TTUHSC School of Medicine at Amarillo
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Residency Program

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Residency Information




GENERAL INFORMATION

The usual complement of Internal Medicine residents now includes ten Categorical at each of the three levels plus four Preliminary first year residents. Thirty-plus third year Texas Tech medical students are involved in core rotations in Amarillo, typically eight or nine at a time in Internal Medicine; a similar number of fourth year students are present, pursuing various requirements and electives.

Patient service and teaching are the foundation of our mission. We achieve good patient volume and diversity via our two main teaching hospitals, Northwest Texas and the Veterans Administration Medical Center. NWTH is a private 400 bed hospital but is also responsible for the indigent of the community. Here we admit our own Texas Tech private patients, those from the Amarillo Hospital District's Wyatt Clinic, and those via the ER without a physician. The inpatient experience is bolstered by outpatient experience at our own Texas Tech Medical Center. In addition, we are closely affiliated with the Harrington Regional Cancer Center.

Our full-time Texas Tech Internal Medicine clinician faculty, all board -certified, are dedicated teachers, weighted toward general internal medicine, but with the subspecialties of Cardiology, Pulmonary, Critical Care, Endocrinology and Geriatrics represented. The VAMC has a separate similarly-sized faculty of various generalists and subspecialists. In addition, we utilize "clinical faculty", i.e. community physicians in other Internal Medicine subspecialties and non-IM fields such as dermatology, ophthalmology, and radiology, etc. for clinical and didactic teaching. Our relationship with community hematology/oncology groups is particularly strong. An outstanding group of Ph.D. researchers rounds out our faculty.

On the subject of didactics, Morning Report is conducted at each teaching hospital. Weekly Grand Rounds, an organized year long curriculum of noon conferences, and weekly Journal Clubs/board review sessions are given. Procedural skills are taught by our Critical Care specialists.

As previously noted, in September 2004 the program received continued full accreditation.

In addition to the pursuit of clinical excellence, we strive to instill the values of professional/personal ethics, responsibility, and accountability to patients, faculty and resident colleagues, and healthcare staff.

PROGRAM REQUIREMENTS and CURRICULUM

The TTUHSC-Amarillo Internal Medicine residency program operates under the Program Requirements for Resident Education in Internal Medicine, established by the ACGME. These are strictly followed. The Core Competencies of Patient Care, Medical Knowledge, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems-Based Practice are stressed. Readers are encouraged to review this document at www.acgme.org . For example, interns are limited to five admissions per call day and upper level residents are limited to ten (our call on ward teams is one-in-four, in ICU one-in-four). Work may not surpass 80 hours per week (or 30 continuous hours) and there are at least four days per month free of patient care duties. In July 2000 at NWTH (and in July 2003 at the VAMC), we began a "night-float" upper-level resident system in which the resident assigned to that duty for the month admits patients during the night to the floor; this eliminates much of the post-call fatigue which has been a traditional part of training programs but is being viewed with increasing disfavor.

When viewed as a three-year whole, at least one-third of the training involves ambulatory experience, as mandated by the ACGME and in keeping with the trend in medicine toward greater outpatient care. Our clinics and hospitals, of course, have computer support with internet access. As previously noted, in May, 2002, we moved our outpatient clinical practice into our new Texas Tech Medical Center building, adjacent to the Texas Tech School of Pharmacy and across the street from NWTH.

PGY - I

The first year resident, with the direct supervision and support of an upper-level resident and faculty attending physician, develops clinical diagnostic and medical management skills and assumes increasing responsibility in caring for patients with a wide variety of acute and chronic problems in the inpatient and outpatient settings. Typical Internal Medicine procedural skills are learned during the first year, including an introduction to placement of arterial lines, central lines, and Swan-Ganz catheters during the Intensive Care rotation. All this supports advancement to the more independent performance and greater responsibility required during the second and third years. The intern is also expected to pursue scholarly learning and, perhaps most importantly, to maintain the highest standard of personal and professional conduct.

Inpatient

Outpatient

PGY - II

The second year resident, still with the support and supervision of the attending physician, further develops clinical diagnostic and medical management skills and assumes greater responsibility for the care of the patient. Added responsibility involves the direct supervision of the intern and medical student. A continued high standard of personal professional ethics and humanistic qualities is required, including being a role model for others on the team. Further procedural skills are developed and supervised. Scholarly activity is encouraged.

Inpatient

Outpatient

PGY - III

The third year resident builds upon the second year, developing further clinical competence and procedural skills, as well as a greater academic foundation. Although many duties in this year are similar to those of the preceding year, and faculty supervision is still in place, the third year resident assumes greater responsibility, leadership, and supervisory capacity. Further subspecialty training via electives, more outpatient experience, and continued scholarly activity lead to the goal of becoming fully independent by the conclusion of residency. As always, the highest personal and professional standards should be upheld; third year residents, in particular, should be exemplary role models.

With input from all residents and faculty, two third-year residents are selected as Chief Residents and assume additional responsibilities regarding schedules, conferences, and teaching.

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Outpatient





BENEFITS

For all benefits and conditions of employment including information concerning leaves of absences and medical malpractice insurance, please visit www.remedy.ttuhsc.edu/GME/ .

INSTITUTIONAL BENEFITS

SALARIES (Academic Year 2008-2009)

PGY-I $42,044 PGY-II $43,416 PGY-III $44,787

MAJOR MEDICAL EXPENSE INSURANCE

Coverage for allowed medical expenses incurred, including professional fees. Dependent coverage available

LONG TERM DISABILITY

Helps replace lost earning in the event of an accident or illness: $1,500 monthly benefits, 30-day waiting period

TERM LIFE INSURANCE

A vital segment of any financial protection plan:

DENTAL INSURANCE

Allows you to attain and maintain good dental health: $50 deductible. Dependent coverage available.

VISION COVERAGE

available

DEPARTMENTAL BENEFITS

PROFESSIONAL ORGANIZATIONS

Participation in the American College of Physicians is strongly encouraged, but not required. Membership dues may be paid with the book allowance (see below).

PAID VACATION TIME PGY-I and PGY-II

Residents receive three weeks paid vacation; PGY-III residents receive four weeks paid vacation. The time off must be approved by the Program Director and Chief Resident 6-8 weeks prior to vacation time.

BOOKS/MEMBERSHIP DUES

Residents are provided with $250 a year for books and membership dues.