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BRISTOL FAMILY MEDICINE

The Bristol Family Medicine Residency Program has a resident complement of 24 and a family physician faculty of six. The residents are based at the Wellmont Bristol Regional Medical Center, a 348-bed, modern, acute-care-facility which is a fully accredited, nonprofit institution. It is the only hospital in town and the largest serving Southwest Virginia. Family Medicine has the only residency based in Bristol, and consequently, the residents experience a wide variety of pathology and assume considerable responsibility. The training program is designed to prepare physicians to practice in a variety of settings which it has been doing successfully since 1976.

The Family Medicine Center, completed in the spring of 1999, is a spacious facility that houses outpatient and educational activities as well as faculty and resident offices.

A community of 45,000 inhabitants, Bristol is located on the Tennessee-Virginia border nestled between the Blue Ridge Mountains and the Cumberland Plateau. It is home to two colleges, excellent public and private schools, a ballet company, a theater company, and one of the largest city parks in Tennessee.

JOHNSON CITY FAMILY MEDICINE

Established in 1979, the community-based Johnson City Family Medicine Residency Program has a resident complement of 18 with a full-time family physician faculty of six. It is based in a modern, 433 bed community hospital - the Johnson City Medical Center. The residency maintains a 12,000 square foot modern, acute-care practice center. Patients are drawn from the diverse population of the area, from rural farm and mountain folk to corporate executives and university faculty. The goal of the program is to train specialists in the art and science of providing comprehensive, empathetic, and efficient health care to individuals in the context of their families and community while providing a nurturing environment for the personal growth and well-being of each resident.

Johnson City provides a dynamic and energetic community atmosphere with excellent schools, rich social and cultural activities, and a wide variety of recreational opportunities. Notable among the residency’s strengths are its faculty and staff, the presence of unique and innovative curricular elements, and its proximity to the university campus and the College of Medicine.

KINGSPORT FAMILY MEDICINE

Established in 1975, the Kingsport Family Medicine Residency Program boasts a full-time family physician faculty of six with a resident complement of 18. Their 10,000 square-foot facility is conveniently located next to the host hospital - Wellmont Holston Valley Hospital and Medical Center. A 590-bed, progressive community hospital, Holston Valley offers a birthing center, a Level III neonatal intensive care unit, four cardiac catheterization labs and four open-heart operating suites, Level I designated Trauma Center and sophisticated diagnostic and intensive care services. The residents are a diverse and cohesive group from all across the country. The mission of our practice is to create an environment supportive and nurturing of both our patients’ and staff’s well-being. We strive to graduate physician healers who are comfortable integrating multiple approaches and skills in a rapidly changing health care environment.

Kingsport provides a complementary blend of metropolitan life in a tucked away setting. Kingsport has a stable economic base and the school system ranks among the best in the state. Community and civic organizations constantly strive to make Kingsport the Model City. The Kingsport program affords an excellent opportunity for personal as well as professional development.

INTERNAL MEDICINE

The fully accredited Internal Medicine Residency Program offers two separate tracts as part of the training program. The categorical (three-year) track is designed for those individuals interested in the traditional internal medicine training program. It offers a broad range of experience in general internal medicine as well an exposure to all of the sub-specialties of internal medicine. Flexibility in the selection of electives affords the resident the opportunity to direct training toward his/her own personal career goals. Some residents take elective rotations outside the discipline of internal medicine. The preliminary (one-year) track is designed for students planning a career in another discipline that requires a prerequisite year of medicine or for those individuals who are uncertain about their career choices. Residents in the preliminary program may opt to transfer to the categorical or primary care programs. In addition, the department offers accredited fellowship training in cardiology, oncology, infectious disease, pulmonary/critical care medicine and gastroenterology.

All residents and fellows enrolled in any of the above programs rotate at four University-Affiliated Hospitals: James H. Quillen Veterans Affairs Medical Center and Johnson City Medical Center in Johnson City, Wellmont Holston Valley Medical Center in Kingsport, and Wellmont Bristol Regional Medical Center in Bristol. The integration of the four hospitals in the training program provides a balanced mixture of patient population and exposure to a wide range of simple as well as complex multi system diseases. Hospital facilities are state of the art and include cardiac catheterization laboratories with open-heart surgery, cancer treatment centers, and the newest diagnostic imaging equipment including CT scans, isotope scans and magnetic resonance imaging. Additionally, Wellmont Holston Valley Medical Center and Johnson City Medical Center serve as the Level I trauma centers for the region.

