How many residents are in the program?We currently have 78 categorical house staff, 4 primary care track, 18 Med/Peds, and 5 prelims/rotators. An additional 4 neurology interns, 6 radiology interns, 1 radiation oncology intern, and 4 ophthalmology interns spend much of their intern year with the department for a total of about 120 residents. How available are attending physicians and specialists? Every rotation has a designated attending physician available around-the-clock, either in the hospital or by pager. An attending rounds on every inpatient service every day. Residents feel very comfortable calling staff as needed. All the subspecialties of medicine have attending physicians (and fellows when applicable) on call around-the-clock. Who precepts on wards? Subspecialty ward services (Cardiology, Hematology, Oncology, and Geriatrics) are covered by subspecialty board-certified attending physicians, and have a fellow assigned to the service. The general medicine ward services are covered by hospitalists (40%), general internists (50%), and selected subspecialists (10%). Who does the teaching (residents, fellows, or faculty)? At UMMC, we are proud to have some of the best educators in the southeast. Most of the didactic sessions in the core curriculum are led by faculty members. A great deal of the teaching of the program is done as patient care decisions are made and comes from other residents, fellows, and faculty, even students! Do residents meet individually with the program leadership? All residents meet individually with the program director or an associate program director on a semi-annual basis for review of performance and milestone accomplishment and to address any of the resident's concerns with the program. Do residents have scholarship mentors? Each resident has the opportunity to be paired with a scholarship mentor, who is not the same person as his or her advisor. The mentor is identified based on the expressed scholarly interest of the resident. An intern who is uncertain of his/her scholarly interest at the start of residency can utilize his or her advisor to aid in identifying a scholarly interest. Mentors are available in general medicine, in every subspecialty, and in quality improvement and patient safety. Additionally, UMMC is home to several large ongoing research studies, including the Jackson Heart Study and Atherosclerosis Risk in Communities Study. UMMC also boasts a large research division including its own clinical trial unit and newly constructed $50 million dollar, 124,852 square-foot Translational Science Research building here on campus. Is research required of residents? All residents are required to complete a scholarly activity at least once during their training. This may include original research, quality improvement, curriculum development, case reports, textbook chapters or review articles. A scholarship curriculum is delivered throughout training to teach more about how to conduct research and to present scholarly work. We have created a Research and Scholarship Committee that includes program leadership and core faculty that is creating a research and scholarship "toolkit" to help residents take advantage of the research opportunities available within the department and on campus. What have recent graduates of the program chosen as their career paths? Most graduates in recent years are pursuing subspecialty training in a wide variety of fields. Some graduates are working as hospitalists and a few are traditional general internists. View our residents' recent fellowship matches here.
How do you evaluate your residents? The program uses an evaluation software called MedHub. Evaluations are required from all team members in order to provide feedback to both trainees and faculty. Our evaluations are competency and milestone based in order to ensure that our residents are prepared for independent practice when they graduate. We keep evaluations anonymous to encourage honest feedback and strongly encourage face to face feedback at all levels. Our clinical competency committee reviews the milestone based progress of every resident once every six months as well. We also use observation during conferences and interaction regarding consults and other patient care needs in the hospital. Lastly, we ask the residents to reflect on their own performance prior to each semi-annual visit with the associate program director or program director.
How can residents offer feedback about the program? Residents are strongly encouraged to talk to the chief residents or to program leadership about any issue that arises. Residents are given surveys of the program yearly where they are able to anonymously voice concerns. The program director and APDs also meet once per month with all the residents for an hour that is dedicated to acknowledging publicly colleagues who have helped out or performed outstanding work and to the residents voicing any new concerns. We make small and sometimes large changes every year to our schedule or curriculum based on feedback or ideas from our residents.
