Inpatient Experience
Our inpatient rotations cover four general medicine services, two ICU services, one consult and procedure service, and seven subspecialty services across our three clinical sites. Through our bedside rounding strategy that includes bedside nurses, pharmacists, care managers, physicians and students, we support a collaborative team-based approach to patient care, increase rounding efficiency and more actively engage patients in decisions about their healthcare.
Our ward structure at UNC is unique because each service is organized by subspecialty. Subspecialists, along with general internal medicine physicians, attend the wards. While subspecialty services also care for general medicine patients, the majority of patients on these services have diseases relevant to that discipline. Our residents learn directly from experts in the subspecialty fields, which leads to mastery in that organ system. We feel this is the most effective way to learn medicine and engenders relationships with established faculty to promote career development.
The nephrology service cares for renal disease of all types with management including renal transplant, ESRD, ANCA vasculitis, lupus nephritis, nephrotic syndromes and acute renal failure.
The infectious diseases team cares for patients with HIV, endocarditis, osteomyelitis, tuberculosis, and infections in immunocompromised hosts, among other diagnoses. Owing to our status as a referral center, we routinely care for patients with manifestations of AIDS and unusual infections.
The geriatrics service is based at UNC Hillsborough and focuses on issues related directly to care of the elderly including syncope, dementia, delirium, infections in the elderly, medication de-escalation, and optimization of end-of-life care.
These services offered both at the UNC Main Campus and WakeMed care for patients with any disease pathology, but a particular focus on patients with end-stage liver disease, GI bleeds, and new diagnoses of malignancy.
This service cares for any malignant hematologic disease, predominantly leukemia and lymphoma. Residents routinely manage oncologic emergencies including blast crisis, differentiation syndrome, and neutropenic fever.
This service focuses on the complications of solid organ malignancy including neutropenic fever, uncontrolled pain, pleural effusions, ascites, chemotherapy side effects and end-of-life care.
Our two cardiology services offer care for a diverse range of cardiac pathology including management of acute coronary syndromes, advanced heart failure, arrhythmias, and valvular diseases.
The Cardiac Intensive Care Unit works closely with Cardiology fellows and critically care trained faculty to care for end stage heart failure patients, those awaiting heart transplant, patients requiring assist devices such as Impellas and LVADs, those with unstable arrhythmias, post-arrest patients, and more.
The Medical ICU rotation is consistently one of the most highly rated rotations among residents. Residents learn as part of a large interdisciplinary team how to manage critically ill patients including ventilator management, procedural skills, end-of-life care, and the fundamentals of critical care.
This service functions as both an inpatient service and an elective service. On this rotation, residents will work with specially trained procedural attendings to help perform procedures for patients on our other inpatient teams including CVC placement, thoracentesis, paracentesis, lumbar punctures, and joint aspiration for medicine and non-medicine services. They will also be exposed to running a consult service, working alongside many of our surgical and non-medical colleagues to offer guidance regarding perioperative medicine and medical management of patients not on a medicine service. The goals of the service are to teach consultative medicine and to learn procedures under supervision of a skilled attending.