MMC supports over 200 residents and fellows in 11 residencies and 8 fellowships approved by the Accreditation Counsel for Graduate Medical Education. MMC is also the principle teaching affiliate of the University of Vermont College of Medicine, and students from the University of Vermont and from other schools across the country are present throughout the year.
Internal Medicine is the largest teaching department of Maine Medical Center. The Department of Medicine is staffed by over 154 board-certified internists, two-thirds of whom have subspecialty certifications and are members of one of the 15 divisions within the department. All of the subspecialty divisions have major referral practices from community physicians who serve more than 1.4 million people in the state of Maine. This ensures a large and diverse patient population for training, ranging from primary care to a full spectrum of tertiary care problems.
General Medicine Inpatient Units
Each ward team consists of an attending physician, two senior residents, two or more first-year residents, a medical student acting intern, and a clinical clerk medical student. The first-year residents assume primary patient care responsibility with guidance from senior residents and the attending physician. The number of patients varies among the services, and averages eight per first-year resident.
The senior residents work with interns and medical students during rounds on all patients. The senior resident also makes the final decision to admit patients after their initial triage and evaluation. Other responsibilities include teaching salient clinical points as well as providing evidence-based literature and educational support when appropriate. The medicine residency program highly values the teaching ability of its residents. In the 2nd year, all residents attend a seminar series (based on the Stanford teaching series model) to improve their skills in teaching and evaluation.
Our teaching faculty continues to be one of our program strengths. Only attendings with a long track record of thoughtful and educational admissions remain as service attendings. Several have been selected by The Best Doctors in America as outstanding clinicians and teachers. As teaching attendings, they conduct teaching rounds four times each week. During these sessions, attendings teach an evidence-based approach to diagnosis and clinical decision making, they discuss the pathophysiology and manifestations of disease, and they role-model clinical behavior and physical exam skills at the patient bedside. In addition to teaching duties, faculty also have attending physician responsibilities for their own patients admitted to the service.
Special Care Unit/Intensive Care Unit (SCU/ICU)
The intensive care unit at Maine Medical Center is a 45-bed unit divided into a General Surgical ICU, Cardiothoracic ICU, Pediatric ICU, and the 22-bed Medical ICU. The Medical ICU has dedicated teams of residents supervised full time by pulmonary/critical care physicians and fellows. All general medicine patients admitted to the unit are cared for by one of the dedicated critcal care teams, whereas subspecialty services (Cardiology, Nephrology and Hematology/Oncology) continue to care for their patients who are critically ill. Critical care teams consist of an attending physician, one 2nd- or 3rd- year resident, one 1st- year resident, and medical student acting intern. The focus of daily rounds is on diagnosis and management of the critically ill patient, pathophysiology of disease, and the appropriate use and management of invasive technologies in the critical care setting (arterial lines, pulmonary artery catheters, intubations, resuscitations, ventilator management, and other procedures). Residents on the critical care service develop skill in the management of patients critically ill from respiratory or circulatory failure.
Cardiology/Coronary Intensive Care Unit (CICU)
Residents rotating through the cardiology service will learn to provide state-of-the-art care for their patients in the CICU who are receiving critical care. The CICU is a 12 bed ICU where patients with primary cardiac concerns may be monitored, maintained on cardiovascular support, and monitored on respiratory support with mechanical ventilation, in the event of pulmonary failure. A cardiology consult service staffed by a cardiology fellow and on-call staff cardiologist is available 24 hours a day to provide supervision.
While on the cardiology service, residents receive didactic teaching sessions from cardiology attendings and fellows. Teaching attendings conduct teaching rounds four times each week. During the sessions, attendings teach an evidence-based approach to diagnosis and clinical decision-making, as well as cardiac physiology and pathophysiology. Through these experiences residents have the opportunity to care for patients with a spectrum of cardiac and multi-system disease.
Hematology/Oncology Unit (Gibson Pavilion)
The Gibson Pavilion is designed as a patient and family friendly place. It was opened to patient care in November of 1998, and within its 26,000 square feet are 37 patient rooms, 20 of them private, and a cluster of specially ventilated isolation rooms for peripheral stem cell transplant patients and others with compromised immune systems. Family members are able to "room-in" with patients, providing crucial support. The rooms have striking views toward Portland and the western mountains, providing a healing connection to the outside environment. The Gibson Pavilion also has a patient lounge and exercise room, kitchen facilities for family members, and classrooms for patients and families to learn about their disease and the plan for treatment.
MMC is one of only three trauma centers in the state of Maine, and the only with Level I designation by the American College of Surgeons. Staffed 24 hours by board-certified emergency physicians, the Maine Medical Center ED has 48,000 patient visits per year. The majority of patients on the inpatient medical services are admitted through the Emergency Department. Medicine residents work alongside house staff from other Maine Medical Center residencies as well as Emergency Medicine teaching faculty. Residents assume various levels of responsibilities in the evaluation and management of medically ill patients. The Emergency Department provides related training in orthopedics, ophthalmology, ob/gyn, and minor surgery.
The program is organized around a firm model in which faculty and residents work together in a group practice caring for a panel of patients. Each resident enrolls in an internal medicine firm led by a group of primary care internists. As part of the group, the resident maintains a practice of 100 to 150 patients in an onsite primary care practice with full clinical and administrative support staff. Full technical support is provided for dictation, word processing, and resident use of personal computers. The clinic has recently transitioned to a completely electronic medical record for all new patients. The computer system is on a network allowing access to clinic patient medical records throughout the hospital and the Emergency Department. The goal of the ambulatory clinic is to provide a cohesive experience for the resident in their own private office combined with encounters on a dedicated inpatient medical service.