Are rotations available in every major subspecialty? Yes. All residents are required to complete inpatient rotations in General Medicine, Cardiology, Critical Care, Geriatrics, Hematology, and Oncology, along with several rotations in the outpatient setting. Each resident also has a three-year assignment to an outpatient continuity-of-care clinic. Consult rotations are available in Cardiology, Nephrology, Pulmonary, Endocrinology, Rheumatology, Allergy/Immunology, Gastroenterology, Infectious Diseases, Hematology, Oncology, Palliative Care and Sleep Medicine. We also have a robust ambulatory curriculum that includes dedicated time to Cardiology, Infectious Diseases, Hematology/Oncology, and Pulmonary in the clinic setting. Opportunities abound for rotations in the community setting, both in the Jackson metropolitan area and in more under-served areas of the state.
How is call structured? On general medicine wards at the University Hospital, day call rotates among five teams and night call is covered by a night float team. At the VA Medical Center, there are 3 medicine teams that operate on a drip system for admissions. Cardiology wards overnight call is covered as a night shift by the team members assigned to the rotation. Hematology, Oncology, and Geriatrics ward services are also covered as a night shift by upper level team members with the exception of a few nights per month. The University ICU, the VA ICU, and Emergency Medicine rotations are shift work.
What is the average patient volume? On inpatient and consult services, PGY-1s generally care for 5-8 patients at a time, upper level residents care for 10-14 patients. In clinic, PGY-1s see 3-4 patients/half day; PGY-2s 4-5 patients/half day, and PGY-3s see 5-6 patients/half day.
How much independence do the residents have? Upper level residents have a great deal of autonomy. As team leaders, they perform initial assessment of patient problems, write admission orders, and make the day-to-day decisions regarding patient care. Attending physicians and fellows are available around-the-clock for advice as needed, but do not dictate patient care decisions. Although interns are supervised more closely by upper level residents and attendings, they are allowed to make decisions regarding patient care. The program philosophy is one of active learning, where education is constantly woven into the primary emphasis on patient well-being, and trainees are allowed enough independence to learn how to appropriately care for patients.
Do residents have time to read? Yes. Duty hour limitations allow time outside the hospital for rest and recreation, and many rotations have "down time" during the day for reading. With the implementation of our X+Y schedule for interns, they have found more time to read. More time becomes available as residents advance in the training program, and at the PGY-3 level many rotations have limited weekend and night call duties as well as increasing time during the day for study.
What opportunities are offered for those interested in pursuing academic medicine? Since we work in an academic medical center, there are ample opportunities to be mentored by a current faculty members in regards to research but also career counseling. For those who think they would like to practice in an academic setting and focus on teaching, we developed the Clinician Educator Track, which is a two-year longitudinal curriculum specifically focused on teaching and leadership. Participants are chosen through an application process in the spring of each year. The curriculum consists of direct teaching of medical students and fellow residents, didactics, journal club, leadership development courses, and the Stanford Medical Educator's course.
What is the core curriculum? The core curriculum is presented at noon conference several days per week and covers general medicine and specialty topics with an emphasis on board preparation. An online ambulatory curriculum is supplemented by didactic sessions. An interactive wellness curriculum is also delivered to interns during their first year.
What other teaching conferences are scheduled? General medicine ward rotations have morning report Monday through Friday, and most subspecialty rotations include a didactic curriculum. In addition to the core curriculum, noon conference includes two departmental conferences: Medical Grand Rounds and Continuous Quality Improvement Conference. Other noon presentations include Special Topics (including billing and coding, malpractice insurance, financial planning, political advocacy, and a curriculum on quality improvement and scholarly activity), Journal Club (a resident-led literature review), and Health Disparities Curriculum. These conferences have a 70% attendance requirement for all residents.
Do your residents participate in quality improvement projects?Yes, our residents all perform team-based quality improvement projects throughout their residency. They receive instruction on the purpose and the specific manner in which quality improvement work is conducted, and they receive guidance from both the program leadership and faculty advisors while performing their projects. Projects may pertain to either the inpatient or outpatient setting, and they often are tied to the hospital’s quality initiatives. The best project is recognized each year by the department.
Do your residents pass the internal medicine board exam? We are proud to say that our ABIM board pass rate is excellent. 95% of our residents passed the board exam last year and with 93% passing over the past 3 years (the national average is around 90%). We offer a free board review course for all residents to help them prepare for this important exam.