The Department of Medicine consists of the Division of General Internal Medicine plus 16 subspecialty divisions that provide a full complement of board-certified sub-specialists and offer a wide range of electives in internal medicine. The Department is fully equipped with laboratory facilities, providing exceptional opportunities for laboratory research to interested residents under subspecialty guidance. In addition, clinical research is strongly encouraged.

The Department is committed in the Division of General Internal Medicine to the appropriate expert training for all residents in the program. Office care facilities are state of the art and offer residents the opportunity to practice medicine in a realistic setting and to perform outpatient procedures such as stress testing, sigmoidoscopy and Holter monitoring.

Educational conferences such as morning report, journal club, grand rounds, morbidity and mortality conference, and subspecialty and general internal medicine lectures are an integrated part to the training. We also have Harrison’s Lectures, which are a curriculum review and board preparation series.

MED/PSYCH PROGRAM

The combined Internal Medicine-Psychiatry Residency Program is a five (5) year program supported and directed by the Departments of Internal Medicine and Psychiatry. The completion of the program will allow participants to be fully board eligible in both Internal Medicine and Psychiatry. This combination offers obvious advantages of interdisciplinary interaction and greater skills for medical specialties in the area of psychological and psychiatric issues as well as a stronger medical expertise for psychiatric patients. Additional flexibility of billing appeals to managed care organizations. Research and administrative opportunities are a few of the potential applications of such combined training. Unlike other programs however, the ETSU combined Med/Psych program is focused on balanced primary care delivery to underserved and rural populations. Many Med/Psych programs are primarily hospital based despite a clear move toward ambulatory care delivery. We have been able to maintain the same level of research opportunities, via an optional research track, as that of other programs. This track exempts residents from clinical duties each week to develop and implement research studies, write up, present and publish findings. Continuity Clinics: As part of the priority placed on primary care delivery, residents will be expected to participate in clinics throughout their training. Both a Psychiatry and Internal Medicine continuity clinic will directly train residents in the importance of continuity as well as integration of patient care over time.

OBSTETRICS AND GYNECOLOGY

The mission of the Obstetrics and Gynecology Residency Program is to enhance the health and welfare of women, especially in the surrounding regions of East Tennessee and Southern Appalachia through: 1) training physicians who apply the art of comprehensive, empathetic, and efficient care for women of all ages; 2) providing comprehensive primary gynecologic and obstetric health care to women from all segments of our communities; and 3) conducting research and scholarship that contribute to the knowledge on which comprehensive primary health care is based.

The program is designed to offer comprehensive training in general obstetrics and gynecology as well as the subspecialties of maternal fetal medicine, gynecologic oncology, adolescent gynecology, Urogynecology, breast disease, and reproductive endocrinology and infertility. Graduates of the program will be well prepared for clinical practice but will also have the skills to proceed in further training and research in academic centers across the nation, if they so desire. This university program has a strong community flavor since residents receive clinical experiences not only at the Johnson City Medical Center (JCMC) but other facilities as well. The Center for Women’s Health at JCMC is an extension of the hospital and indicates the commitment to providing the region with the most advanced care in women’s health and maternity services. Individual on-call rooms for residents are conveniently next to the labor and delivery area. A resident office is located within the Women’s Center to provide an area for study and data collection.

ANATOMIC AND CLINICAL PATHOLOGY

An approved four year training program for residents is available in anatomic and clinical pathology. Training in anatomic pathology includes autopsy and surgical pathology, cytopathology, neuropathology, forensic pathology, and electron microscopy. Training in clinical pathology includes clinical chemistry, blood banking, hematology, and microbiology. Specialized training is available to residents in cytogenetics, fluorescence microscopy, flow cytometry, and toxicology. The educational objectives of the program include the acquisition of fundamental knowledge in anatomic and clinical pathology which will prepare the resident for the general practice of pathology; the progressive development of the diagnostic, interpretive, technical and consultative skills; the development of skills necessary for laboratory management and administration; and the opportunity to gain experience in teaching and research.

