.I., Author of "The ICU Book"

Morbidity and Mortality Conference is held quarterly as a part of our grand rounds curriculum. M&M typically is moderated by one of our generalist faculty.  Through this conference series, we utilize a systems-based approach to evaluate medical errors and improve patient safety. This conference series always is a favorite amongst the residents and other members of the department.

Innovative Wednesday Curriculum

We have designed a novel, innovative curriculum for Wednesday mornings from 8:00 a.m. – 8:45 a.m.  

  • The first Wednesday of every month focuses on physical exam teaching on a different organ system each month.
  • The second Wednesday of every month is our resident M&M curriculum.  Each PGY-3 resident is assigned a faculty “patient-safety mentor.”  After selecting a case in which an adverse outcome or near-miss occurred, the PGY-3 resident meets with his/her patient safety mentor to discuss the case.  Following that meeting, each PGY-3 resident has an opportunity to present the case to his/her peers and facilitate discussion on the relevant patient safety issues.  Using the Institute of Medicine aims for patient safety, the group examines and discusses the case in a low pressure environment with the goal of improving care in the future.  
  • The third Wednesday of every month focuses on a variety of topics that lend themselves well to group discussion.  Some examples of topics covered include medical ethics, teaching and learning, health policy, and medical humanities.
  • The fourth Wednesday of every month provides the residents a chance to meet with the departmental leadership to discuss a variety of things including curricular changes and various policies and procedures.   

Journal Club

Journal Club is held monthly during noon conference and is led by a PGY-2 resident.  Under the mentorship of a faculty member, the PGY-2 resident chooses a recent article and completes a review of the pertinent literature.  After the article is presented to his/her peers, the audience has an opportunity to discuss the methodology, findings, and impact on clinical practice.  Skills learned include basic statistics, epidemiology, and critical appraisal of medical literature. 

Symposia

Our symposia are quarterly four-hour workshops on topics crucial to internal medicine that are difficult to review in a one-hour forum. Continuity clinics are canceled so that all residents/faculty may attend. Recent topics included patient handoffs, health care policy, sports medicine, perioperative evaluation/care, alternative medicine, gynecology review, health maintenance and prevention, and palliative care medicine.

One of the most popular offerings is our annual two-day “Procedure Workshop.” The Department of Internal Medicine owns multiple simulator models for different procedures for resident education. With the help of our experienced faculty, proper algorithms and model instruction are conducted for the following procedures: arterial line placement, arthrocentesis of the shoulder, central line placement, intubation, lumbar puncture, thoracentesis, and use of ultrasound as an adjunct when performing vascular procedures.

Board Review

The Department of Internal Medicine faculty conducts an extensive Board Review Series every year. These sessions are designed for our PGY-3 residents although all are welcome to attend.  Generally, this series consists of two sessions per month in the evenings from September through May. Both our General Medicine and Subspecialty Division leaders are involved with this series and put a tremendous amount of effort into these reviews.

In addition, a monthly lunchtime Board Review series is held during noon conference. Audience response system technology is used during these sessions to cover difficult topics that frequently come up on the ABIM exam.

Our residents are well prepared for the ABIM exam by the time they finish their residency training.  Our first-time ABIM pass rate is 100 percent since 2008 which places our program in the top 5 percent of Internal Medicine residency training programs nationwide. 

In-Training Exam in Internal Medicine

In our program, categorical residents take the In-Training Exam in Internal Medicine each year that they are in the program. We have found that sitting for the exam annually assists our residents greatly with time management and other skills that are critical to navigating the ABIM exam successfully.

Internal Medecine Residents Curriculum

Rising PGY-3 Leadership Seminar

All of our rising PGY-3 residents participate in this two day off-site retreat. The seminar is taught by CMC faculty and attended by residents from multi-disciplinary residency programs across the southeastern United States. Topics covered include leadership skill development, conflict resolution, teaching skills, and time management, etc. A quality improvement poster reception during this event gives our residents the opportunity to present their QI work.  For the past two years at this event, residents from our department have received the “Most Impactful Project” award as well as the award for “Interdisciplinary Teamwork” which highlights the outstanding work that our residents are doing in quality improvement and patient safety.

