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Curriculum

Our curriculum has been designed to equip residents to be competent and confident physicians. Residents will be allowed to sit for the American Board of Internal Medicine (ABIM). We also offer optional training in Osteopathic Manipulative Therapy (OMT) to both allopathic and osteopathic residents interested in musculoskeletal medicine.

The curriculum emphasizes focused learning in inpatient and outpatient settings. Residents on inpatient general internal medicine and intensive care unit rotations have limited outpatient responsibilities so they can focus on the care of their inpatient rotation. Likewise, residents on an ambulatory rotation have limited inpatient cross-coverage, to optimize their time learning from their rotation. Residents rotate with a core of teaching attendings on the wards and in continuity clinic. Teaching attendings take residents to the bedside and engage patients, family and nursing staff to provide patient-centered care. In the continuity clinic, residents participate in team-based care with medical assistants, nurse practitioners, nurses and IM faculty.

Career Development Tracks

In addition to our general internal medicine training, we offer several tracks to help individualize learning and prepare residents for their future career goals. Information for our specific tracks can be found below.

Highlights

Ambulatory Medicine 

The ambulatory experience is enhanced by 8 weeks of ambulatory general internal medicine each academic year, when residents spend time in continuity clinic as well as other ambulatory settings for the block. This allows residents to experience all aspects of ambulatory care, including acute illness visits, routine continuity visits, chronic disease management visits with patients, post-hospital discharge visits and primary care specialty visits. Some unique features of our ambulatory curriculum include:

Academic Internal Medicine Partners Continuity Clinic

Residents are precepted in continuity clinic by Internal Medicine (IM) faculty at Academic Internal Medicine Partners, a newly constructed ambulatory facility across the street from GMC-Lawrenceville. Here, residents get to build a patient panel which they will follow throughout their residency program.  Many of the patients are recruited during a resident’s inpatient ward experience and continuity in transition into the outpatient setting is maintained.

Foundations in General Internal Medicine Curriculum

Residents spend four hours a week discussing core topics in general internal medicine. Topics are thoroughly reviewed through online module pre-work, reading and discussing landmark articles and guidelines, and working through cases.

Procedure clinic

Outpatient procedural training occurs both during acute visits when required and in our weekly Procedure Clinic in which residents learn and perform both simple and advanced outpatient procedures under the guidance of an experienced general/trauma surgeon.

Osteopathic Manipulative Therapy (OMT)/Musculoskeletal Clinic

Residents interested in musculoskeletal medicine can participate in weekly OMT/MSK clinic as well. The focus is on practical, hand-on experience in dealing with common musculoskeletal complaints that are abundant in all primary care practices. Residents learn common modalities of manual therapy, exercise therapy and supplemental medical therapy to optimize patients’ functional and quality of life.

Veterans Affairs Ambulatory Clinic

Through collaboration with the Atlanta VA Medical Center senior residents see patients at the Lawrenceville VA Community Based Outpatient Clinic during the ambulatory block to gain experience in the health care of veterans. This exposes residents to a unique patient population as well as a unique health care system.

Public Health/Tuberculosis Clinic

Perhaps one of the most unique experiences residents at GMC receive is working at the Gwinnett-Rockdale-Newton Public Health Preventative Health Clinic in Lawrenceville. Here, residents get the opportunity to treat patients with tuberculosis as well as other common chronic conditions, which are often diagnosed at presentation. Residents see cases of extrapulmonary TB from head to toe, including TB meningitis, peritonitis, Pott’s disease, genitorurinary TB and TB arthritis. Additionally, residents get to learn the fundamentals and practice of social medicine, as many of the patients in the clinic do not have insurance or any history of prior healthcare. Residents get to practice continuity of care as our patients from this clinic continue to follow us at AIMP after their tuberculosis is treated.

During this experience, residents also learn to place and read PPDs, read common x-rays and CT findings suggestive of TB, do home visits and directly observed therapy (DOT) and see opportunities for working with the Department of Public Health (DPH).

 

Didactics

Academic Half Day

Residents have a dedicated educational block ("academic half day"), during which they participate in both didactic and interactive educational sessions. During academic half day, activities include team-based learning activities, board review, quality improvement and patient safety curriculum, and skills development using task trainers for bedside procedures.

Grand Rounds

Internal Medicine residents participate in a weekly Grand Rounds series, that bring guest presenters, both locally and nationally, to talk about various topics in Internal Medicine.  

