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.
Recent Morning report topics/ cases:
- Anti-synthetase syndrome in a 64 year old patient with newly diagnosed polymyositis
- Diagnosis, Management and Treatment of Stable Ventricular Tachycardia
- Erlichiosis presenting as thrombocytopenia and fever in a 30 year old pregnant female
- Gastric Kaposi sarcoma in a 40 year old HIV positive male
- Acute Kidney Failure from new diagnosis Multiple Myeloma
- Allergic bronchopulmonary aspergillosis presenting with cough and peripheral eosinophilia
- Management and Treatment of CVA's occurring during cardiac catheterization
- Upper GI bleed from duodenal ulcer and gastric cancer
- New acute promyelocytic anemia in a 19 year old female presenting with 'easy bruising'
- Cutaneous B-Cell lymphoma in a 70 year old male presenting with fatigue
Interns come together on Thursdays at noon for their very own didactic time under the direction of our chief residents. Early in the intern year the conference focuses on didactics that cover key intern-oriented topics (i.e. management and workup of chest pain, EKG essentials, hypotension and shock, evidence-based medicine basics, etc). As the year progresses, the conference shifts to more of a case-based format, continuing to focus on high-yield topics valuable in the first year of residency.
Grand Rounds is held Wednesday mornings. This conference brings together a wide academic and community provider population. Maine Medical Center attracts speakers of national, international, and local renown. Topics are applicable to both general internal medicine and subspecialty medicine.
Morbidity and Mortality Conference
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 Housestaff Quality and Safety Council meeting.
Friday Conference (Academic Half-Day)
This weekly half-day conference integrates core general medicine and sub-specialty didactics with interactive learning activities, including small-group learning and simulation. Our evidence-based medicine / journal review sessions are also integrated into this curriculum (see below). This is protected time during which cross-coverage is arranged to facilitate uninterrupted participation by most on-service housestaff, and all off-service housestaff. Residents are provided with pre-reading materials prior to conference to begin their review of the week's topics.
Evidence-Based Medicine / Journal Review
EBM is integrated into our Friday conference series. Residents meet twice per month for a critical review of the curent and "landmark" medical literature. This conference is led by residents, with mentorship by Kathleen M. Fairfield, M.D., DrPH.
Board Review Series
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.
State and Regional Meetings
MMC 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:
Maine Chapter of American College of Physicians (ACP)
Maine Chapter of Society of Hospital Medicine (SHM)
New England Region of the Society of General Internal Medicine (SGIM)