Below is a list of frequently asked questions about the Meds-Peds residency program.
Q: How often will I be on call?
A: Peds: We have a night team system where interns typically do one week of night team during each inpatient unit month. They work from 5pm to 7am Sunday through Friday night and have no day-time responsibilities. Senior residents typically do two weeks during their inpatient months. Residents are in the call pool while on the inpatient unit rotation and when on electives for weekend coverage. NICU utilizes a night team system as well but runs Thursday - Monday nights, with NICU NP's covering on Tuesday and Wednesday nights. Emergency medicine rotations are shift work and are generally concentrated in the evenings to allow maximum exposure to pediatric patients. Senior residents participate in a back-up call system.
A: Med: The Medicine department also uses a night team system. Interns and PGY2's while on General Medicine Inpatient services do two weeks of night team during two of their Gen Med assignments, working 5:30PM to 7:00AM Sunday through Thursday. Residents are in the call pool while on inpatient rotations and when on electives for weekend coverage. The Adult Critical Care rotation is using a q4 call system for seniors and a night team model for interns. Both intern and senior residents participate in a "jeopardy" backup system.
Q: Will I be doing much teaching and supervising?
A: All residents are actively involved in supporting the Clerkship and 4th year medical student experience. This involves direct supervision of inpatient and ambulatory rotations and also teaching sessions with the medical students. Second, third, and fourth year residents directly supervise interns and students on the inpatient units, NICU, emergency room, and ambulatory center.
Upper level Med-Peds residents partake in a teaching course called the Program in Clinical Teaching from the Stanford Faculty Development Center. The program is one of the most widely-known clinical teacher development programs in the world. With a curriculum specifically aimed to the resident teacher, the Program reviews general teaching principles including setting the learning climate, communication of goals, control of session, evaluation, feedback, and promotion of understanding and retention. Sessions are active and experiential and include the opportunity to practice the teaching techniques discussed. Its utility in improving teaching and leadership skills is also well-established in the literature.
Tufts School of Medicine - Maine Medical Center Program students will spend all of their third and most of their fourth years of medical school at MMC and in rural areas of Maine in addition to spending time during their first and second years taking classes and working with preceptors in the Portland area and at Maine Medical Center. In addition, students from the Boston based Tufts, the University of New England, and medical students from all over the country partake in clinical experiences at MMC. This allows ample opportunity for residents to interface with and teach medical students.
Q: What are Personal Learning Blocks?
A: The Personal Learning Block (PLB) is a unique opportunity that blossomed from the asynchronous rotation length of Medicine (4-week) and Pediatric (1 month) rotations. PLBs occur during transitions between these specialties (i.e. Medicine to Pediatrics or Pediatrics to Medicine). During this time period, residents have an opportunity to create a specialized curriculum that suits their particular interests. For example, some residents have used this time period to work on scholarly activities such as writing a case for publication, completing a poster for a conference, working on clinic quality improvement projects, and writing useful e-learn modules. Others have used this time to acquire procedural/technical skills of interest such as ultrasound, OMT, cardiac stress testing. In addition, we are incorporating part of the internal medicine curriculum for quality improvement and preparation for M&M conferences during these blocks. This rotation is meant to be tailored to the residents' specific interests.
Q: Will I get any feedback on my performance?
A: Feedback is frequent and regular, including formal monthly evaluations written on each resident. A few times each year, an evaluation committee meets to provide an overview of the residents' progress. The Internal Medicine-Pediatric Program Director discusses the evaluations with each resident during one-on-one evaluation meetings. Faculty is expected to provide verbal feedback during rotations to address expectations and ways to improve. Residents also complete evaluations of the faculty and of the different rotations, which are taken very seriously in ongoing program development, as well as self-evaluations, which are used to guide resident goals and objectives for each year of training. Additional evaluative measures for residents include intern-level OSCEs, patient and paraprofessional evaluations, in training exams, and continuity clinic Mini-Clinical Evaluation Exercises (Mini-CEXs).
