We are excited that you are looking at our new MAHEC Internal Medicine Residency Program as a potential site for your future training.
Mountain Area Health Education Center (MAHEC) has a long history of excellence in graduate medical education training and we are thrilled to join their family of residency programs. We will build on the longstanding successes by working with the MAHEC organization, our talented faculty, our engaged community and our residents to build one of the most unique internal medicine training programs in the nation. Our goal is to train the well-rounded internist in a supportive yet challenging environment in which one develops not only as a physician but as a leader and teacher in our community.
Our very experienced leadership team consists of physician educators with track records in medical education innovation. Our forward-thinking curriculum balances optimal training in the largest Area Health Education Center in North Carolina with training in a busy, tertiary care, state-of-the-art hospital system. In these and other settings we are able to emphasize training in the delivery of rural care, the reduction of health disparities, the care of the older patient, community-based care and the care of special populations such as patients with substance use disorders. We also provide training experiences in all specialties of internal medicine through our fantastic partnership with Mission Hospital, where our residents will care for patients on medicine services, ICUs, cardiology services, specialty consultation services and in the emergency department. Unique rural-based rotations, public health opportunities, and scholarship experiences provide additional learner-centered, mission-focused training experiences. These skills are practiced and reinforced in our core seminars, which take place in our large, state-of-the-art simulation center in our weekly academic half day.
One of the core values of our program is service to community. We are committed to responding to the needs of our community and the region in which we live. Residents and faculty teach and learn together in a collaborative learning community, all with the aim of providing improved care of the population we serve. The curriculum includes experiences that put you in the heart of the communities of Western North Carolina as well as opportunities to play a role in the reduction of health care disparities in the region. We expect our trainees to lead and teach in our community.
We created a program that will challenge you to become your best self as an internist over three years of training. We also focused on creating a supportive environment that fosters your development and allows flexibility so that you succeed in your personal and professional goals. The schedules and curricula are designed to provide you with the training that you need AND to ensure that you have time to focus on your wellbeing and your personal interests. We incorporated specific resilience training, reflection opportunities, and wellbeing experiences. You are a valued colleague; we will grow together as we learn how to balance professional commitment and personal growth.
It's an honor that you are considering training with us, and we're excited to meet you. Come and explore the education we offer, the values we share, and how we can help you develop into the physician leader of the future.
MAHEC is committed to creating an equitable and inclusive place to work, learn, and receive care. We actively recruit physicians, staff, and students from underrepresented minorities, and we strive to implement policies and procedures that value and support diverse backgrounds and experiences. MAHEC does not discriminate on the basis of socioeconomic status, race, ethnicity, sexual orientation, gender identity or expression, spiritual practice, geography, disability, or age.
Our Internal Medicine Residency Program aims to train and educate diverse, well-rounded, competent, caring, compassionate physician leaders who:
Our program is designed in a competency-based advancement structure. Individuals are continuously observed, assessed and provided with feedback in all experiences. Goal-setting is based on Internal Medicine milestones. Once an individual achieves competency in a goal, they set new goals and are advanced in their level of responsibility. As such, we use a competency-based language to define stages of development rather than a time-based language. Our learners move through phases of development - from Learner (PGY1 year) to Manager (usually end of PGY1 year into PGY2 year) to Teacher/Leader (usually mid PGY2 year to end of training). The stages are defined below.
Learner - In the learner phase of training, an individual works under close supervision and coaching to achieve basic milestones in Internal Medicine. We use a deliberate practice model in which learners set milestone based goals, work to develop knowledge, skills and attitudes with direct observation and feedback from faculty, seniors and team members, and then based on feedback, set new goals. Supervisors are trained in "supervised autonomy" as a principle so that learners are not "directed" but coached to grow.
Manager - Once a learner reaches competency in all learner-level milestones, they advance to the manager phase of training. In this phase, one works to establish independence in the management of common Internal Medicine ambulatory and inpatient patient presentations. Our managers do not supervise learners, nor are they supervised by upper level residents. They work collaboratively on manager-level rotations with attending physicians to establish competence. Residents consider this the most challenging and most rewarding phase of training as they truly grow into clinical independence in this phase.
