Internal Medicine Residency Columbia - Areas of Rotation

Admissions are triaged and distributed by the hospitalist. The teams accept admissions primarily from the Emergency Department but do also have responsibility for direct admissions and transfers from outside hospitals at times. The on-call wards team functions as the code team as well. Admissions every 24 hours consist of three daytime admissions by the wards or dayfloat team and two nighttime admissions by the night float resident. In addition, teams may be assigned up to two consults per 24 hours, managed by the senior resident. A senior resident is limited to a maximum of twenty patients on his or her service. The intern can be primarily responsible for up to ten patients at a time.

The night float is a PGY-2 or PGY-3 resident. The night float takes new admissions from 9 p.m. to 6 a.m. (Monday through Saturday) and attends morning report M–F. Prior to morning report, the night float meets with the residents and attending receiving the ongoing care of patients admitted to review admissions and have dedicated education time.

The MICU rotation takes place at Prisma Health Richland Hospital. The MICU team for the month consists of three senior residents, four interns, and 3rd and 4th year medical students. The senior residents come from both the Internal Medicine department and the Emergency Medicine department. The interns come from Internal Medicine, Emergency Medicine, and Family Medicine. The team is responsible for patients in the 18-bed Medical Intensive Care Unit. Admissions come primarily from the Emergency Department but can also consist of outside hospital transfers and rapid responses from the general medical wards as well.

Our critical care rotation is one of the greatest strengths of our program. Attending involvement, bedside ultrasound rounds, resident autonomy, opportunity to perform procedures, and a multidisciplinary approach set us apart. During the rotation, there is 24-hour critical care fellow support to assist with rounds, management plans and procedures.

At Prisma Health, you will receive excellent training in cardiology. Residents train in a free-standing heart hospital with experienced faculty and cardiology fellows. The cardiology block provides an excellent mix of didactics and hands on clinical experience in core cardiology, as well as exposure to cardiology subspecialties including interventional cardiology, advanced heart failure, and electrophysiology.

During your geriatric rotation, you will have the opportunity to enjoy one on one training with our amazing faculty and fellows. Inpatient time is spent in the region’s only acute care of the elderly (ACE) unit. Outpatient experiences include time in the mobility clinic, Senior Primary Care Clinic, and Prisma Health Senior Care’s adult health day centers. Prisma Health’s geriatric fellowship is the only training program in the state.

Since its inception in 1997, the Geriatrics Fellowship Program at Prisma Health has graduated more than 30 physicians who now practice in a wide variety of settings. The program has been accredited “with commendation” by the RRC. With the aging of the population, the opportunities in the field of geriatrics will only expand over time. The fellowship program and the Division of Geriatrics are recognized as one of the top programs in the nation with recognition from the Donald W. Reynolds Foundation, the Hartford Foundation and the Geriatric Education Center funded by HRSA.

Infectious diseases is one of the most valuable rotations during our training.

Our immunology team's Ryan White clinic is the largest HIV/AIDS clinic in the region, with approximately 25 new HIV-infected patients every month. At this site, more than 1,400 HIV infected patients are currently enrolled in the Ryan White program. The clinic is staffed by the Ryan White administration with social services, compliance/adherence support, mental health and substance abuse services on-site. It also has a dedicated HIV-in-pregnancy clinic and serves a diverse community of many ethnic and social backgrounds.

In addition to Ryan White services, our immunology team also provides a location to see ambulatory infectious disease consults. We are the largest outpatient infectious disease practice in the region. We have a busy practice with a wealth of referrals from the community as well as follow-up patients from the inpatient consultation service.

While on the infectious diseases elective, residents will also have the opportunity to work with the antimicrobial stewardship team, where they can gain practical experience and understanding in the utility of hospital formularies and antimicrobial stewardship. Training will include understanding the process in the appropriate selection, dosing, route and administration of antimicrobial agents; gaining an appreciation for the financial impact of hospital formularies; and understanding the practical aspects of the balance between limiting antimicrobial overuse and the need to provide prompt, adequate antimicrobial therapy.

This is a favorite of every resident who rotates through. It is primarily an outpatient-based rotation with some hospital consult work as well. Comprehensive rheumatology lectures occur each morning with the teaching attending. Our program has recently been expanded to include a focus on musculoskeletal ultrasound to augment clinical practice.

Prisma Health and the UofSC School of Medicine Columbia are leading institutions for training in point-of-care ultrasonography. Internal medicine residents have the option of completing a dedicated ultrasound elective, where they will be exposed numerous skills in image acquisition and interpretation. Additionally, residents can utilize the UofSC School of Medicine Ultrasound Institute's ultrasound simulations and standardized patients. Finally, residents have the opportunity to improve their ultrasound skills by rounding alongside the internal medicine and emergency medicine ultrasound fellows.