The curriculum of this program is designed to provide residents not only with the knowledge needed for ABIM certification but also the clinical skills to practice within any specialty in internal medicine. Utilization of a variety of teaching methods provides residents with opportunities to learn in the ways that most benefit them. During a resident’s time here they will have the opportunity to rotate through multiple different clinical settings within the world of internal medicine including general medical wards, intensive care units, subspecialty consultation services and clinics, and the resident’s own continuity clinic. Our residents have one half-day of clinic each week in which they establish a panel of patients for which they serve as the primary care physician.

The major components of the educational curriculum include: 

Tuesday Morning Block Conference – Every Tuesday morning a block conference is held at Cabell Huntington Hospital for all residents to attend. This conference begins with a Grand Rounds presentation which can range from anything including guest speakers from outside universities, presentation of relevant research developments within the department, discussion of practice-changing research within the field of medicine, or the monthly Morbidity and Mortality conference. Following grand rounds, residents participate in a weekly-rotating schedule of conference activities including Morning Report and Medical Jeopardy among others. Following this rotating session, residents will receive block lectures from one of the sections within our department (general internal medicine, endocrinology, infectious disease, etc). Lectures are designed to be interactive and focus on board preparation while also emphasizing key clinical elements included in information that will be useful on the wards. During this block conference from 8 AM-1 PM residents are relieved of all clinical duties. Team phones are carried by the team’s attending physician. 

VA Educational Conferences – While rotating at the Hershel “Woody” Williams VA Medical Center, residents will participate in additional education conferences. Conferences are moderated by the VA Education Chief Resident (a PGY4 resident who is devoted entirely to providing high quality didactic and ambulatory care training at the H”W”WVAMC) and occur every Monday, Wednesday, and Friday afternoon from 12:30-1:30 along with a Thursday Morning Report session from 8:30-9:00. As with Tuesday morning conference, these times are protected for education and clinical responsibilities are covered by the attending physicians on service. Afternoon conferences tend to be question-based sessions with residents working together to determine answers to clinical questions followed by group discussions of clinical reasoning. Thursday Morning Report consists of discussion of an interesting or unique case admitted overnight. 

Ambulatory Training – Residents participate in multiple aspects of ambulatory care training in addition to the standard responsibility of their continuity clinic. Residents will rotate through the Marshall Internal Medicine Walk-in Clinic where they will learn to care for patients’ acute complaints. As part of this rotation residents will complete an Ambulatory Care project which focuses on honing the knowledge and skills required to understand and utilize a systems-based practice. Each year, trainees will also complete a Practice-Based Learning Project further bolstering their skills in systems-based practice and quality improvement. 

Board Review – All third year residents participate in weekly board review sessions. These sessions are resident-driven and topic focused. Additionally, a protected comprehensive board review session is held by the department and taught by department faculty in May of each year to further prepare graduating residents to take their board exam.

Residents rotate through three hospitals in the Huntington community as part of this program: Cabell Huntington Hospital, St. Mary’s Medical Center, and the Hershel “Woody” Williams VA Medical Center. These facilities are located within 15 minutes of each other, provide a full spectrum of ancillary services, and together provide a broad array of clinical experiences for trainees. 

Cabell Huntington Hospital

Approximately 40 of the 303 beds at Cabell Huntington Hospital are staffed by the Marshall Internal Medicine service. These responsibilities are divided between two teams of residents, one senior resident and two interns per team, a devoted clinical pharmacist, as well as medical and pharmacy students. Cabell Huntington Hospital serves as an academic tertiary referral center for the surrounding region including southern Ohio, eastern Kentucky, and a large portion of western and southern West Virginia and serves as the primary training site for the residency programs within the Marshall Joan C. Edwards School of Medicine. This facility offers immense opportunities to work with consultants from all fields and services available include general surgery, neurological surgery, nationally recognized orthopedic surgical services, obstetrics / gynecological services, full oncologic services at the Edwards Comprehensive Cancer Center, and pediatric care at the Hoops Family Children’s Hospital.  Residents will complete the majority of their intensive care unit experience at Cabell which houses a 38 bed combined medical and surgical intensive care unit along with a state-of-the art burn intensive care unit both of which serve as regional referral centers. ICU rotations are comprised of two teams of medical residents each consisting of a senior resident and two interns. Residents have the opportunity to work with highly skilled attending intensivists, clinical pharmacists, nurses, case managers, dieticians, physical, occupational, and speech therapists in order to learn how to provide strong multidisciplinary care for critically ill patients. Residents will also have ample opportunities to learn to perform bedside procedures crucial to intensive care unit treatment. A night float system is in place for both the general medical floor teams and the ICU teams. 