Teacher/Leader - Once a manager is considered independent in managing most common medical conditions, they advance to the teacher/leader phase of training. In this phase, they continue to gain the necessary experience over time in managing many medical conditions and they work on teaching and leadership skills. Their milestones during this phase are worded as phrases such as "can teach others...", "leads a healthcare team", "coordinates care across...", "role models for others...". It is in this level of training that our residents lead teams on the wards, in the ICUs, specialize in consultative care and serve in advanced roles in the ambulatory practice setting.
Our unique tandem block schedule was designed by residents and studied in an Internal Medicine residency. The schedule was created with the following goals in mind:
The tandem block schedule pairs four-week direct patient care inpatient experiences (wards/icu/specialty services - designated as "I" in schematic below) with other experiences (ambulatory, consults, research, electives - designated as A) in an alternating eight-week block schedule. The "A" designation indicates that the resident has continuity clinic three ½ days per week during that rotation. The residents are partnered together in practice partnerships so that one of the partners is always in clinic that week and manages outpatient responsibilities for the patient panels during that time. Residents do not have clinic during "I" blocks.
The schematic below represents two residents’ schedules for the first 16 weeks of a year. Each column is two weeks. John and Stacey are clinic partners. They are in clinic 3 ½ days per week on A blocks.
|Block Number (each block is two weeks)|
|John||ICU (I)||Pulm (A)||ICU (I)||Pulm (A)||Wards (I)||Amb (A)||Wards (I)||Amb (A)|
|Stacey||Geri (A)||Wards (I)||Geri (A)||Wards (I)||Amb (A)||Cards (I)||Amb (A)||Cards (I)|
|General Internal Medicine||12 weeks||8 weeks||8 weeks|
|Cardiology||4 weeks (floor)||4 weeks (ICU)|
|General Medicine Consultation/Co-Management||4 weeks|
|ICU||4 weeks||4 weeks (includes nights)||4 weeks (includes nights)|
|Night Medicine||2 weeks||4 weeks||4 weeks|
|Emergency Medicine||4 weeks|
|TOTAL INPATIENT TIME||22 plus EM||24||20|
|Ambulatory Block||4 weeks|
|Rural Health||2 weeks||4 weeks|
|Infectious Diseases||2 weeks||2 weeks|
|Hematology/Oncology||2 weeks||2 weeks|
|Palliative Care||2 weeks|
|Sports Medicine||2 weeks|
|Pulmonary/Sleep Medicine||4 weeks|
|Dogwood Health Trust||4 weeks|
|Scholarship||4 weeks||4 weeks|
|Elective||4 weeks||6 weeks||8 weeks|
|TOTAL TIME||52 weeks||52 weeks||52 weeks|
*vacation taken from elective or specialty experience time (two weeks per year in pgy1, pgy2; three weeks per year in pgy3)
Mountain Area Health Education Center (MAHEC) was established in 1974 and serves a 16-county region in Western North Carolina. MAHEC is the largest Area Health Education Center in North Carolina and evolved to address national and state concerns with the supply, retention, and quality of healthcare professionals. MAHEC’s approach to caring for patients is based on an advanced care team model. MAHEC's Biltmore campus houses residency training programs in family medicine, internal medicine, obstetrics and gynecology, general surgery, pharmacy, and dentistry. The brand new internal medicine residency clinic is housed in the MAHEC Family Health Center building and includes 42 exam rooms, laboratory and radiology facilities, large spaces for precepting and teaching, a group visit space, and a resident workroom. The space has been designed to support a collaborative care model which includes behavioral health and pharmacy services.
MAHEC's Biltmore campus is also home to UNC Health Sciences at MAHEC, an academic health center in partnership with UNC-Chapel Hill that includes programs from the UNC School of Medicine, UNC Gillings School of Global Public Health, and UNC Eshelman School of Pharmacy.
Mission Hospital is a part of the Mission Health system and a regional referral center for tertiary and quaternary care for 16 counties in Western North Carolina and parts of Tennessee, South Carolina, West Virginia, and Virginia. Mission Hospital in Asheville is an 815-bed hospital, featuring state-of-the-art facilities and offering care in all internal medicine specialties. The complex includes a brand new, 630,000 square-foot North Tower housing a 220-bed acute and critical care facility. The emergency department at Mission averages over 95,000 patient visits per year. The medical staff comprises approximately 650 physicians, with nearly all subspecialties available.