PEDIATRICS

The Pediatric Residency Program is designed to offer comprehensive training in general Pediatrics, preparing our graduates to become successful general Pediatricians or providing a solid general Pediatric knowledge base to our graduates who choose to pursue subspecialty training.  The Department of Pediatrics at East Tennessee State University is comprised of faculty members who practice General Pediatrics, Neonatology, Pediatric Intensive Care, Pediatric Surgery and the Pediatric Subspecialties of Adolescent Medicine, Cardiology, Developmental and Behavioral Pediatrics, Gastroenterology, Hematology/Oncology, Nephrology and Pulmonology .  There are 15 resident positions in the Pediatric Residency program.  We serve a diverse patient population ranging in age from newborn through adolescence drawn from four states in this Appalachian region.

All inpatient clinical training is conducted at the Johnson City Medical Center, located next to the medical school campus.  This facility includes a 10 bed Pediatric Intensive Care Unit, a 24 bed general Pediatric Ward and a 36 bed Level III Neonatal Intensive Care Unit.  We are privileged to be able to work in a brand new,  state-of-the-art Regional Children’s Hospital.  The new Niswonger Children’s Hospital includes  dedicated Pediatric Surgical facilities and a Pediatric Emergency Department, as well as an increased beds on the general Pediatric Ward and NICU rooms designed to accommodate long-term stays for entire families. 

Our outpatient General Pediatric Clinic and Pediatric subspecialty clinics are located in the Clinical Education Building across the street from the Johnson City Medical Center.  The outpatient clinic facilities recently underwent a major refurbishment to incorporate more patient care and educational facilities.  The outpatient clinic also houses a clinical laboratory and maintains a phlebotomist on staff who is skilled in working with children.

The Department of Pediatrics also provides training in the evaluation of child abuse through the local Child Advocacy Center. 

There are various research opportunities available to Pediatric residents.  The Department of Pediatrics has among its faculty a full-time PhD dedicated to basic science research and holding multiple NIH grants and a full-time General Pediatrician with an MPH and time dedicated to clinical and educational research projects.  Residents are expected to complete a scholarly activity project during the training period. Several of our residents have presented their work at regional and national meetings in the last year.

The Department of Pediatrics has full responsibility for the education in Pediatrics of the medical students of the James H. Quillen College of Medicine.  The third year Pediatric clerkship is one of the most popular clerkships largely due to the students’ interactions with the Pediatric house staff.  Many opportunities exist for teaching medical students, nursing students and junior house staff.

A wide range of educational conferences are scheduled to augment the Pediatric residents’ formal education.  They include Morning Report, Grand Rounds, Journal Club, Morbidity and Mortality review, board review sessions, ambulatory care conferences, subspecialty lectures, Critical Care and Neonatology lectures and Pediatrics/Psychiatry lecture.  The Department of Pediatrics regularly hosts visiting professors who provide additional educational opportunities for the faculty and residents.  Through the Quillen College of Medicine, the Pediatric residents have regularly scheduled sessions in the Human Patient Simulator lab to practice critical care skills.

The Department of Pediatrics administrative offices are located in Building 1 of the VA Medical campus.  We strive to provide a dynamic environment conducive to scholarly advancement and quality patient care.  We welcome all inquiries into our program and look forward to helping our residents meet their personal goals.


PSYCHIATRY

Residency training in Psychiatry and Behavioral Health Sciences is an accredited four-year program that provides training in a variety of clinical settings, under the supervision of a dedicated faculty. The program is also approved for a five-year combined residency in Psychiatry and Internal Medicine.

The Department of Psychiatry is based at the historic James H. Quillen Veterans Affairs Medical Center (VAMC) at Mountain Home, TN. Inpatient training is provided at VAMC, JCMC and Woodridge Psychiatric Hospital. All inpatient facilities are JCAHO-accredited.

Outpatient training in community psychiatry is provided through the Frontier Health, Inc. network of community mental health facilities, Mountain States Health Alliance EAP Program, Woodridge Hospital Outpatient Clinic, ETSU Counseling Center, and Veterans Affairs Mental Health Outpatient Clinic.

