In order to meet the needs of individual interns and to improve intern integration into the program, interns participate in high yield group-based activities at the beginning of the year. This is comprised of sessions covering topics such as the 10 most common acute care issues in the hospital, EKGs, ABGs, high yield physical exam, ACLS, starting insulin, GI bleeds and many more. 

In order to prepare advancing residents for the transition into a supervisory role, leadership training is provided during the month of June for all rising PGY2s and PGY3s. 

Noon report takes place every Wednesday from 12:30 - 1:30pm. It is run by core faculty and is resident led. Residents prepare case presentations on relevant topics, focusing on clinical pearls and guidelines. 

Third-year residents are mentored to present grand rounds with a topic expert and program director mentorship.

Journal club and M&M are held regularly at UNC Health Blue Ridge. These conferences are run by a PGY2 or PGY3 resident with mentorship from a core faculty member. During journal club, the resident presents a pertinent clinical question and a journal article that answers the question. During this time, the group discusses validity of the article, results and clinical applicability of the findings. Morbidity and Mortality conference focuses on the concept of root cause analysis of a case that had an adverse outcome. This conference is multidisciplinary with multiple departments of the hospital often represented. The goal of this conference is to educate residents on patient safety and increase awareness of system-based issues that contribute to individual nurse or physician error.

A board reviewed FOCUS series based on MKSAP is delivered by the program director weekly. The residents generally use the MKSAP question bank to review questions with the input of faculty. Additionally, residents use the New England Journal of Medicine’s Knowledge + for board preparation. This is an online board prep series purchased for each resident and available starting during the intern year. PGY3s attend a more in-depth board review series to prepare for the ABIM exam. 

At least twice a month, specialists provide lectures on clinically relevant topics.

An 18-month cycle of weekly didactics covering all clinically relevant topics are taught on Fridays. Friday afternoons are protected time for didactics, invited lectures, and board review. 

In addition to didactic education, residents have a variety of simulation and online learning. 

• Johns Hopkins (PEAC) modules in topics such as hypertension and anemia
• Simulation learning including procedure workshops, doctor patient relationships and code blue
• Women’s Health online modules

As part of residency training, residents are cycled through various institutional committees to gain an understanding of hospital administration and quality. These committees include infection prevention and control, antibiotic stewardship, an optional administrative/research month with the CMO, stroke committee, etc.

The Internal Medicine Residency Program participates in the ACP In-Training Exam in Internal Medicine every September. The Residents are also required to take either the USMLE Step 3 or COMLEX Level 3, during residency.

• Ambulatory general internal medicine training is done at Mountain Valley Health Clinic, located on the UNC Health Blue Ridge campus.
  • Ambulatory training has a 1.5 hour per week didactic held at the continuity clinic for those on Ambulatory Medicine and Geriatrics.
• Subspecialty training is done at various subspecialty offices within UNC Health Blue Ridge and the Salisbury Veterans Administration.
• Residents also have opportunities to rotate through community practices in the area.

• Interns typically complete two 2-week blocks of night float (Sunday–Friday).
• Each intern also covers approximately 7–8 Saturday night calls per year.
• No ICU call responsibilities for interns.
• Interns handle approximately five admissions per night.
• Starting in January, interns begin cross-covering patients on the medicine services.

• Resident night float typically consists of two, 2-week blocks of nights a year (Sunday through Friday).
  • Upper level residents also work night float in the ICU.

• Interns and residents check out new admissions and discuss overnight issues with the day teams between 6:30 and 7am
• If they have completed their work, they may leave at 7am and will not be scheduled to return until the next day.

• Faculty to Resident ratio is 1:3 leaving ample time for bedside teaching
• Nurse to Resident ratio is 1:2
• Fully integrated EMR is used in clinic and the hospital
• Attending physicians see all intern patients for the first six months
• Patient population is diverse with 45% Medicare patients and 20% privately insured patients
• The clinic also sees a large number of charity patients
• Patient numbers are: PGY1s 4-5, PGY2s 5-7, PGY3s 7-10 per half day

• Diabetes Education
• Clinical Pharmacist
• Spirometry, POC testing, EKGs, IV fluids

Team 1 is made up of 2 interns, a PGY2 and a PGY3.

The team 1 works on an innovative new team structure focused on resident learning and progression to autonomous care. The team is capped at 15 admissions, and receives up to three admissions daily. We comply fully with the ACGME patient cap of 9 patients per intern.

We have a very diverse population of patients both socioeconomically and culturally. Given that we are a primary care center and the problems with access to care in WNC, most patients come in with problems that are undiagnosed for long periods of time before presentation.

Our categorical residents see their own continuity panel of patients at Mountain Valley Health Clinic. The ambulatory training site provides comprehensive care to both low income, under or uninsured patients as well as insured patients. Patients referred there are often medically and socially complex, providing excellent outpatient training for the resident physicians. The night float resident is on call for the clinic after business hours.

The short answer is yes. Here at UNC Health Blue Ridge, we have created an environment of graded autonomy so that each resident can work independently while having an adequate safety net. Support and guidance are important to us and the faculty pride themselves on maintaining open dialogues about every patient. We also entrust upper level residents with the autonomy to be teachers to the interns and maintain a healthy team dynamic.