Q: Do residents have input into the program?
A: We actively solicit our residents' opinions about their training. These opinions can be anonymous or direct. We have a great training program and desire to improve it even more. The best insights often come from our residents. There are formal lines of communication, but primarily we rely on open dialogue between faculty, residents, and support staff. Residents are an integral part of our Med-Peds Education Committee and monthly resident meetings where major programmatic changes and development take place. Each year we have a Med-Peds Spring Retreat - an opportunity for residents to reflect back on the academic year and give the administration their input and feedback. Additionally, the Med-Peds administrative office has an open door policy.
Q: What are the ancillary services like at MMC?
A: Ward teams are assisted in their daily responsibilities by a diverse network of ancillary personnel providing a multitude of services. 24-hour phlebotomy, IV placement, and electrocardiogram services are provided. For Pediatrics many of the IV’s and blood draws are performed by residents. A consult service is available for PICC line placement. In addition to these ancillary services, expert advice is available from a variety of clinical fields. Clinical pharmacists round with inpatient general pediatric and adult teams, oncology, cardiology, critical care and infectious disease teams. Dietary consults are available for any inpatient, providing valuable recommendations and monitoring of nutritional needs of patients. They are available for advice on enteral and parenteral options. Care managers (RN and social workers) help facilitate discharge plans and the coordination of care after patients leave the hospital. Team-based care is highly valued at MMC.
Q: How is resident stress addressed?
A: The number of hours on call has steadily declined over the last few years and we have a well-established night float system for all four years of training. Our program supports and endorses duty hour legislation and closely monitors resident stress and fatigue. Graduate Medical Education has developed a website on Wellness and there is a Peer-Peer support program.
Our support system includes a Faculty Advisor Program in which each resident is paired up with an attending physician who serves as a resource for, and advocate of, his/her advisee at least through internship and beyond as desired. In addition, there are monthly resident support meetings as well as access to department-funded counseling services for residents. We schedule a wellness ½ day during the first two months of internship (which is then optional during PLB’s for the next three years of residency) to allow time for PCP, dentist appointments, etc. The program helps arrange easy access to PCPs at the start of internship.
Each fall we join the Internal Medicine and Pediatric residents and faculty in 2 two-day, off-campus retreats where we participate in team building and learning style activities as well as create a chance for resident bonding away from the hospital. The Med-Peds residents have a ½ day spring retreat, combining program reflection, team building and some fun. In addition, the chief residents organize social functions throughout the year. We have a close-knit group of residents and we consciously encourage this relationship.
Q: How many residents go into primary care vs. fellowships?
A: Med: On average, 35% of IM residents go into primary care and 65% go into IM fellowships.
A: Peds: On average, 65% of pediatric residents enter primary care and 35% go on to pediatric fellowships.
A: Med-Peds: 45% of our Med-Peds graduates have entered primary care, 30% have gone into Medicine and/or Pediatric subspecialties, and 25% are practicing hospitalist medicine.
Q: What local opportunities exist for me after I finish training?
A: In general, job opportunities abound in Maine for those interested in pursuing Internal Medicine, Pediatrics or combined Internal Medicine-Pediatrics. More specifically:
- Med: 6 graduates from the last 5 years are currently practicing in Maine as primary care physicians. 9 are practicing hospital medicine and 5 are practicing a subspecialty in the state post-fellowship training.
- Peds: 9 graduates from the last 5 years are currently practicing primary care medicine in Maine and 6 are Pediatric Hospitalists.
- Med-Peds: There are many practice sites and hospitals in Maine looking for a Med-Peds trained physician. These include positions as a Med-Peds hospitalist, primary care physician, and as a sub-specialist. 45% of the program graduates are practicing in Maine in primary care, hospital medicine and as subspecialists.
Q: How successful are MMC residents in getting the fellowship of their choice?
A: Med: Over the last 5 years, 90 percent of residents choosing to pursue fellowship training have successfully matched at their first choice fellowship program.