St Mary’s Medical Center

Approximately 40 of the 393 beds at St. Mary’s are staffed by the Marshall Internal Medicine service while the University Cardiology Service comprises an additional 30-40 beds. Residents work as part of two teams comprised of two senior residents and two interns each and there is a dedicated night float system with one senior resident and one intern. St. Mary’s serves as the regional referral center for cardiovascular diseases and offers a full array of medical and surgical cardiovascular services while also providing a full complement of medical and surgical consultative services. Rotating at St. Mary’s provides residents with an experience similar to that of a “community hospital” while maintaining a focus on education by having Marshall Internal Medicine faculty attend for the teams and serving as a primary site for medical student clinical rotations in internal medicine.    

Hershel “Woody” Williams VA Medical Center

We consider it the highest honor to have the opportunity to take care of America’s veterans. While rotating at the Veterans Administration Medical Center, residents will become familiar with the diagnosis and treatment of many common medical conditions while also being exposed to many rare conditions. The inpatient service at the VA comprises approximately 70 beds and includes acute care, intermediate care, and intensive care units. Three teams of residents provide the vast majority of inpatient medical care and each team consists of one senior resident and two intern residents and frequently a fourth year medical student. The intensive care unit service is staffed by a dedicated senior resident. Admitting structure at the H”W”WVAMC follows a modified drip system with each of the three teams receiving admissions every third day. A dedicated night float system consisting of one senior resident and one intern cross covers the medical service overnight.   

Ambulatory Clinics

Ambulatory clinic activities take place primarily at the Erma Ora Byrd Clinical Center. “The Byrd,” as residents know it, is a state-of-the-art facility located across the street from Cabell Huntington Hospital and houses Marshall’s general internal medicine clinics, subspecialty clinics including cardiology, endocrinology, infectious disease, rheumatology, and gastroenterology, a fully operational laboratory, and radiology department which can provide patient with onsite X-ray and CT scan services. Many residents also have ambulatory clinic experiences at the H”W”WVAMC, St. Mary’s, and the Ebenezer Medical Outreach clinic. 

The PGY-1 resident schedule (categorical and preliminary year residents) includes the following:

• 6-7 months of inpatient hospital service
• 2 months of intensive care unit (ICU)
• 1 month of ambulatory clinic (Walk-In Clinic)
• 1-3 months of elective rotations
• 3 weeks vacation and 1 week educational leave (taken only in 2 week blocks or 4 week block during PGY-1 year). Vacations blocks of 2 weeks may be combined with a 2 week elective for that particular month. Vacation cannot be taken while on hospital service.

The PGY-2 resident schedule includes the following:

• 3-4 months of hospital service
• 2 months of intensive care unit (ICU)
• 1 month of ambulatory clinic
• 1 month of emergency medicine
• 6 weeks of night float
• 2-3 months of elective rotations
• 3 weeks vacation and 1 week educational leave. Vacation cannot be taken while on hospital service or the required Cardiology rotation.

The PGY-3 resident schedule includes the following:

• 2-3 months of hospital service
• 1 month of ICU
• 6 weeks of night float
• 1 month of geriatric medicine
• 5-6 months of elective rotations
• 3 weeks vacation and 1 week educational leave. Vacation cannot be taken while on hospital service or the required Cardiology rotation.
• Core Elective rotations include the following: Cardiology (required for all residents in either PGY-2 or PGY-3 year), Neurology (required for all residents).

During residency, you must also complete 6 of the 8 listed selective elective rotations listed below:

• Endocrinology
• Gastroenterology
• Hematology/Oncology
• Infectious Diseases
• Nephrology
• Neurology
• Pulmonary
• Rheumatology
• Other elective rotations are available including: Anesthesiology, Dermatology, ENT, Optometry, Psychiatry, Radiology, Stress Testing/Echo, and other rotations may be arranged upon request if possible.

The program has made great strides in recent years to increase the research footprint of the Internal Medicine department here at Marshall University . Through the formation of a research committee, the program has developed a research curriculum that provides didactic sessions and interactive, team-based learning opportunities to provide each resident with the core knowledge required to conduct clinical or basic science research. Residents receive instruction in the formulation of a research question, development of a project protocol and informed consent, navigation of the IRB approval process, and the drafting of the eventual manuscript. 

Our residents have enjoyed great success in their research endeavors including publication in high impact journals and presentation at regional and national conferences. Each resident is required to complete one quality-improvement project as part of their graduation requirements but many residents choose to pursue many more projects ranging from case reports or series to more detailed prospective and retrospective projects.

Internal Medicine Specific Benefits

• 5 Days of Leave for CME Training
• Additional Funding for Research is available.