We recognize the important role in training the internal medicine physicians that will care for the citizens of the entire state of Maine. In keeping with the Tufts University School of Medicine - Maine Medical Center Program's focus on rural medicine and primary care, and the hospital's strategic aim to make Maine the healthiest state in the nation, the Internal Medicine Residency Program aims to provide our residents ample opportunities for training in rural medicine. The Maine Practice Network (MPN) provides this training in rural healthcare. The program includes 17 hospitals and over 70 board-certified internal medicine physicians throughout the state. Rural practice sites are carefully chosen and preceptors have been selected for their interest in teaching. Second-year residents spend one month experiencing practice in a rural environment. Residents are exposed to the practice of internal medicine in both ambulatory and hospital settings away from the subspecialty environment of MMC. Residents can also choose to spend additional months in rural settings as part of their elective time. Many of our residents have chosen careers in primary care medicine after this rewarding experience in rural medicine. The MPN locations include, Bath, Belfast, Biddeford, Bridgton, Brunswick, Damariscotta, Ellsworth, Farmington, Fort Kent, Houlton, Lewiston, Norway, Old Orchard Beach, Rockport, Saco, Skowhegan and York.
The International Health Clinic has served the international community of Portland and Cumberland County for over 20 years. Portland has a diverse international community, with over 50 languages spoken in the public school system. The bulk of immigrants are from Southeast Asia, Eastern Europe and Sub-Saharan Africa. We have invested in the care of these patients by funding a multi-disciplinary clinic staffed with dedicated physicians, nurses, interpreters and other cultural support services critical to international health. International medicine is an important part of the ambulatory experience on the 2 week Bramhall rotation each year. Our residents also receive a specific didactic curriculum in health issues specific to refugees and international travelers.
Away Rotations in International Health
Many of our Internal Medicine residents have broadened their international medicine experience with electives in Vietnam, India, Nepal, Botswana, Mexico, Honduras, Paraguay, Thailand, Poland, Dominican Republic and Haiti. The residency program offers some financial support for resident international rotations through a competitive grant application process. More recently, we have established a medical education partnership with a teaching hospital in Haiti.
Resident as Teacher
The program aims to help residents develop their skills in teaching, recognizing that a successful career as a physician requires the ability to teach patients, caregivers, students, health care professionals, and the public. Our second-year residents participate in the Resident Teaching Course, which is directed by a specialist in medical education, Dr. Robert Trowbridge, and is based on the Stanford medical education teaching series. Residents then apply what they learn in the teaching course to a simulation experience in teaching ("OSTE"). Our annual resident retreat includes further instruction in teaching techniques in a small group format. Finally, residents are given feedback on their teaching abilities via the evaluation process from medical students, interns, and their attending physicians.
Our curriculum in the use of ultrasound continues to grow each year. Our teaching faculty for ultrasound includes general internists, hospitalists, and emergency medicine physicians. Training experiences with ultrasound begin during intern orientation, when our new interns are introduced to the basics of bedside ultrasound use for safe performance of medical procedures. All residents receive training in the physics of ultrasound, the basics of operating a bedside ultrasound machine, and the evidence-base behind common applications of bedside ultrasound in internal medicine. Residents are then provided with mentorship and feedback as they gain practical experience with applying ultrasound to their patient care throughout residency. Rotations where ultrasound is utilized continues to grow, but currently includes inpatient general medicine, critical care, inpatient cardiology, emergency medicine, pulmonary consult, and rheumatology.