Business North Carolina ranked Mission Hospital the #1 “Best Hospital” in North Carolina for 2017 and 2018, and Mission Hospital ranked among the top 1% of “Best Hospitals” nationally in 2016 by Healthgrades. Internal Medicine residents spend over 40% of their training at Mission Hospital, rotating on general internal medicine services, neurology, cardiology, critical care units, cardiology critical care units, and in the emergency department and on consultation experiences with all internal medicine specialties. Residents also rotate with a variety of Mission-affiliated specialty practices in Asheville.
The Charles George VA Medical Center is a Joint Commission-accredited, tertiary referral, 1C facility that provides a full spectrum of health services to Veterans residing in a 23-county area of Western North Carolina. The medical center has 119 authorized acute care beds (including a 16-bed inpatient psychiatric unit), two state-of-the-art ICUs, 120 authorized community living center (CLC) beds, and 18 beds authorized for a substance use residential rehabilitation treatment program. The medical center also operates community-based outpatient clinics (CBOCs) in Franklin, Rutherford County, and Hickory, NC.
Cherokee Indian Hospital Authority (CIHA) blends state-of-the-art healthcare within a system of inpatient and outpatient resources across the Qualla Boundary and its outlying clinics. It is a unique educational experience in health systems as the health system is tribal owned and in a rural setting. Residents will rotate 4 weeks during their PGY2 year in both the ambulatory and inpatient settings serving a wide variety of patients and disease states in Cherokee County. Clinical experiences will include inpatient care in a 16-bed hospital unit, ED care, primary care clinics, specialty clinics and addiction medicine experiences. Residents will also engage in a structured curriculum in cultural humility during this rotation. The site director has an extensive history of experience with education and enjoys innovative teaching methods.
Internal medicine residents rotate at a variety of rural health sites in Western North Carolina over their three years of training, including both ambulatory and inpatient experiences. In addition, electives are offered at the University of North Carolina Hospitals System and at a variety of other sites in and around Asheville, NC.
We will proceed in the 2022-23 match season in alignment with the AAIM Recommendations for the 2022-2023 Internal Medicine Residency Interview Season. All applications will be reviewed based on holistic review principles and practices as outlined by the AAMC. We follow the framework outlined by the AAMC to resident selection at multiple steps in our recruiting process. All faculty members and staff are trained in implicit bias, specifically as it pertains to assessment of applicants; our process is designed to incorporate principles of mitigating bias.
We will start our review process on September 28th and will release invites in four different waves. Our first wave of invites will be released on October 7th. The second wave of invites will be released on October 14th. A third wave will be released on November 15th . A final wave of invites will be released on December 15th. All applicants whose application is submitted by October 1st will be notified by October 17th of their status – invited, under review, or declined. All applicants under review will have a final status identified by December 15th. We will not be offering on-site visits.
All applicants that accept an interview invite within 48 hours will be guaranteed an interview slot.
All interviews for the 2022-23 season will be conducted virtually. Our half-day interview will include the following activities:
Interview dates for the 2022-23 season are listed below.
Residents who complete the MAHEC Internal Medicine Residency are eligible to pursue board certification in internal medicine through the American Board of Internal Medicine. Please visit ABIM for certification requirements.
The Graduate Medical Education (GME) programs will select from among eligible applicants on the basis of residency program-related criteria such as their preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation and integrity.
An applicant must meet or exceed the following minimum qualification(s) to be eligible for selection and appointment to MAHEC’s GME residency programs:
Special laws and regulations apply to international medical graduates who wish to enter the United States to undertake graduate medical education. MAHEC's policies and procedures regarding graduates of international medical schools comply with federal and state laws and regulations and MAHEC's commitment to graduate medical education.
Graduates of medical schools outside the United States and Canada must have a currently valid certificate from ECFMG. Applicants must successfully pass both Step 1 (basic medical) and Step 2 (clinical knowledge and skills) of the United States Medical Licensing Examination (USMLE).
While MAHEC does not sponsor a visa, the international medical graduate applicant must also possess a current/valid visa option or other status governed by the U.S. Immigration Regulations to participate in a GME program.
Finally, the North Carolina Medical Board requires that physicians who are graduates of schools that are not accredited by the LCME or the AOA (foreign medical schools) must be individually certified by ECFMG, have successfully completed at least three years of accredited graduate medical training, and have passed the USMLE or its equivalent to be eligible for application for full licensure. An international medical graduate must complete all other application requirements required by MAHEC and the GME program.