Morning Report is a definite favorite among residents and faculty. This dynamic, interactive one-hour conference is held three days per week. Current cases from our various inpatient and outpatient services are presented in this forum. The focus of this conference is on differential diagnosis, clinical reasoning, evaluation and management, prevention of diagnostic error, and cost-effective decision-making. Cases are presented by the residents under the guidance of our chief residents. General internal medicine faculty and sub-specialty attendings provide additional teaching through this case-based format. Additional areas of focus include ECG and imaging interpretation, as well as board review.
Interns come together on Tuesday afternoons for their own protected didactic time. The curriculum is designed to cover the high-yield, clinically relevant material that an intern will encounter throughout their first-year rotations. In addition, there are longitudinal themes including “Caring for Vulnerable and Underserved Populations” (e.g., Harm Reduction, Patients who use Intravenous Drugs), “Wellness” (e.g., building a supportive community among your colleagues), “Resident as Teacher” (e.g., “Teaching Medical Students on the Wards”), among others.
Grand Rounds is held Wednesday at noon. This conference brings together a wide academic and community provider population. MaineHealth Maine Medical Center attracts speakers of national, international, and local renown. Topics are applicable to both general internal medicine and subspecialty medicine.
The Morbidity and Mortality Conference presentations are born out of each third-year resident's one week rotation in root cause analysis (RCA). During this rotation, the resident gains knowledge and skills in performing a "systems audit" related to a case of interest. In addition to researching the specifics of their case, residents read introductory papers about RCA, complete IHI (Institute for Healthcare Improvement ) learning modules, meet with key stakeholders for their case, create a fishbone diagram, perform a cost analysis, and outline the effort-yield projection for each case studied.
One of the end-products from this RCA week is the resident presentation at the Department of Medicine M&M Conference. This interactive, multi-disciplinary, case-based discussion occurs once a month, and focuses on patient safety and systems improvement. This conference represents a safe, collegial, non-accusatory environment with an emphasis on systems improvement. The resident also presents the case and any recommendations for systems improvement at the House Staff Quality and Safety Council meeting.
This Thursday afternoon conference for PGY-2 and above integrates core general medicine and sub-specialty didactics with active learning strategies, including small-group learning and case-based discussion. This is protected time during which cross-coverage is arranged to facilitate uninterrupted participation by most on-service house staff, and all off-service house staff. There are longitudinal themes in addition to the core clinical teaching (building on the sessions presented during the intern academic half-days), including “Leadership in Medicine”, “Resident as Teacher”, “Caring for Vulnerable and Underserved Populations” and “Wellness”.
EBM is integrated into our Friday Morning Reports. Residents meet twice per month for a critical review of the current and "landmark" medical literature. This conference is led by second-year residents, with mentorship by our Director of Resident Research, Research Navigator, and Hospital Medicine attendings.
This weekly conference, under the guidance of the program director and chief residents, supplements the residents' self-study preparation for the ABIM Certification Examination. Various teaching tools are used for this conference, including MKSAP, Virtual Dx, USMLE World, and board-relevant articles from the common internal medicine journals each week.
MHMMC internal medicine residents are encouraged and supported to attend local, regional, and national meetings. In addition to attending, our residents regularly present scholarly activities at these meetings. Popular state and regional meetings that our residents regularly attend include: