Clinical Experiences

As a resident in Internal Medicine at Prisma Health, your advanced training will offer an excellent balance of learning in both inpatient and outpatient settings. You will be given opportunities to manage patients with graduated autonomy, learn and practice new procedures, and develop existing skills necessary for exemplary patient-physician relationships. Please see below for some details regarding our curriculum and clinical experience.

Inpatient Teaching Services

There are three general medicine services, a pulmonary service, a critical care service, and an inpatient cardiology service that residents rotate on. Resident physicians also have the opportunity to elect to rotate with subspecialty services. While on all services, residents will work directly with supervisory teaching attending physicians, allowing robust learning. We utilize a night medicine model, so residents are not required to take traditional 24-hour call.

group of four people
group of four people

Outpatient Opportunities

The primary outpatient teaching site is the Internal Medicine Clinic, where residents have their continuity clinic. PGY-1 residents will spend half a day each week in their own continuity clinic and provide follow-up care to patients originally seen in the hospital and to patients who are followed for ongoing ambulatory care. Upper-level residents spend two half days in continuity clinic when not on inpatient services.

Residents are also able to elect to rotate in all outpatient subspecialties, with clinics held both at the Greenville Memorial Hospital campus as well as other Prisma Health affiliated practices in the area.

Elective Rotations

Residents are able to choose from a wide variety of existing electives. Additionally, residents with special interests are supported in developing unique electives to meet their educational and future career needs. Examples of this include women’s health, private practice primary care, culinary medicine, transplant hematology-oncology, community and population health, and procedural electives with Anesthesiology. Below is a sampling of some of our popular electives.

Allergy
This is a two to four-week elective with a local allergist and immunologist. While rotating with these specialists you will be exposed and become more familiar with allergy testing, asthma evaluations, immunological disorders and testing, etc.

Dermatology
This is a two-week outpatient Dermatology rotation at a local outpatient Dermatology office. Residents will evaluate new patients and help see continuity visits learning about common dermatology complaints such as acne, psoriasis, skin cancer, etc.

Endocrinology
This four-week rotation is a combination inpatient/outpatient Endocrinology experience. Residents will see patients in the Endocrinology outpatient clinic across the street from the Greenville Memorial Hospital and if there are interesting hospital consults called in (ex: possible adrenal crisis, thyrotoxicosis, DKA) in the afternoon, the residents will complete and staff these new consults. You will also get to rotate through the Endocrinology subspecialty clinic affiliated with your Medicine Center Clinics weekly.

Gastroenterology
This four-week rotation is 2 weeks inpatient and 2 weeks outpatient Gastroenterology where you will be consulted on and follow patients during their hospital course (ex: Inflammatory bowel disease flare, hematemesis, hematochezia/melena). Residents will be able to watch endoscopies and colonoscopies in the inpatient setting and will also rotate through the Gastroenterology subspecialty clinic affiliated with your Medicine Center Clinics weekly.

Geriatrics
This is a four-week elective in which residents will rotate through multiple different areas focused on geriatric medicine. You will have the opportunity to cover inpatient consults and will also rotate at local area nursing and rehab facilities to be exposed to the process of admitting patients and rounding on patients within these facilities. There are also opportunities to work with outpatient geriatricians in a memory care outpatient clinic focused on full evaluations and management of dementia as well as the SeniorCare PACE program which functions as a 40 hour a week adult daycare with therapies, recreational activities, nutrition and full clinic for their patients.

Dermatology
This is a two-week outpatient Dermatology rotation at a local outpatient Dermatology office. Residents will evaluate new patients and help see continuity visits learning about common dermatology complaints such as acne, psoriasis, skin cancer, etc.

Hematology/Oncology
This is a four-week rotation is mainly an outpatient Hematology/Oncology experience at clinical offices near the Patewood Hospital Campus and at Greenville Memorial Hospital with some inpatient consults.

Hospitalist
This is a four-week elective for those with more interest in hospital medicine where they are paired with a hospitalist attending each week and function with more autonomy on the private hospitalist service both on general inpatient wards as well as in the ICU.

Infectious Disease
This four-week rotation is mainly an inpatient Infectious Disease consult experience at the Greenville Memorial Hospital where residents complete and staff new consults and follow patients during their hospital course. Residents will also get to rotate through the nearby by primary HIV clinic where the Infectious Disease physicians work.

Nephrology
This four-week rotation is mainly an inpatient Nephrology consult experience at Greenville Memorial Hospital where residents complete and staff new consults (ex: acute kidney injury, the need for hemolysis, concern for nephrotic or nephritic syndrome) and follow patients during their hospital course. Residents will also get to rotate through the Nephrology subspecialty clinic affiliated with your Medicine Center Clinics weekly.

Neurology
This is a two to four-week rotation that can be inpatient or outpatient focused where residents will complete and staff new consult, follow patients during their hospital course, and participate in specialty clinics. They will see a variety of pathologies such as cerebral vascular accidents, altered mental status of uncertain etiology and status epilepticus.

