Maine Medical Center

Rural Internal Medicine Maine (RIMM) Pathway


A unique internal medicine residency program that blends experiences of training at an urban tertiary care center, MHMMC in Portland, and MaineHealth Stephens Hospital in Norway.


Listen to what RIMM resident, Dr. Sam Ferguson, has to say about his experience at MaineHealth Stephens Hospital.

 


 

  • Founded in 2017 as the first rural internal medicine residency track in the U.S.
  • One resident per year (3 in total), identified through a separate Match process.
  • Unique urban-rural block schedule format that blends clinical learning opportunities at both an urban academic tertiary care center (MaineHealth Maine Medical Center) and a rural critical access health system (MaineHealth Stephens Hospital).
  • Full integration of rural pathway residents into MHMMC’s categorical IM residency program, including all teaching conferences and residency events (including orientation, retreats, wellness programs, and simulation).
  • Training for rural primary care with an increased scope of practice.
  • Dedicated rural curriculum focusing on leadership, teaching, and rural population health.
  • Flexibility to develop the clinical and procedural skills that meet your future practice goals.
  • Rural research opportunities through the MaineHealth Institute for Research
  • 100% graduate placement in rural practice.

Our Goals

  • To better meet our society’s healthcare needs by addressing rural physician workforce shortages and rural health disparities, with a particular focus on Maine’s rural communities.
  • To provide an innovative training model which prepares internal medicine residents for practice in a rural community.

The Rural Internist as Generalist and Specialist

In addition to preparation for office and hospital-based general internal medicine practice, RIMM Pathway residents will have the opportunity to gain advanced training in the evaluation and management of specific medical conditions often managed by medical subspecialists in more urban areas.

Procedure Training for the Rural Internist

RIMM Pathway residents will have the opportunity to gain additional experience in the procedures that meet their individual career goals and the needs of their future rural community.

Rural Population Health and Rural Health Disparities

RIMM Pathway residents will develop the skills necessary to assess and improve the health of rural populations within their practice and community.

Teamwork and Leadership in Rural Practice

RIMM Pathway residents will learn the skills needed to effectively partner with a multi-disciplinary care team, while also developing the skills required to become a healthcare leader in their future community.

Lifelong Learning and Teaching in Rural Practice

RIMM Pathway residents will gain the skills essential to being a lifelong learner and teacher while practicing in a rural setting.

  • First rural internal medicine residency pathway in U.S.
  • Resident continuity clinic based in the rural setting.
  • Shared EMR (Epic) between MaineHealth Stephens Hospital and MHMMC.
  • Shared teaching faculty between MaineHealth Stephens Hospital and MHMMC.
  • Shared didactics with MHMMC via videoconferencing.
  • Urban-rural (X+Y) block schedule format that alternates rotations between urban (MHMMC) and rural (MaineHealth Stephens Hospital) settings: 
     

    YearRural (MaineHealth Stephens Hospital)Urban (MHMMC)
    PGY-1/PGY-2Continuity Clinic
    Procedures
    Rural Hospital Medicine
    Rural Emergency Medicine
    Rural Geriatrics
    Rural Specialty Clinics
     
    Inpatient General Medicine
    MICU
    Inpatient Cardiology/CICU
    Inpatient Hem-Onc
    Inpatient Renal Transplant
    Sub-specialty Consults
    Neurology
    Night Float
     
    PGY-3Continuity Clinic
    Procedures
    Rural Hospital Medicine
    Rural Emergency Medicine
    Rural Specialty Clinics
    Electives
     
    Inpatient General Medicine
    MICU
    VA sub-specialty clinics
    Medicine Consult
    Electives
     

     

  • Resident continuity clinic panel based at MaineHealth Stephens Hospital.
  • Representative breakdown of RIMM rural continuity clinic weeks:
    • Continuity clinic: four half days
    • Specialty clinics: two half days
    • Procedures: one half day
    • RIMM curriculum modules: one half day
    • MMC Academic Half-day: one half day
    • Flex time: one half day
  • Shared didactics with MMC via blend of videoconferencing and in-person learning.
  • Advanced procedure opportunities: non-invasive cardiology (treadmill stress testing, EKG, ABIs), dermoscopy and skin biopsy, pulmonary function tests, endoscopy, joint aspiration/injection, POCUS.
  • RIMM curriculum modules for leadership, teaching (culminating in MITE Clinical Teaching Certificate), addiction medicine (including X-waiver training), population health, and QI/PS (culminating in Lean Six Sigma White Belt course).
  • Rural research opportunities available through Northern New England Clinical and Translational Research Network.

     


 

MaineHealth Stephens Hospital, a MaineHealth member organization located in Norway ME, serves as the rural teaching site for the RIMM pathway. Norway is a community of 5000 people located 45 miles to the north of Portland in the foothills of the White Mountains. The surrounding area of Oxford County has a population of approximately 57,000 people.

Teaching sites at MaineHealth Stephens Hospital include a 25 bed critical access hospital with 4 bed ICU, Primary Care | MaineHealth Stephens Hospital, a patient-centered medical home practice of six board-certified internal medicine physicians, and the MaineHealth Bob & Sandy Bahre Health Center. MaineHealth Stephens Hospital has been named a Top Rural Hospital by the Leapfrog Group.

The physicians at MaineHealth Stephens Hospital have a long and valued history as medical educators and healthcare leaders in Maine. For over 30 years MHMMC Internal Medicine residents have rotated through MaineHealth Stephens Hospital as part of their PGY-2 Rural Medicine rotation. Since 2011 the site has also been home to 3 TUSM - Maine Track medical students for the longitudinal integrated clerkship (LIC). MaineHealth Stephens Hospital physicians have served in leadership roles within MaineHealth and the Maine Chapter of ACP.

As a MaineHealth member, MaineHealth Stephens Hospitalshares an integrated electronic health record (Epic) and telehealth platform with Maine Medical Center.

PGY 3

Yusuf Ebrahim

Yusuf Ebrahim

PGY 2

Rosellen Shahidi

Rosellen Shahidi

PGY1

Karishma Patel

Karishma Patel 

2024
Rachel Heuer, MD: PCP and hospitalist, Barrett Hospital and Healthcare, Dillon, MT

2023
Gunnar Huffman, DO; Rural Primary Care, MaineHealth Stephens Hospital, Norway, ME

2022
Adriana Nadeau, MD: Rural Primary Care, MaineHealth Stephens Hospital, Norway, ME

2021
Shane Kirkegaard, DO: Rural Primary Care, Pocahontas, IA

2020
Sam Ferguson, DO: Rural Primary Care, MaineHealth Stephens Hospital, Norway, ME


 

Housing is provided for RIMM residents and TUSM-MHMMC third year medical students at a housing complex located in downtown Norway adjacent to MaineHealth Stephens Hospital.

Transportation costs for travel between MaineHealth Stephens Hospital and MHMMC is supported.

Applications for the RIMM program will be accepted only through the Electronic Residency Application Service (ERAS) Application. No paper applications will be accepted. Our code for the National Resident Matching Program is: Rural Internal Medicine Maine Pathway (NRMP code 1236140M0). Applicants may apply to both the RIMM program and categorical IM program, or just the RIMM program alone. While invitations to interview will be extended separately for the RIMM and categorical IM programs, applicants may interview with both programs on the same interview day. The combined RIMM & Categorical IM interview days will include dedicated informational sessions and faculty interviews for each program.