Internal Medicine

 

Dear Applicant,

I want to take this opportunity to thank you for your interest in the Internal Medicine Residency Program at UTMB. I did not know much about the IM Residency Program until I was asked to consider coming as the new Program Director in 2008. I had worked at Baylor College of Medicine in Houston for almost 20 years. I had directed the Gastroenterology/Hepatology Fellowship Program at Baylor and was a General Internal Medicine Attending on the wards of the Ben Taub General Hospital. For years my wife, five children, and I had enjoyed day trips to Galveston for fishing, surfing, birding, boating, eating, and other attractive aspects of the Island's scenery and culture. Also, one of my sons was a UTMB medical student from 2001-5. But I really didn't know much about the IM program at UTMB until I walked the halls of the John Sealy Hospital, talked to residents, fellows, and faculty in the Department of Medicine, AND went to an Astros game with Dr. Urban, the Chairman of the Department. I did this (and more) for about 4 months and I began to be inspired by a vision of a new way to use my internal medicine training and experience. In August of 2008 I told Dr. Urban that I would be honored to direct the residency program.

Hurricane Ike occurred a few weeks later and that storm turned the life of everyone connected to UTMB into a new adventure. My first duty as the new Program Director was to oversee our 105 Internal Medicine residents who had been placed in alternative training sites throughout Texas. Our residency leadership was able to demonstrate our strong commitment to residents' well-being and education by making sure none of them fell behind in their training schedule. Over the next few months State and Federal funds, plus a strong endorsement by local and State government, secured UTMB's future. Even the most recent Texas legislative session was good news for UTMB. It approved millions of dollars for the proposed new medical surgical hospital. The Department of Medicine used the chaos of Ike as an opportunity to expand many of its clinical services to the mainland. UTMB now has over 80 clinical practice facilities at 51 locations south and east of Houston. Research in the Department was bolstered by a 24 million dollar NIH-funded Clinical and Translational Research Award. The FEMA money from the storm continues to enable massive renovation of facilities and equipment that benefits the whole UTMB complex. The last 18 months have shown some of the highest clinical and research revenues and productivity in decades. In many ways the storm helped UTMB, the Department of Medicine, and our IM residency launch in a new direction which has taken us to a place that was only a dream before.

I have had many "new" challenges and experiences in my life: lived in the Caribbean studying schistosomiasis, led a Department of Internal Medicine at one of Africa's great medical schools, watched and wrote about the HIV epidemic in Africa, promoted indigent care in Houston at the Ben Taub Hospital, and learned advanced gastrointestinal endoscopy and endoscopic ultrasound. All of these have been great challenges that yielded great benefits. I have enjoyed being with the UTMB IM Residency in a "new" phase. When you come to interview at UTMB you will see and hear about these exciting new developments in the Internal Medicine Residency: the way we benefit from and support the Department of Medicine's 5-year strategic focus (Chronic Diseases, Quality and Outcomes Research, and Global Health); a renewed culture of quality, safety, and cost effectiveness supported throughout our patient care enterprise and residency curriculum; the display of scholarly activity by residents at our Annual Residency Quality and Research Symposium; expansion of resident continuity clinics into the Victory Lakes Town Center on the Mainland; a Global Health Program that supports and promotes international clinical rotations in Kenya and Peru with the option of pursuing certification examination in geographic and travel medicine; multiple residency tracts that allow residents to focus on research, chronic disease, global health, preventive medicine, aerospace medicine, or preparation for an academic career; opportunities to integrate an MMS or MPH degree into residency training; the special training and research options offered by the Sealy Center on Aging and the stark Diabetes Center; UTMB's partnership with Harvard, Yale, Dartmouth, Brown, Maryland, Virginia, and others in the US-Funded Rwanda Health Consortium; the IM Residency and the Pulmonary/Critical Care faculty partnership will develop a comprehensive method of procedural teaching and credentialing using simulation.

UTMB, Texas' first medical school, has a long tradition of educational excellence, a close bond between faculty, residents, and students, and outstanding teaching and learning facilities. This strong history is now on a trajectory of exceeding excellence. We have 68 Categorical IM Residents, 5 Combined IM/Preventive Medicine and IM/Aerospace Medicine, and 13 Preliminary Residents. During our most recent ACGME review, the IM Residency received a three year full accreditation with special commendation for its recovery after Ike and for its innovative and comprehensive 6-monthly evaluation and feedback system. Approximately 80 clinical faculty from the 11 Divisions of the Department of Medicine supervise and teach residents. The on-campus training hospitals (450 beds) offer a diversity of patients. The John Sealy Hospital is an advanced University owned and operated hospital that serves a cross-section of Texans. The Texas Department of Corrections Hospital serves a unique population of prison inmates with a wide array of diseases with advanced pathology and unusual manifestations. The subspecialty Divisions provide consultation for inpatients and outpatients and subspecialty rotations for residents with in-depth learning opportunities. All 11 fellowship programs are fully accredited and have robust clinical, educational, and research activities. Committed subspecialty faculty with resources and expertise in clinical research are available to the residents who want to participate in investigative or disseminative scholarly activity. Many residents use locally supported scholarly activity to support their application for subspecialty fellowships and/or full-time academic careers.

My vision for the internal medicine program is uncomplicated and straightforward. I am committed to fostering a safe learning climate focused on competence and excellence in Internal Medicine. The vision for our Program centers on these core values:

• The education and patient care systems maximize learning and promote patient safety.
• The diversity and severity of illness of patients promotes educational breadth and depth.
• Well-trained and enthusiastic hospital-based faculty provide competency-based teaching and assessment on the inpatient services.
• Master clinicians interact with residents on consultation and specialty inpatient and outpatient rotations.
• Resident-staffed outpatient clinics function as a model "medical home" for Galveston county residents.
• Resident-centered support services make this large program feel small and personal.

I look forward to illustrating how these values are already actualized in established policies and programs here at UTMB. Rich old traditions are being combined with fresh ideas to make this a wonderful place to learn our specialty. This is a challenging and rewarding journey for me. I am excited about the opportunity to meet you and invite some of you to be a part of this wonderful place to learn Internal Medicine. Please do not hesitate to contact me or our residency office if you have any questions as you plan your visit.

Sincerely,
Richard Goodgame, MD
Professor of Medicine
Program Director, Internal Medicine Residency Program
University of Texas Medical Branch