Internal Medicine Residency Overview

SAUSHEC Internal Medicine Residency is the largest in the Department of Defense with 96 accredited training positions. The program offers a beautiful new addition to the main hospital, completed in 2012, and broad exposure to a diverse, large patient population, facilitating robust training. Residents selecting SAUSHEC as their training site will have the advantage of frequent contact and teaching with all internal medicine subspecialties, ensuring both excellent patient care and many opportunities to explore subspecialty training. The residency complies with all Accreditation Council for Graduate Medical Education (ACGME) requirements and abides by their guidance regarding duty hours and rigorous academic standards.

SAUSHEC Internal Medicine is led by an administration including a Program Director, three Associate Program Directors, and two board-certified Internists (one Air Force and one Army) who each serve in the role of Chief of Residents. In 2014, another board-certified Internist was added to serve as Chief of Quality Improvement and Patient Safety (QIPS). They are well-informed about the unique requirements of each service for producing high-quality Internists, and they lead the program in a team-oriented fashion. Faculty members are readily available, located near the residents, and participate in a one-on-one mentoring program with the residents to provide academic and career guidance.

Inpatient services are provided at SAMMC, located on the East side of San Antonio. Some clinic rotations are performed at Wilford Hall Ambulatory Surgical Cetner (WHASC) on the Southwest side of San Antonio. Residents also rotate at the local University Hospital, the downtown Infectious Disease clinic, and with the Fort Sam Houston Adolescent Clinic. A unique feature of this program is the opportunity to complete medically-related military courses and experience Medical Readiness Training Exercises (MEDRETEs) throughout the world. Some of the recent military courses completed by our residents include Combat, Chemical, Casualty Course (C4), Tactical Combat Medical Care (TCMC), Chem/Bio Warfare Course, and Expert Field Medical Badge (EFMB). MEDRETE experiences, usually lasting about two weeks, have included Haiti, Dominican Republic, Guatemala, and Suriname, to name a few. On these missions, residents learn to care for the local populace while being guided by staff physicians, and how to manage resources for their patients.

Daily academic instruction includes a 45-minute “morning report.” Morning reports are generally case-based, but are held in a variety of styles to highlight various aspects of inpatient and outpatient clinical practice. Each day the focus may vary to include building a differential diagnosis, management, clinical decision-making, evidence-based medicine, and patient safety/quality assurance. General Internal Medicine and subspecialty staff attendance is highly encouraged, and the faculty members add to the education of the residents during morning report. Conference occurs once weekly (on Tuesdays) in an Academic Day format. Conferences run from 1-4 pm and are organized by the Chief of Residents. During conference, a number of topics will be covered by the subject matter experts. A variety of styles are used to include team-based learning, simulation, demonstration, interactive cases, and traditional lectures. All academic sessions are reviewed daily by the Senior Teacher, who distributes a review document with included articles and discussion of topics or questions brought up in the morning report or conference. In addition to formal academics, board review materials are available for resident use and an informal practice of board review during lunch has been adopted by many of the residents.

In SAUSHEC Internal Medicine, opportunities for advanced training, international experiences, and military-unique training are abundant. The program offers all required and desired components of a rigorous training program that prepares its graduates to serve the internal medicine needs of their patients.