Internal Medicine

 Scope of Clinical Experience

Catchment Area

IMRS is fortunate to work in an area where medicine is an economic driver. Patients from four states and Canada use Spokane for their tertiary care needs. Over 2M people spread across 95,000 square miles

Catchment Area Map

Spokane has a large catchment covering a population of over 2 million people. This allows us to see and manage disease processes such as HLH, tertiary syphilis and odd presentations of vasculitis while still having a personal feel of a community residency program

Michael Stewart

Class of 2021, IMRS Resident

Patient Complexity

Providence Sacred Heart Medical Center and Children’s Hospital is one of the largest hospitals in the Northwest. It functions as a safety-net hospital and provides the most up-to-date, technical care. PSHMC is “home” to many LVAD patients and provides heart-lung transplants to patients in our region. Pancreas and renal transplantation is common. Basically, patients have all of their most critical needs met (with the exception of extensive burns and liver transplantation) in our region.

Residents receive a strong foundation in both inpatient and outpatient medicine. We have busy services but have realized that too many patients means not enough time to pursue clinical questions and satisfy clinical curiosity. You will become very familiar with common topics such as COPD exacerbation, NSTEMI, TIA/Stroke, Pulmonary embolism to name a few but we also look for and find the “zebras” that make internal medicine fun and challenging.

Sample of cases encountered by IM residents on housestaff during one month:

  • Lemierre’s syndrome
  • SLE/Catastrophic anti-phospholipid syndrome initially presenting as autoimmune hemolytic anemia, diffuse alveolar hemorrhage and cardiac tamponade
  • Cerebellar ataxia as an initial presentation for Non-Hodgkin’s lymphoma
  • Aortic valve endocarditis presenting as third degree heart block
  • MPGN secondary to diffuse large B-cell lymphoma
  • Secondary syphilis with septic pulmonary nodules
  • VZV pancreatitis

Rural Opportunities

Spokane is surrounded by many rural communities who are very welcoming to residents who wish a rural training experience.

International Opportunities

IMRS residents have rotated in Ethiopia and Nepal. We are excited to add Zambia as a new rotation site this year.

Residents volunteering in other countries

Diabetes Summer Camp

Camp STIX is an independent, community-based, summer camp for children and teens with diabetes throughout the Northwest. Every summer two residents join a faculty attending as volunteers on the medical team for Camp STIX.

Diabetes management and medical care for campers is provided by an outstanding, interdisciplinary group of health care providers and students including family medicine residents, pharmacy and nursing. Residents are involved in every detail – blood sugars are checked many times a day, enabling residents to make real-time treatment decisions and get invaluable hands-on experience with insulin management including the use of insulin pumps and continuous glucose monitors, as well as the acute treatment of hypoglycemia and DKA.

Residents volunteering at diabetes summer camp