Residency Program

Program

The mission and vision of the Thomas Hospital Residency Program is to provide excellent internal medicine training and to create physician leaders who will serve our community with integrity and the highest standards of medical care. Ten PGY-1 residents are selected each year for the Thomas Hospital Internal Medicine Residency program. In addition to core internal medicine clinical training, the program emphasizes the integration of new technology including bedside ultrasonography, simulation lab training, a telemedicine rotation and a rotation with the Associate Program Director, Dr. Darren Scroggie who is board-certified in clinical informatics. All robust Epic functionalities are taught and emphasized. Faculty critiques bedside examination and interview skills, many of which were passed down from various masters of the American College of Physicians. The Morbidity and Mortality Conference and Journal Club conferences inculcate the use of evidence-based medicine and the development of critical thinking skills. Harrison's Principles of Internal Medicine is the premier internal medicine textbook and is utilized extensively in the didactic lecture series.

ROTATIONS 

Sixty percent of Resident time is devoted to ward services and emergency medicine electives at Thomas Hospital, with teaching divided between the hospitalist staff members and the core faculty ward attendings. The remaining time is devoted to diverse ambulatory internal medicine rotations and sub-specialty electives at the Diagnostic & Medical Clinic and with other private practice physicians in the community. Additionally, there are state-of-the-art new ambulatory clinics in Saraland (Northside Clinic), Mobile (Hillcrest Clinic), and yet another 75,000 square-foot facility under construction in Baldwin County (Malbis). These facilities all have on-site comprehensive imaging capabilities as well as adjacent free-standing urgent care services. Residents have their weekly half-day continuity clinic under the direction of Dr. Bill Goetter at the Thomas Hospital Internal Medicine Clinic.

Our residents rotate through these facilities for subspecialty and ambulatory care experience.

 

CONFERENCES

The Morbidity and Mortality conference is given at noon every other Wednesday and includes interactive case discussions emphasizing the integration of multiple diagnoses, symptom and physical findings, history, laboratory and imaging results as well as literature input. Critical thinking is emphasized and there is a vigorous exchange of management approaches from core faculty members participating in these discussions.

Journal Club consists of one presentation weekly by OMS-3 students. Articles from the New England Journal of Medicine, the Annals of Internal Medicine and JAMA are usually reviewed. Evidence-based medicine is introduced in the inaugural Journal Club lecture reviewing the Cochrane report which stresses the important differentiation between peer-reviewed articles with statistical methodology versus internet “searches” which may support a specific agenda.

Morning Report is at noon on Mondays and reviews admissions and important updates from the previous weekend. 

Noon Didactic "lunch & learn" Lectures on Tuesdays and Thursdays with presentations from faculty in Internal Medicine and various subspecialties reference Harrison’s textbook of medicine and other evidence-based resources.

POCUS (Point of Care Ultrasound) Workshops and Pharmacology Fridays (led by a PharmD) are conducted on a biweekly basis on Fridays at noon. The pharmacology lecture includes an examination of drug-drug interactions, utilization of EPIC tools relating to medication reconciliation and dosing based on metabolic parameters, body weight, surface area, etc. Pharmacogenetics, drug fate and metabolism are reviewed, and there is an emphasis on antibiotic stewardship and newer biologic medications.

MKSAP Review Sessions are scheduled twice a week with Dr. Holly Pursley. During these hour-long sessions, Internal Medicine Board review questions are discussed, and residents actively participate in answering questions as well as understanding the material covered in preparation for the American Internal Medicine exam. All residents are provided their own individual MKSAP subscription.

Simulation Training Workshops occur throughout the year under faculty direction using our Blue Phantom Ultrasound Training Models so that residents may safely learn and practice procedures such as thoracentesis, central venous line placement, paracentesis, lumbar puncture, arthrocentesis and arterial line placement.

Although interns are the primary doctors in the inpatient setting senior residents and faculty provide close supervision so that safety of care is constantly subject to supervisory interaction and feedback.

 

 

WARD TEACHING ROUNDS

Since involvement and respect for the multidisciplinary team members is such an important element of effective and safe patient care, the residents are instructed and encouraged to do a pre-conference huddle with the various team members during which input from all team members is solicited. A model for this activity is our morning Safety Huddle which involves all members of the hospital team.

 

 

ACADEMIC TEACHING ROUNDS

Academic teaching rounds occur daily with the Attendings. Patient care, treatment and discharge plans are reviewed. 

WELL-BEING

Resident/physician burnout is an important concern. Well-being is a priority in the Thomas Hospital Internal Medicine Program. Academic rigor and excellent training in inpatient care are complemented by activities that promote Resident emotional, physical and spiritual well-being. Dr. Holly Pursley, Director of Well-being, facilitates programs that encourage community amongst residents. A Sunset Dinner Social overlooking beautiful Mobile Bay is planned annually, in addition to other events throughout the year. Residents are invited and encouraged to join the wonderful outdoor activities in our area, such as biking at the Gulf State Park, kayaking, paddleboarding, golfing, fishing, boating, bird watching and running. Thomas Fitness Center, located on the hospital's campus, has modern equipment and a well-trained staff and provides affordable and responsible health promotion. Residents are encouraged to participate in local charity events such as the Angel Tree program at Christmas time. Resident work hours are frequently reviewed ensuring ACGME compliance and personal protective equipment is readily provided. The Thomas Hospital Resident lounge, sleep area and conference room are beautiful and state-of-the-art. In addition to monthly reviews of evaluations and performance data, the Resident semi-annual review with core faculty provides an opportunity to detect fatigue, burnout and well-being.

Advanced skills in the use of Epic will reduce the average daily click count from 7,000, which has been reported in various internal medicine clinics to half that through focused attention and education by the informatics team. Resident notes are reviewed by faculty to identify non-essential tasks and have them reassigned to paramedical staff. Subject matter mastery also contributes to wellness, hence the emphasis on educational conferences “one on one” teaching, feedback drills and mentorship programs. Scheduled town hall meetings with residents and faculty and combined social events provide an opportunity for more informal discussions of the program’s aims, goals and methods.

 The grounds at Marriott's Grand Hotel in Point Clear are a beautiful destination. 

Location

Thomas Hospital is located in Fairhope, Alabama, a small, charming town that carries the honor of being named one of Southern Living's best towns in the South. Fairhope is located on the eastern shore of Mobile Bay and is known for its walkable downtown, laid-back atmosphere and excellent public, private and parochial schools. Residents enjoy the superb location. In addition to the beautiful walking trails on the bluffs overlooking Mobile Bay, the short commute to Mobile offers the advantages of a metropolitan city and the 45-minute drive to the sandy shores of the Gulf of Mexico makes for a great weekend or evening adventure. Sailing, hunting and fishing are popular sports, but if you want to take it easy and relax, grab a chair and take in one of the spectacular sunsets Fairhope has to offer.

 

 

COVID-19

At Thomas Hospital, Residents have been actively involved in COVID-19 patient treatment, drive-thru screenings and vaccinations. Physicians at Infirmary Health have treated the majority of COVID-19 patients in Mobile and Baldwin Counties, many of which are ICU admissions.

For more information about the Internal Medicine Residency Program at Thomas Hospital, email imresidency@infirmaryhealth.org or call Ana Peters at 251-279-1529. Join us on twitter, @TH_IMRES, or CLICK HERE.