Do you have a point of care ultrasound curriculum?Yes, we have initiated a point of care ultrasound (POCUS) curriculum throughout multiple consult rotations and also offer a procedure elective month alongside the procedure team at University Hospital for any PGY-2 or PGY-3.
Tell me about your primary care track.We developed the track nearly 10 years ago due to the need for more primary care physicians in Mississippi. We match two applicants per year into the primary care track. The track increases the amount of continuity clinic exposure for each resident by approximately 50% over the course of his or her residency. In addition, primary care track residents have at least one month of experience in a private practice clinic, typically in a rural or underserved area where office based procedures are part of the normal clinic practice. There is a dedicated didactic series for our primary care track residents, which includes a focus on primary care billing and practice operations. Our primary care residents continue to have the opportunity to earn the HIV certificate by participating in HIV clinic on a weekly basis for one year of the track. Future plans include the addition of longitudinal care of a small cohort of nursing home patients, as well as partnership with other locations in the state for valuable community experiences. Dr. Jessie Lavender serves as the Primary Care Track director.
What are your plans for future programs?We will be making changes to our Primary Care Track to ensure that residents participating in it are exposed to rural medicine, nursing home care, office based procedures, physical medicine & rehab, and the business of primary care. We have started a "Residents as Teachers" curriculum to ensure all residents have basic teaching skills. We currently operate on an X+Y schedule, but are planning to implement an X+Y+Z (4+2+2) schedule 2021-2022 academic year for the entire program. We will structure the intern experience to ensure that all interns have between 12 and 18 full weekends free of duty. We continually assess the program and make small and large changes based on feedback from our residents.
Is this a university-based or a community-based program? The program is university-based with UMMC as the primary training site. About 1/4 of each resident's time across the 36 months of training is spent at the adjacent VA Medical Center. UMMC is the the only Level 1 trauma hospital in the state. With a total of 722 beds, it is the largest diagnostic, treatment and referral care system in Mississippi. Inpatient stays total about 29,000 annually with more than 209,000 outpatient and emergency visits every year. UMMC encompasses 6 health science schools with more than 2,800 students and with over 10,000 employees, the medical center is the largest employer in Mississippi. The VA has a maximum capacity of 60 medical beds, and the MICU has been remodeled recently.
What is the patient population (disease processes, socioeconomic background, variety)? As the only academic medical center in a state with great disparities in health status, high disease and mortality rates and low socioeconomic status, UMMC serves a large and culturally diverse population. A large number of patients from the Jackson area use the University for primary care, and patients from around Mississippi are referred for procedures and for diagnostic or therapeutic dilemmas. About half the patients are government-insured (Medicare and/or Medicaid) with a fair number of uninsured and some privately insured patients. Many state and local officials are cared for at the University Hospital. The VA population is predominantly male, older, and with more "bread and butter" internal medicine diagnoses.
How much training in primary care vs. tertiary care? A third of a resident's time over the three years of training is spent in the ambulatory setting, much of that in primary care and subspecialty ambulatory clinics. The other two-thirds are either consultative or inpatient rotations which are most often tertiary care.
How much vacation time annually? All residents have three weeks of vacation time each year with an additional five days completely free of duty around Christmas or New Year's Day.
Is there provision for educational leave?Attendance at regional or national meetings is encouraged and administrative leave is provided for meetings. Additionally, the Trainee Scholarship Fund is used to help fund trainees' travel and meeting registration for presentations.
What is the maternity/sick leave policy? Medical leave is available for use in accordance with hospital policy. The amount of paid leave available depends on the length of employment. Up to six weeks of maternity leave may be taken without extending training time.
Is affordable housing available near the hospital?Yes, there are several neighborhoods within 10 minutes driving distance of the hospital with affordable housing.
Is parking free for residents? Yes, residents are provided covered parking at no charge.
What is the salary? Information regarding salary and benefits can be found here.