Below is a partial list of fellowships where Medicine graduates have gone in recent years:
- Allergy/Immunology: University of Virginia
- Cardiology: Lahey Clinic, Maine Medical Center, University of Nebraska
- Endocrinology: Boston University
- Gastroenterology: Oregon Health Sciences University
- Geriatrics: Maine Medical Center, Mt. Sinai, University of Rochester
- Hematology/Oncology: Baystate Medical Center, Beth Israel Deaconess, University of Vermont, University of Virginia
- Infectious Diseases: Maine Medical Center, University of Virginia
- Nephrology: Maine Medical Center
- Pulmonary/Critical Care: Lahey Clinic, Maine Medical Center, Tufts University, Ohio State University
- Rheumatology: Beth Israel Deaconess
- Sleep Medicine: Drexel University
Below is a partial list of fellowships where Peds graduates have gone in recent years:
- Allergy/Immunology: Duke University, Ohio State University, Children's Hospital Boston
- Cardiology: Cincinnati Children's Hospital
- Development/Behavior: Children's Hospital Boston
- Endocrinology: Brown University
- Gastroenterology: John's Hopkins, Medical College of Wisconsin
- Infectious Diseases: Children's Hospital Boston and Albany Medical Center
- Nephrology: Cincinnati Children's Hospital
- Neonatology: Cincinnati Children's Hospital
- Pediatric Critical Care: University of Utah
- Pulmonology: Johns Hopkins, Oregon Health Science Center
- Sports Medicine: Maine Medical Center, UNC-Chapel Hill
- Adolescent Medicine: John's Hopkins University
- Adult Cardiology: Maine Medical Center
- Adult Infectious Disease: Maine Medical Center
- Adult Rheumatology: Northwestern University
- Pediatric Cardiology: Medical College of Wisconsin
- Pediatric Critical Care: Duke University
- Pediatric Infectious Disease: Stanford University
Rheumatology (combined Med-Peds): Duke University
Q: What is the housing like in Portland?
A: Portland is both a delightful and safe city in which to live. The hospital is located in a residential district and many of the residents live in homes/apartments within walking distance of the hospital. Rural and smaller coastal communities with affordable housing are only 15-20 minutes away, for those who like to live outside the city. Maine Medical Center pays a very competitive salary. This, in addition to the relatively modest cost of living, means that many residents are able to afford to purchase condominiums or homes. Learn more about Life in Portland here.
Q: What about benefits and vacations?
A: Our residents' salaries have consistently been above the 75th percentile. On top of this we offer a benefits package including medical, dental, and disability care, malpractice insurance, and life insurance. Each resident receives 21 vacation days each year plus 5 days off at either Thanksgiving or Christmas. The department also provides educational funds for our residents so they can attend meetings and/or buy textbooks or journals. The Med-Peds program also pays for resident membership in the American Academy of Pediatrics (AAP) and the American College of Physicians (ACP).
Q: Are meals provided to me?
A: Every resident gets $12 per 24-hour call applied to his or her cafeteria account while on both Medicine and Pediatric rotations. Meal card money is applied to accounts on a yearly basis.
Q: What computerized educational resources are available for residents?
A: Up-to-Date is available throughout the hospital from any computer and can be downloaded to your personal device with an application that is free to house staff. In addition, the MMC Library provides access to OVID, PubMed, DynaMed, and MDConsult to name a few. Many of these programs can be used at home via remote access.
Q: Are residents happy?
A: Without a doubt! But why not find out for yourself by visiting us for an interview? During this time each applicant will meet with both faculty and residents. Because MMC serves as both a community hospital for Portland and a tertiary referral center for Maine, our residents work hard and they learn a lot. Our residents also have ample opportunity to play hard in the wonderful state of Maine, which provides an abundance of outdoor activities as well as more metropolitan experiences in the larger cities like Portland. Our hospital is located in one of the most beautiful small cities in the country, offering unparalleled access to outdoor activities year round. Come and check us out!