Internal Medicine – Teaching

Purple Team

The purple inpatient team is a novel approach to assisting the senior resident develop skills to manage a team as well as learn/practice educational techniques. This year, this team is changing into an admission-only team to hone triage and admission skills and to improve workflow of the rounding housestaff teams.

    ACLS

    Residents are the hospital code team and are kept up-to-date in ACLS training.  The program provides supplemental training (advanced airway management, pharmacology and cardiac rhythm lectures, interdisciplinary code team training) to truly prepare our residents to feel confident running codes.

    ACLS-EP

    Second year residents take an ACLS-EP course given by the IMRS faculty.

    • Provides recertification for ACLS (IMRS pays for the course and cards)
    • Allows exploration of in-depth, but less common ACLS scenarios
    • Hypothermia
    • Toxins, including poisoning
    • Severe asthma management
    • Lightning strikes
    • Advanced electrolyte abnormalities
    • Advanced airway procedures(using pig tracheas for cricothyroidotomies)

    IMRS Faculty

    IMRS is fortunate to have a faculty dedicated solely to medical education.  They are creative and innovative in their approach to medicine and are interested in each learner.

    Transition To Senior Resident

    All of the R1s attend an evening (complete with food) with the Program Director and a senior resident. R1s learn the duties of a senior resident including how to present to attendings at night, guidelines for calls, covering clinic patient calls, etc. In addition, they identify traits they wish to emulate as a senior resident and those they will avoid. Leadership of a team is discussed and they troubleshoot potential problems inherent in a team. This work is continued in the Teach the Teacher workshop.

    Spokane 10

    Our residents and faculty consider these 10 diagnoses to be the cornerstone to internal medicine. We encourage every R1 to master this list – everything from epidemiology, pathophysiology, diagnosis and treatment.

    • Diabetes/DKA
    • COPD/asthma
    • Sepsis
    • Afib
    • Cirrhosis
    • ACS (includes STEMI, NSTEMI)
    • Stroke
    • GI Bleed
    • AKI/CKD
    • PE/DVT

    “The faculty are so deliberate on providing us as many useful learning opportunities as possible while also actively seeking our feedback.”

    Taylor Christensen

    Class of 2019

    Teach The Teacher Workshop

    Annual workshop organized by faculty and fellows, geared specifically to give tools for success for senior residents.

    Topics include:

    • Teaching skills for senior residents
    • Grading, teaching and managing medical students
    • Dealing with difficult interns and faculty
    • Being an effective senior on night float
    • Conflicts at the workplace
    • Managerial skills for senior residents
    Student Teaching Conference

    Humanities

    IMRS provides a vital Medical Humanities curriculum, built on evidence of clinically-relevant empathy and adult learning of “theory of mind.” Noon conferences use narrative literature to examine our own stances and assumptions, and navigate difficult ethical and clinical situations. Social science elements build cultural humility and required care competencies. The history of medical thought illuminates physicians’ moral and functional role in society. Physical examination skills are taught using in part art-based habits of observation and interpretation. Centrally, IMRS emphasizes Medicine itself as an Art, a set of actions to be practiced and performed, rather than just a body of facts to be known.

    IMRS faculty maintain an active education-research program on the impact of humanities work on clinical performance and human empathy. We encourage our residents to participate in scholarly activity, research, publications and presentations in this arena, along with their other clinical interest topics.

    Residency Programs In Spokane

    IMRS residents work with Family Medicine, Psychiatry and Transitional year residents on a variety of teams in the hospital. They interact frequently in our shared precepting space in the clinic. In addition, they interact socially with the other residency groups. You can always find someone who shares your interests!

    Resident Involvement In Governance

    We pride ourselves on responsiveness to resident input. The residents, faculty and admin staff meet monthly to enhance communication but also to problem solve any issues. The residents meet without faculty every other month to discuss any concerns and also to devise improvements. The topics discussed are brought to the Program Director who can institute new policy/change or bring these issues to the joint meeting described above. IMRS also has three extended resident/faculty meetings throughout the year that allow for more in depth discussion and solution generation. 

    Examples of resident participation that have resulted in change:

    • Development of night float system (replacing Q4 call system)
    • Implementation of Wellness Half Days
    • Review of transitions of care curriculum
    • Assignment of same-day Continuity Clinic to allow for improved patient continuity.
    • Institution of house staff admitting-only team

    Ample opportunities exist for residents to participate in Program Evaluation Committees and hospital committees where their input is valued and change accomplished

    Hospital Collaboration

    In the hospital (PSHMC), we join forces with pharmacy, radiology and other residents. We actively participate in code team training and Hospitalist grand rounds, to name just a few of our interdisciplinary projects.

    Clinic Collaboration

    The clinic is a rich environment for collaboration. Three residency programs co-habitate there and we experience support from pharmacy, social work, behavioral health, legal support for health-harm needs, exercise, nutrition and diabetes educators, all who provide teaching while they provide care for patients.

    Mentors

    Each R1 is paired with an R3 who will reach out to them and welcome them to the program. The seasoned R3 can help the new intern navigate a complex system and answer those burning questions that crop up frequently in the first several months.

    The faculty provide mentorship/advice for a cadre of residents of varying years. They share lunch together several times/year, meet to discuss presentations, assist with career plans and serve as a resource.

    “IMRS had the best culture and “resident first” environment of all the programs with which I interviewed.”

    Kurt Myers

    Class of 2019

    “As a 4th year medical student on rotation in Spokane, I specifically recall a specialist who allowed me to follow an interesting case, even though I was not on rotation, because they were genuinely interested in my learning.”

    David Applebury

    Class of 2019

    Volunteer Attendings

    The volunteer faculty provide amazing teaching and opportunities for residents. In some institutions, attendings are “shadowy” figures that come and go several times/week and aren’t readily available. Not so in Spokane. IMRS residents feel very comfortable stopping an attending in the hall to ask a question, ask for a consult or just visit for a minute. Many faculty go out of their way to nurture residents and ensure their success.

    Contact Us

    Teri Yaeger
    Teri Yaeger

    Program Coordinator

    Internal Medicine Residency

    101 W. 8th Ave

    Spokane WA, 99204

    Ph: 509.474.3237

    F: 509.474.5316

    Your residency starts here. What are you waiting for?