Morning Report and Intern Report

During the week, residents participate in morning report, where cases from the night prior are discussed in depth. The focus of learning is on clinical reasoning and evidenced based diagnosis and management.  Once weekly, there is an intern specific report, which focuses on history taking and diagnostic reasoning.

Patient Safety Conference

Once monthly, we have a patient safety conference where cases that highlight issues of patient safety are discussed. Residents learn the process of root cause analysis and the multifactorial nature of patient safety. Conferences end with discussion of institutional changes that can happen to prevent similar patient safety issues in the future, as well as discussion of implementation of prior changes from previous conferences.

 

Skills Development Block 

As one of our most innovative rotations, the skills development block is a dedicated 2-week rotation in block 7 of intern year that aims to enhance physical exam skills, medical knowledge and clinical decision making. The rotation takes interns through a variety of learning methods, including simulation, didactic lecture, intensive ambulatory experience, game-based review and resident-led teaching. Residents also go through a team-building retreat and intensive osteopathic principles and practice review. Topics covered during the block are based on a needs assessment determined by rotation feedback, in-training exams, and directly observed needs by faculty. 

 

Simulation 

Simulation is one of the most important innovations in medical education in recent times. Gwinnett Medical Center has embraced simulation-based training in its residency programs and throughout the hospital. We have a growing and robust simulation center with cutting-edge technology, including multiple hi-fidelity simulators, a cardiopulmonary physical exam simulator, and procedural task trainers for central line placement, thoracentesis, paracentesis, lumbar puncture and knee/shoulder injections.

Internal Medicine residents also receive individual licenses for online instructional modules for point of care diagnostic ultrasound with the ability to practice on both real ultrasound and an ultrasound that simulates common pathologies.

 

 

 

 

 

 

Simulation sessions are held weekly on the ambulatory rotation, monthly in academic half day, and at various times in the year including intern orientation and the Skills Development Block. Internal medicine faculty focus the simulations on individual deficiencies to be able to make the most out of simulation training.

 

Resident as Teacher 

Residents have multiple opportunities to grow as educators throughout their training. During inpatient general medicine wards and cardiology service, residents will supervise 3rd and 4th year medical students. Senior residents also serve as team leaders and managers of the inpatient team, supervising interns in Internal Medicine and Transitional Year programs.

Retreats are held on a semi-annual basis that focus on team building, leadership, and teaching methods to improve skills as a team managers and educators. During the last 3 blocks of the year, 1st and  2nd year residents go through a senior development curriculum while 3rd year residents perform board review.

 

Geriatrics

Residents have ample exposure to geriatrics during their residency training. Each resident will complete a geriatrics rotation, where they rotate at Gwinnett Extended Care Center, located at Gwinnett Medical Center-Lawrenceville, caring for nursing home patients on the teaching long-term care service. In addition, they also run the geriatrics trauma consultation service, under the supervision of a board certified geriatrician, to provide multidisciplinary team care for elderly patients who are admitted on the trauma service.

 

Online Curriculum 

Medical knowledge is constantly evolving and to assist residents in keeping up with reading and self-assessment, the program provides several web-accessible curricula and question banks specifically for Internal Medicine residents. Residents have paid access to Challenger, a large online question bank and reference material for topics in internal medicine and NEJM Knowledge+, an interactive board review platform. Online access to the Physician Education and Assessment Center’s Internal Medicine Ambulatory Care Curriculum provides focused ambulatory education for residents to complete during their outpatient rotations. In addition, residents may use CME funds for access to any other board review programming of their choosing, such as the American College of Physicians MKSAP program. All residents have access to Uptodate and Dynamed, as well as the full online medical library at GMC. 

 

Osteopathic Education 

Residents interested in OMT have multiple longitudinal opportunities to grow as osteopathic practitioners. Residents may participate in OMT clinic and teaching during the ambulatory block. They have opportunity to perform OMT during inpatient and outpatient patient visits under the supervision of osteopathic trained faculty. With our osteopathic affiliate, Philadelphia College of Osteopathic Medicine – Georgia Campus right around the corner, residents also benefit from the teaching and mentorship of osteopathic physicians who are board certified in OMM/Neuromuscular Medicine. In addition to small group review sessions, they also provide osteopathic skills development conferences monthly throughout the year.  

 

Community Service 

Advocacy and community involvement are some of the cornerstones of being a well-balanced physician. In this spirit, residents participate in a community service project yearly that gives back to the Gwinnett County community in which we serve. Former resident projects have included volunteering at community health fairs, providing medical care at free clinics, and creating “swag bags” to provide feminine hygiene products to low income middle school girls.