PGY-2 Resident as Teacher Symposium

This two-day symposium is designed for our PGY-2 residents and led by Drs. Furney and Lloyd.  During this popular, interactive conference, our residents are equipped to improve their skills of medical student teaching and feedback.

Simulation Center

Carolinas Medical Center has an extensive, full-time simulation laboratory on campus. The Simulation Center opened in 2007 and is fully accredited by the American College of Surgeons.

It includes everything from lumbar puncture trainers, knee/shoulder arthrocentesis models, thoracentesis models, to full resuscitation models. We fully utilize the Simulation Center to complement our residents’ training experience including the Intern Patient Safety Skills OSCE and Common Critical Care Curriculum. 

View additional information about Carolinas Medical Center’s Simulation Center.

Also, view a list of all of the materials at the center!

Intern Patient Safety Skills OSCE

All of our incoming PGY-1 residents take part in an OSCE [Observed Structured Clinical Exam] during their orientation period.  History and physical exam skills, not to mention procedural skills, often vary depending on the level of exposure a particular incoming intern may have had during medical school.  Our Intern OSCE is a low pressure mechanism that offers incoming PGY-1 residents direct feedback on several different modules.  Topics covered during this session include history taking from a simulated patient, the cardiac and pulmonary exam, LP training, basic suturing and knot tying, foley catheterization, and the pelvic exam.  Our incoming trainees have felt the OSCE to be a very valuable experience. 

PGY-1 Common Critical Care Curriculum

Later during intern year, all of our PGY-1 residents participate in our Common Critical Care Curriculum (4Cs).  This series consists of three 4-hour critical patient care and procedure sessions in the simulation lab.  Topics covered during this series include code blue resuscitation, procedure training including central line placement, and scenarios involving delivering bad news to a patient or disclosing a medical error. 

Audience Response Technology

Today’s learners are more technologically savvy than ever before, and one of our most popular ways to incorporate technology into education has been the frequent use of our Audience Response System. This technology provides a quick and easy way for the speaker to acknowledge the levels of the learners’ knowledge.  It also provides a low-pressure, comfortable environment for learners to identify their errors and learn from their mistakes. We frequently use this technology at our Morbidity and Mortality Conferences, Board Review Series, and Noon Conferences.

Rotation Pre and Post Testing

Many of our subspecialty departments administer both a pre-test and post-test for the consult rotations.  These tests do not count toward the resident’s evaluation per se but are used for the residents to self-identify areas of weakness to be addressed during the rotation.  They also provide an opportunity for the house staff to see how they have improved by the end of the month!  Many of these tests are created internally, but we also use some external educational materials.  Specifically, we use the Yale Office Based Medicine Curriculum for ambulatory education as well as the Society of Hospital Medicine teaching modules which provide instruction on perioperative care.   

EKG and Cardiology Quizzes

Internal Medecine Residents Curriculum

Each month, two of our cardiologists prepare interesting EKG and cardiology board-question quizzes. Residents have the opportunities to respond via email with prizes given to those who answer correctly. This friendly competition has grown to be wildly popular amongst our housestaff. 

International Activities

We highly encourage our residents to take part in scholarly activities on an international level. Currently, we do not have any formal relationships with any external sites although we are exploring an opportunity with a hospital in Cameroon, Africa.  Regardless, our residents have tremendous flexibility in terms of where they would like to travel and study.  All opportunities are reviewed and approved on a case-by-case basis.

Our residents literally have been around the world, from as close as Costa Rica or Guatemala, to as far away as Sydney, Australia.  Recent resident travel rotations have included month-long experiences in Costa Rica, Niger, and Kenya.

In addition, Carolinas Medical Center will allow PGY2 and PGY3 level residents to use their book/travel funds (which total $1900/year) to be applied toward international rotation travel expenses.  This often has been the difference that has allowed residents to take advantage of these opportunities.

Our program leadership has been exceedingly flexible in allowing the residents to find the opportunities that best fit their learning objectives – whether that may be a mission trip combined with Medical Spanish immersion, or an intense third world experience to serve as a base for a lifetime of international volunteerism.  Again, our flexibility is about helping you to achieve your goals and needs!

The following links are commonly used for residents who are considering these opportunities:

Please feel free to ask about this on your interview day!! 

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