The community/academic fusion
When deciding what residency program was best for me, I struggled with the question about which was better: an unopposed, community-based program or an opposed, academic-based program. What I realize now is that one is not better than the other; they each have their own strengths and weaknesses. Unopposed, community based programs provide you with broad training because of the lack of competing residency programs. But, without those competing programs, you can lose important specialty training you would otherwise receive. In an opposed, academic-based program, you often have a greater opportunity to receive specialty training. However, residents can be “squeezed out” of caring for patients that they would otherwise be able to care for in a community-based program.
Why force yourself to decide? This residency is a fusion – the best of both worlds. We split our time between a large, tertiary care medical center (Medical University of South Carolina - MUSC), and our home – Trident Medical Center, a 360 bed, community hospital. At MUSC we spend months working as pediatric residents at the MUSC Children’s Hospital; admitting more than 300 pediatric patients a year! We also spend months working as MUSC OB residents, receiving specialized OB training from other OB residents and attendings.
At Trident, we are the only residency program at Trident Medical Center, so we admit EVERYTHING. We see patients with a wide range of issues – from Acute Coronary Syndrome to Lupus Meningitis. When a patient is admitted to our service, consultants may see the patient, but they never leave our care. Because Trident is a community hospital, the consultants we see are community physicians – not other residents. Once you finish this training, you do not have to spend time adjusting to life outside of residency, because this residency program is set in an environment exactly like that “life outside of residency.”

Adaptable, specialized training
I have a special interest within Family Practice – I would like to be an attending physician one day. This program supports those special interests. The program has created tracks, which offer specialized education for people with special interests. The original tracks are faculty development, sports medicine, and hospitalist medicine. Don’t find what you’re interested in? Since starting this system several years ago residents and faculty have designed their own tracks – such as Women’s Health and Care of the Underserved. If you can picture it, you can do it.

Focus on the future of Family Practice
Let’s face it, Family Medicine is changing. You need a residency program that will keep you current. This residency program does this in innumerable ways – I’ll highlight two: Electronic Medical Records (EMR) and Continuous Quality Improvement (CQI) Research.
When most programs were still (and many still are) using computers only to play Pong, this residency program was using an EMR. For 30 years, the program has been using an EMR for all office visits. Both hospitals are already using EMRs for laboratory and radiographic data, and will soon be completely electronic. If you’re looking for experience using EMRs, we are your program.
Sooner or later, all family medicine practitioners will be doing CQI in order to maintain their licenses. With pay-for-performance looming on the horizon as well, not getting trained in CQI will hurt you in the real world. As a mandatory part of this residency program, each resident must participate in CQI research. But it does not end there. The program encourages publishing and presenting this research with not just words, but also with rewards. If you present your research at a conference, your flight, hotel room, and food is covered by the program. This past year (2006-7), 4 residents went to STFM in Chicago and 2 went to NAPCRG in Arizona.

Diverse Patient Population
Finally, rock stars would be nothing without their fans; we would be nothing without our patients. Located where we are – on the edge of a large, ethnically diverse and young city – we see an amazing population mix of rural and urban, rich and poor, old and young, and ethnically diverse. Since we care for such a broad spectrum of patients, we see the broadest spectrum of problems. One of the keys to residency training is maximizing exposure to as many disease processes as possible while in training. This residency program provides this experience.

I believe what makes us different makes us special. The fusion of community and academic programs gives us just enough exposure to specialty training in all the areas we need, without sacrificing the autonomy that every family medicine doctor craves. This program offers exposure to an amazingly diverse population and problems. The ability to get a well rounded education, but also an individualized education through the track program will give you the tools you want to have when you leave. And when you leave, because of the future-focused training you received, you will be ready for what the world throws at you.