Where Residents Spend Their Time

Medicine Wards Medical ICU Coronary Care Unit Electives/ Subspecialty consults* ER blocks PGY1 5 1 0 5 1 PGY2 3 1½ 1 6½ 0 PGY3 3 1 1 7 0

Emergency Department
Interns have the opportunity to work with faculty and residents in the Department of Emergency Medicine, which has a strong national reputation for excellence. They will work under the supervision of board-certified Emergency Medicine attendings, seeing adults with major and minor emergencies. There will be ample opportunities for a variety of minor procedures, including suturing and incision and drainage, as well as more invasive procedures. This rotation is four weeks in length; vacation cannot be taken during this experience. During the month, interns typically work twenty 10-hour shifts.

Coronary Care Unit (CCU)
Second- and third-year residents are each assigned to one-month rotations on this 20-bed unit, also known as the Dickson Heart Unit, or DHU. They work with cardiologists in the Sanger Clinic, which is a very large multi-specialty Cardiology practice that is part of Carolinas HealthCare System. A very select number of the group's partners are extended the opportunity to attend on the resident teaching service; residents assist the cardiologists in the care of patients with acute cardiac illnesses. Residents are also part of the CODE STEMI team, which is the early response team for ST-elevation Myocardial Infarctions. Residents will have the opportunity to hear about these patients en route, see them as they arrive in the Emergency Department and then follow them through the cardiac catheterization lab to the CCU. This is a very unique opportunity - typically residents do not get to be part of the initial evaluation of patients with acute ST elevation MI's. Residents will also be part of the CODE BLUE team and assist with responding to all cardiac arrests in the hospital. CCU call is currently every third night but this will change as of July 2011. Beginning in July 2011, the CCU will change over to a 7 a.m. to 6 p.m. day shift rotation, with no overnight call, but will still have the option to take additional hours at nighttime, particularly for those very interested in Cardiology. Additionally, a board-certified faculty cardiologist is assigned full-time to the CCU for teaching purposes. There are always attending level cardiologists in house (24 hours a day, seven days a week) for residents to discuss patient issues with as needed. A doctor of pharmacology and a registered critical care dietitian are part of the CCU team as well. 

Medical Intensive Care Unit (MICU)
The ICU is a 30-bed unit supervised by full-time faculty; all are certified in pulmonology and critical care. We currently have 16 full-time Pulmonary and Critical Care faculty that are involved with the Medical ICU. A formal lecture curriculum also exists with lectures a minimum of three times a week. The curriculum always includes an introduction to ventilators, reviews of critical articles on the management of sepsis and instruction on placement of invasive procedures. We own our own Site-Rite^TM machine, so we can use this for line placement without needing to involve the radiology department. First-, second- and third-year residents assigned to one-month ICU rotations assist in the care of both private and staff patients. Call is every third night for the resident and usually works out to be every fourth to every fifth night for the interns. This will change as of July 2011.  Beginning in July 2011, the MICU will consist only of shifts no longer than 14 hours in length. A doctor of pharmacology and a registered critical care dietitian are part of the ICU team. We also have board-certified Critical Care attendings in-house 24 hours a day for assistance with critically ill patients.

Carolinas Medical Center recently completed construction of an ICU Tower. This state-of-the art 30-bed Medical Intensive Care Unit facility opened in January 2008, allowing an even higher quality of care for our patients.