University of Maryland Medical Center – Internal Medicine Residency

University of Maryland Medical Center, a private not-for-profit hospital, is a major tertiary and primary care facility with more than 750 beds and over 38,000 admissions each year.

The medical services consist of over 200 beds divided among a variety of general medicine and subspecialty services.

On each medical service, residents provide care for our patients under the supervision of our faculty. We have robust and supportive non-teaching services where general medicine, oncology and intermediate care (IMC) patients are also admitted.

First year residents are responsible for the day-to-day evaluation and management of their patients. Upper level residents are the leaders of each team and have significant clinical, supervisory and teaching responsibilities.

Medical Inpatient Units

The medical teams at UMMC include:

• Four General Medical services
• An ID service
• Two MICU teams
• One Primary Cardiology team
• One Complex Cardiology team
• A Cancer Center service (leukemia and hematologic malignancies)

Teams are structured with the senior resident as team leader supervising interns, sub-interns and third year medical students. Attending rounds are held daily. All teams employ a "drip system" that limits the number of admissions near the end of a shift to ensure that our residents can leave on time and maintain all duty hours.

Resident teams are assisted in their daily work by an interdisciplinary care team, including a case manager, physical and occupational therapists, social workers, phlebotomy and IV teams, substance abuse counselors and respiratory therapists. Clinical pharmacists (PharmD) are integrated into and round with our teams to provide in-real time support to our residents. Discharge coordinators assist residents in preparing patients for discharge and improving efficiency.

Residents use EPIC as their EMR which can also be accessed from their smart phones, tablets and their home via a VPN system.

General Medicine and Med-ID Teams

The non-ICU services consist of three General Medicine services (Med 2-4) and an Infectious Disease service (Med-ID).

Med 2-4 Teams consist of one senior and three interns who are supervised by our academic hospitalists. Med ID has one resident and three interns who are supervised by ID teaching faculty and fellows. A senior resident moonlighter works from 5 to 9 pm Monday-Friday to address all cross-cover issues on Med 2-4, while the Med-ID Day Float resident assists that service by taking admissions until 9 pm.

A fully staffed, seven-day-per-week Night Float Team System covers all the floor teams. Nocturnists and intensivists are present throughout the night shifts and assist with patient care and supervision.

Admitting Intern and Resident (AIR) Team

AIR is our fourth general medicine service. Interns and residents rotate on AIR for primary experience admitting patients to the general medicine services. They work alongside our hospitalist faculty in evaluating and managing our complex care patients, initiating consults, performing procedures and implementing initial care. The AIR rotation consists of approximately ten day shifts over two weeks.

Medical Intensive Care Unit

The MICU consists of two teams, each with an intensivist, one fellow, two residents, three interns and one sub-intern, each caring for ten patients (remainder are cared for by NPs).

Our state-of-the-art 29-bed MICU has 24/7 intensivists in the MICU at all times. Interns and residents rotate in two-week blocks, taking overnight call every fourth day for 24 hours with intensivists and fellows supervising the resident and interns overnight.

We employ a strict Fatigue Management Policy that ensures a 60-minute nap for both residents and interns during 24-hour calls.

Primary Cardiology Service (PCS) and Complex Cardiology Unit (CCU)

PCS focuses on caring for patients with ischemic heart disease, MI's, valvular heart disease and arrhythmias. The team consists of a cardiology attending, two residents, tow interns and 1 sub-intern. There is no overnight call on PCS; a night float resident covers the service at night.

The CCU team consists of two attendings, two cardiology fellows, two or three residents and one intern. This rotation provides comprehensive experience in the care of critically ill cardiac patients in a multidisciplinary approach. There is no overnight call on CCU; a cardiology fellow covers the service at night.

Cancer Center

The Leukemia Service in our NCI-Designated Greenebaum Comprehensive Cancer Center provides our senior residents with the opportunity to care for individuals with newly diagnosed or refractory/relapsed acute leukemia, lymphoma and those admitted for acute complications of their chemotherapy.

This team consists of a malignant hematology attending, one fellow, three day team senior residents, and one night float senior resident.