The Internal Medicine Residency Program at Texas Tech - Amarillo received a full five year accreditation from the Accreditation Council for Graduate Medical Education (ACGME) as of May 2009. Recently, the ACGME added one additional year giving the program a total of six years of full accreditation. The next ACGME program review will be in May of 2015.
The usual complement of Internal Medicine residents now includes twelve Categorical at each of the three levels. Fifty-two 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 Hospital (NWTH) and the Veterans Administration Medical Center (VAMC). NWTH is a private 400-bed hospital but is also responsible for the indigent of the community and is our regional trauma center. 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 Thomas E. Creek VAMC provides treatment to 25,000 patients yearly. The VAMC maintains 69 acute care beds and a 120-bed skilled nursing care unit. The inpatient experience is bolstered by outpatient experience at our own Texas Tech Medical Center. In addition, we are closely affiliated with the local clinic of Texas Oncology, P.A., a large network of oncology physicians in the State of Texas
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 Pulmonary, Critical Care, Endocrinology, Women's Health, Infectious Disease 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. 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. Texas Tech of Amarillo has a multi-million dollar simulation center as part of a collaborative effort between Texas Tech, Amarillo College and West Texas A&M University. Through the simulation center, the residents receive training on hospital-based clinical scenarios and procedures.
As previously noted, the program received continued full accreditation in May 2009. Additionally, our ABIM Board pass rate has been 100% for the past five years.
In addition to the pursuit of clinical excellence, we strive to instill the values of professional/personal ethics, responsibility, and accountability to patients, faculty, 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). In order to accommodate the most recent ACGME duty hour requirements and prevent resident fatigue, Texas Tech at Amarillo has converted to clinical service coverage that requires no longer than 16 hour shifts for any of the residents or interns. On all inpatient services, night shift coverage prevents any resident or intern from having to take overnight call. The 80 hour per week limit is strictly enforced, though rarely do any residents approach this limit in their routine work requirements. All residents and interns get at least 4 days off per month.
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 around the clock internet access to medical references and clinical support sites. Our outpatient resident continuity clinic is equipped with a fully implemented electronic medical record by Allscripts. Residents will receive training to be able to provide comprehensive medical care for their patients in an otherwise "paperless" clinical setting.
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.
- NWTH "Ward" - 3-4 months
- VAMC "Ward" - 2-3 months
- NWTH ICU/CCU - 1 month
- NWTH Night Shift - 1 month
- VAMC Cardiology - 1 month
- NWTH Consults - 1 month
- NWTH Women's Health/Ambulatory Care - 1 month
- VAMC Neurology - 1 month
- One afternoon per week IM continuity clinic at our Texas Tech Internal Medicine Clinic.
- (Scheduled Monday, Tuesday, Thursday, or Friday; to continue throughout the 3-year residency)
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.
NWTH "Ward" - 2-3 months
VAMC "Ward" - 2 months
NWTH ICU/CCU - 2 months
NWTH Consults - 1 month
NWTH ER - 1 month
"Night Float" - 2 month
Electives - 2 months (1 month each of Cardiology, Hematology/Oncology and Geriatrics required in 2nd or 3rd year; other choices include typical IM subspecialties such as Pulmonology, GI, Nephrology, Endocrinology, Rheumatology, Infectious Diseases, or related fields such as Dermatology, Radiology, Gynecology, ENT/Ophth; a Research elective month is also available)
- One afternoon per week IM continuity clinic at Texas Tech as before.
- Clinic/office experience specific to each elective, including Flex Sig and Stress Testing
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.
- NWTH "Ward" - 2-3 months
- VAMC "Ward" - 1-2 months
- NWTH ICU/CCU - 2 months
- "Night Float" - 1 month
- Electives - 5-6 months (see choices under PGY-II)
- One afternoon per week at Texas Tech as before.
- Clinic/office experience specific to each elective, including procedural skills
For all benefits and conditions of employment including information concerning leaves of absences and medical malpractice insurance, please visit www.remedy.ttuhsc.edu/GME/ .
SALARIES (Academic Year 2013-2014)
PGY-I $46,875 PGY-II $48,404 PGY-III $49,933
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:
- $100,000 benefits on resident
- $10,000 benefits on spouse (optional)
- $5,000 benefits per child (optional)
Allows you to attain and maintain good dental health: $50 deductible. Dependent coverage available.
Membership in the American College of Physicians is paid by the Department. This membership includes the 'Annals of Internal Medicine' publication.
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.
The Department provides each resident with a subscription to UpToDate, an online reference service. This license includes 24/7 access to the UpToDate site from any computer with an Internet connection in addition to software that can be installed on a compatible PDA.
The Department encourages research and publication and with a grant from the Dean's Office, residents are awarded $250 for each publication. The Department also sponsors attendance at the state ACP meeting for each chief resident, a jeopardy team of 4 residents, and residents with abstracts accepted at the meeting.
Thank you for your interest in our Internal Medicine Residency Program. Please click here for a PDF document outlining Applicant Information for the 2013-2014 academic year.