Emergency Medicine at USCSOMG and GHS: Part 1

I had a wonderful opportunity to sit down with Camiron Pfennig, MD, recently and discuss the progress and future of the Emergency Medicine residency program that will be coming to Greenville Health System (GHS) and the University of South Carolina School of Medicine Greenville (USCSOMG) very soon.

Dr. Pfennig is a board-certified Emergency Medicine physician who will be the Program Director for this new residency program. She completed her medical school and residency training at Indiana University in Indianapolis, and she has always had an interest in teaching both residents and medical students. Immediately after she graduated from residency, she moved to Nashville, Tenn., to work as faculty at Vanderbilt University. There, she first served as the Assistant Clerkship Director, then the Clerkship Director and ultimately the Director of Undergraduate Medical Education for the Department of Emergency Medicine. She also served in many other roles for both medical students and residents during her time at Vanderbilt. We’ve already been lucky enough to see Dr. Pfennig’s enthusiasm for supporting students in her time here in Greenville as she began the “colleges” system for the medical school. (For those of you who aren’t a medical student here, think Harry Potter!)

Maglin: What drew you to Greenville and GHS?

Dr. Pfennig: I was not looking to move. I was not looking for a new job. I loved Vanderbilt, loved Nashville and loved the institution – and serendipitously landed in a fortunate situation when I was out at ACEP* in Seattle in October 2012 and learned through the grapevine that there was this hospital system in Greenville that was transitioning to the academic model and would be creating a department…[I] just kind of put it in the back of my mind. One thing led to another, and the next thing I know, come April 2014, the newly hired chair reached out to me to see if I was interested in speaking about opportunities. In late July 2014, I was offered the Program Director position. Through my mentorship from Dr. Corey Slovis** I decided that this was the best decision for a long-term career plan…to not only be a program director but to start a program from scratch. So, I took the leap of faith, and here we are now.

* Dr. Pfennig is referring to the annual meeting of the American College of Emergency Medicine Physicians. Students interested in Emergency Medicine can also join this organization at a reduced fee.
**Chair of the Emergency Medicine Department at Vanderbilt University Medical Center

M: What makes Greenville a good place to start an Emergency Medicine residency?

DP: The clinical training opportunity at GHS is unbelievable with the high volume and acuity. When you look at the total volume of Greenville Health System, you’re looking at about 360,000 ED visits a year. To put that into comparison, Vanderbilt, an incredible training venue, is about 100,000 (including peds) a year …Greenville Memorial itself is 104,000 ED visits per year, which is just tremendous. And you start to think about other opportunities that we could expand on…MD360, Hillcrest, Greer, North Greenville…also Oconee and Laurens if there were to be a resident interested in rural medicine.

M: How does the acuity to compare to your previous hospitals?

DP: When I sit back and reflect on the sick people in general I see on a shift…there are sicker people that come through this Emergency Department. Compared to Vanderbilt, Vanderbilt sees a lot of very sick patients – very rare cancers, heart transplants, LVADs, things of that nature – but when you talk about the bread and butter, flash-pulmonary-edema-guy who’s not seen a doctor in 30 years and we don’t know why he’s altered, [there] is way more opportunity to expand your differential, procedures and learning environment than I had experienced in my other two places* combined. So, I think we will offer excellent training for our future residents. I’m very excited to go live.

A resident graduating on June 30 walking out of this program will be able to practice anywhere. They will be trained to practice in rural areas or in the most sophisticated academic hospital. They will be trained to practice in the most competitive of academic environments. They will be able to go to stand-alone emergency departments. They’re going to come out with a breadth of experience that I’m not sure anywhere else in the region can really compete with right now.

*Indiana University and Vanderbilt University

M: Where are we in the process of starting the residency now?

DP: The application has been submitted to the ACGME (Accreditation Council for Graduate Medical Education) in its entirety, and we are eagerly awaiting an email… [it] could be any minute that we get told when our formal site visit is with the goal that we will be approved in late April to begin the process of recruiting our first class to start in July 2017.

Now the ACGME has [our application]… and they look at it and send it to the field study team. The field study team has it now, and we are waiting for them to assign us site visitors, which will likely not be Emergency Medicine physicians. They will come out and do a formal site visit. It’s very similar to an LCME (Liaison Committee on Medical Education) visit.*

We’re looking to bring 10 residents in a year to a total of 30. So, we will begin our recruiting now and will begin our interview season in November [2016]. We will plan to open our application season in September, just like any other residency program does, so the time right now will be focused on building the curriculum, critiquing and formatting the evaluations, and bringing everyone together to make sure we’re ready to roll. And also really focusing our energy, this winter going into spring, on preparing our medical students that are here as well as opening up opportunities to visiting students. We will enter VSAS** similar to any other program in April and offer our Acting Internship***, first and foremost to the Greenville students, and then we will open it beyond that to visiting students. We have worked together with Dr. Janse, Dr. Bridges, Dr. Pirrallo and myself in putting together the criteria and plan for VSAS.

*The University of South Carolina School of Medicine Greenville has gone through multiple site visits from the LCME, the accrediting body, since its first class matriculated in 2012.

**VSAS is the application system for third-year students to apply for rotations at other institutions during their fourth year. I did two of these types of rotations, which allowed me to see what Emergency Medicine residencies look like at different programs and to receive fantastic teaching from different faculty.

***An Acting Internship is a rotation completed by fourth-year medical students, usually in the specialty they have chosen to pursue. Here, Dr. Pfennig is referring to an Emergency Medicine rotation that will be offered to fourth-year medical students both here at USCSOMG and also to students from other medical schools who are interested in experiencing the program here.


Maglin Halsey

Maglin Halsey

I’m originally from Knoxville, TN, and found my way to South Carolina four years ago to pursue my undergraduate education at Clemson University. I graduated in May 2012 with a degree in Bioengineering, and I’m thrilled to be spending four more years in this area. I am passionate about USC School of Medicine Greenville’s commitment to community wellness and developing well-rounded doctors. I am excited to share this journey of our charter class with you.

Jean Petrizzo