Outpatient Cardiology
This four-week elective allows for focused ambulatory cardiology exposure with multiple Prisma Health cardiologists in the local area clinics. Depending on particular interests, you can rotate through general cardiology clinics, electrophysiology, congenital heart disease, heart failure and also have exposure to different modalities of testing such as exercise, nuclear and echocardiogram stress testing.

Palliative Care
This is a two or four-week elective that allows residents to work with our multidisciplinary palliative care team mostly on the inpatient setting. This allows residents to be exposed to and develop more experience in palliative care working with physicians, physician extenders, nurses, social workers and chaplains to address complex social cases, goals of care and symptom management.

Private Practice
This is a four-week elective for those with more interest in primary care, you can rotate with one or more local primary care practices to have exposure to how other practices function as well as different patient populations in the primary care setting.

Pulmonology
This is a four-week outpatient Pulmonary rotation working with the Pulmonary Disease Associates, the same group of attendings that work on the inpatient Critical Care Teaching Service. This is located on the beautiful Patewood Hospital Campus. Residents will help manage common pulmonary and sleep complaints such as COPD, Obstructive Sleep Apnea, Pulmonary hypertension, and Asthma.

Rheumatology
This is a two or four-week elective in which residents are assigned to work in the outpatient clinic with one of our Prisma Health rheumatologists. You will be exposed to a wide variety of rheumatological consults, work-ups, treatments, etc. You will have the opportunity to use imaging, especially ultrasound, perform procedures such as arthrocentesis, and be exposed to a wide spectrum of rheumatological disease processes.

Sports Medicine
This is a four-week rotation that is mainly an outpatient Sports Medicine experience at the Patewood or Hillcrest Hospital campuses. Residents will evaluate new patients with common musculoskeletal complaints, rotate through the evening Steadman Hawkins Shift clinic at the Patewood Campus and also attend local sporting events with Sports Medicine physicians. Residents learn the basic physical exam maneuvers and signs of the shoulder, hip, knee and ankle joints and will be able to participate in knee joint therapeutic injections and possible aspiration.

Point-of-Care Ultrasound Training

Our Internal Medicine point-of-care ultrasound (POCUS) program is led by Dr. Mike Wagner. As the Director of Internal Medicine Ultrasound, Dr. Wagner coordinates and oversees POCUS activities in the department of medicine across 6 medical campuses at the CME, GME, and UME level. Dr. Wagner is helping advance the field of IMPOCUS nation-wide through speaking engagements, hands-on workshops, online resources, publications, and serving in leadership positions for numerous medical organizations. Other professional areas of interest include physical diagnosis and clinical reasoning, simulation and bedside teaching. To ensure we provide a robust and safe learning environment, we are building a team of IMPOCUS-trained faculty to help residents and students integrate ultrasound in both the inpatient and outpatient setting.


Through this curriculum, residents can learn to use a variety of types of equipment in different settings (clinic, wards, intensive care unit).


Our residents also have the opportunity to practice ultrasound guided procedures in our state-of-the-art simulation center – you can see an example of training in dynamic needle guidance using ultrasound.


We use a variety of innovative teaching methods to ensure you not only learn the core applications of IMPOCUS but also how to use ultrasound to improve your traditional physical exam skills. In the age of Covid-19, we are also exploring novel ways to leverage cutting-edge technology to allow learners to safely practice and obtain feedback on their IMPOCUS skills during these challenging times.

Simulation

At the beginning of their PGY-1 year, our residents participate in six weeks of a weekly simulation training course. Using sophisticated mannequins, this experience is designed to give residents training in procedures such as intubation, central line placement, arterial line placement, lumbar puncture and chest tube placement. Residents are mentored by experienced faculty and chief residents in a supportive environment. Throughout the year, residents will have additional opportunities to participate in simulation as well.

Click here to learn more about the HealthCare Simulation Center.

Global Health

Interested residents are able to pursue away rotations, including in global health. Residents are able to arrange for global health experiences of their selection with adequate preparation and approval. Additionally, many residents choose to participate in the annual Brazil medical mission trip led by Internal Medicine Clinic attending and former Med-Peds graduate, Dr. Jeremy Byrd (Class of 2009). This is a two-week elective annually in the fall that will be completed with most days being spent in Fortaleza, Brazil. This is a passion of our Associate Program Director, Dr. Mary Blumer, who would be happy to speak more with you about her experiences in Kenya as well.

Board Review Preparation

We are proud to have an 100% 3-year board passage rate in our program. The program pays for all residents to receive MKSAP and MedStudy as part of self-study preparation to pass the Internal Medicine board exam. We also have a faculty-led longitudinal board preparation curriculum that spans all three years. Additionally, all of our PGY-3 residents participate in a board review elective as their last rotation in residency, which they have found very valuable.