Most of the clinical training sites are located within blocks of the James H. Quillen College of Medicine and the Department of Psychiatry. Other principle training sites are located within easy driving distance through the scenic countryside.

The residency in Psychiatry provides education and training in evidenced-based approaches to the treatment of mental disorders. During the early years of training, residents develop competence in a wide range of therapies. During the latter years, residents are encouraged to pursue, in depth, treatment approaches in which they have special interests.

GENERAL SURGERY

Ten PGY I positions are available each year. Of these, six are categorical and four are preliminary. The Accreditation Council for Graduate Medical Education currently approves a total of 34 surgical residents. Four hospitals are integrated under the general surgery residency program. These are tertiary referral centers for the Northeast Tennessee area and adjacent areas of Virginia, North Carolina, and Kentucky. Surgical support services at Mountain States Health Alliance Johnson City Medical Center are state of the art including a Level I Trauma Center, a 55-bed ICU, hemodialysis unit, cardiothoracic surgery unit, and renal and pancreatic transplant service. Residents are trained in general surgery and do rotations in neurosurgery, vascular surgery, pediatric surgery and transplant surgery. Surgery services at the James H. Quillen Veterans Affairs Medical Center include divisions of vascular surgery, general surgery, urology, otolaryngology-head and neck surgery and thoracic surgery.  Wellmont Holston Valley Medical Center residents are trained in general surgery, vascular surgery, surgical oncology, bariatric surgery, orthopaedic surgery and trauma management, critical care and acute care surgery.  Wellmont Bristol Regional Medical Center provides valuable experience in general, vascular, and cardiothoracic surgery. The Surgery program is a five year clinical program designed to develop a highly skilled general surgeon. The program has been designed to allow the resident to develop technical skills and progressive clinical maturity while receiving conscientious training and supervision from a highly qualified and dedicated surgical staff.

The first two years of the surgical training program are arranged to allow introduction to general surgery as well as ample exposure to surgical specialties.  In addition, the junior house officer will rotate on the Level I trauma service. The program is essentially equivalent for both categorical as well as preliminary residents.

The third and fourth years of the program allow more time in general surgery as well as further involvement in surgical specialties -thoracic and cardiovascular surgery, pediatric surgery, oncology, vascular surgery, and participation as a senior member of the trauma team.

The fifth year is one of chief residency with rotations at the James H. Quillen Veterans Affairs Hospital, Wellmont Holston Valley Medical Center, Wellmont Bristol Regional Hospital and Mountain States Health Alliance Johnson City Medical Center.   Chief residents function as the leaders of the surgical team at their respective hospitals.  Their duties include supervision of all the junior resident rotations at their hospital. They also play a major role in the Level I trauma center and participate in the management of the complicated surgical patients.

Friday afternoons are dedicated to organized educational activities and residents are provided protected time to participate in these conferences.

SURGERY GRAND ROUNDS: Weekly Surgical Grand Rounds are held at Mountain States Health Alliance. Current topics of interest are presented by local faculty or invited lecturers. The Grand Rounds sessions are a forum for active participation by house staff, full-time faculty, and clinical faculty from all four affiliated hospitals.

RESIDENT TEACHING CONFERENCE: The surgical house staff meets weekly for didactic sessions in the basic science curriculum using SCORE from ABS, journal reviews, clinical presentations and ABSITE review topics. Residents attend weekly conferences in vascular surgery and surgical oncology.  There are multiple interdisciplinary conferences that occur weekly at each hospital.

MORBIDITY AND MORTALITY CONFERENCE: A weekly mortality and morbidity conference is held in which house staff and faculty discuss in detail all complications and patient deaths as well as cases performed the previous week at the four hospitals.

SIMULATOR LAB – The residents are given opportunities to participate in the laparoscopic simulator lab on a monthly basis.  This lab contains laparoscopic,  FLS, and endoscopic simulators.

The Research Laboratory: The research laboratory is available for resident participation. It is a requirement of the Department of Surgery for all residents to be involved in some scholarly activity. Although the surgical resident is not required to spend time in the laboratory, they are invited to participate in its many activities.  Residents who desire a career in academic surgery have the opportunity to take time out to do research or fellowships.