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St. Elizabeth Family Medicine Residency

Curriculum

PGY-1   |     PGY-2   |     PGY-3   |     Didactics

Program Year #1
 

Principles of Family Medicine: One month.
An introduction to the core principles of Family Medicine, as well as an orientation to the hospital, residency, and specialty. Residents will spend the first month of the PGY1 year working with the Family Medicine faculty, their fellow residents, and the Family Health Center staff. Initial assessment of resident abilities will also be performed, so as to prepare an individualized educational program for each resident.

Family Medicine: Two months.
The resident will gain experience as the junior member of the inpatient care team, with the common responsibilities of a Family Physician as they relate to inpatient medicine. Duties include coordination of care, dealing with patient and hospital telephone calls, and interacting with the many health care team members involved in the care of the hospitalized patient. Emphasis will be on adult patients, but the rotation may include experience with hospitalized children and the care of newborns in the hospital.

Emergency Medicine: One month.
Done under the supervision of Emergency Room attending physicians, the rotation will enable the resident to gain experience in the diagnosis and management of common urgent and emergent medical and surgical disorders. The resident will learn common emergency procedures and initial management of emergencies, as well as appropriate utilization of other medical specialists in the care of the emergency patient.

MICU: One month.
Provide competent care for adults that suffer from critical illnesses requiring admission to the Medical Intensive Care Unit. The resident will learn the indications for admission or transfer in and out of the MICU and be closely involved in patients’ management during their stay with supervision from Critical Care physicians. The resident will gain understanding of the essential roles of both primary care and subspecialty physicians in optimal Critical Care Management.

Inpatient Pediatrics: One month.
The resident will provide competent care for infants, children, and adolescents that suffer from complicated or significant illnesses requiring hospitalization. Emphasis will be placed on the evaluation and management of hospitalized children with the assistance of pediatric hospitalists and pediatric specialists. Currently, this rotation occurs at the Beeghly Campus of Akron Children’s Hospital in Youngstown.

Outpatient Pediatrics: One month.
Provide competent care for infants, children, and adolescents in an ambulatory setting. This is done in the Ambulatory Care Pediatric Center at the St Elizabeth Health Center. Emphasis will be placed on routine well-child care as well as the evaluation and management of acute illnesses and the care of ambulatory chronic conditions.

Internal Medicine: Two months.
The resident will care for adults that suffer from complicated or significant illnesses requiring hospitalization. Emphasis will be placed on the evaluation and management of hospitalized adults with the assistance of internal medicine sub-specialists. This rotation is done with attending faculty from the Department of Internal Medicine residency.

Surgery: One month.
Working with surgery residents and under the supervision of faculty from the Surgery residency, the resident will develop understanding of the diagnosis and management of common surgical problems. The resident will gain experience in pre- and postoperative management, surgical principles, and those surgical techniques likely to be utilized in family medicine.

Obstetrics: Two months.
Provide competent care for pregnant women during the antenatal, peripartum, and postpartum period. Emphasis will be placed on the management of normal pregnancy, labor, and delivery. Obstetricians will directly supervise this rotation.

Community Medicine: Completed longitudinally throughout the PGY1 year, this is designed to complement longitudinal training that occurs throughout the residency. Residents will gain an understanding of Preventative and Occupational Medicine as well as population-based medical care. Emphasis will be on experience in settings outside of the hospital or physician’s office.

Office Hours: The resident will spend on average of two half days a week seeing patients in the Family Health Center.

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Program Year #2
 

Family Medicine: Two months.
Develop experience as a member of the inpatient team. The resident will gain experience with the common responsibilities of a Family Physician as they relate to inpatient medicine, including coordination of care, dealing with patient and hospital telephone calls, and interacting with the many health care team members involved in the care of the hospitalized patient. Emphasis will be on adult patients, but the rotation may include experience with hospitalized children and the care of newborns in the hospital.

Geriatrics: One month.
Under the supervision of a Geriatrician, the resident will provide and assist in the coordinating care for older adults. The resident will develop an understanding of the unique interactions of family, community, and spiritual components important in caring for this population.

Pediatric Emergency Room: One month.
Under the supervision of Pediatric Emergency Room Physicians, the resident will gain experience in the diagnosis and management of common urgent and emergent pediatric medical and surgical disorders. The resident will learn common emergency procedures, initial stabilization of the pediatric patient, and management of pediatric emergencies, as well as appropriate utilization of other medical specialists in the care of the pediatric emergency patient.

Outpatient Pediatrics: One month.
Provide competent care for infants, children, and adolescents in an ambulatory setting. This is done in the Ambulatory Care Pediatric Center at the St Elizabeth Health Center. Emphasis will be placed on routine well-child care as well as the evaluation and management of acute illnesses and the care of ambulatory chronic conditions.

Orthopedics/Sports Medicine: One month.
The resident will gain experience in the diagnosis and management of common musculoskeletal disorders. Sports medicine experiences will include non-orthopedic issues such as the evaluation of fitness for activities and acute injury evaluation and treatment, including rehabilitation. Emphasis will be on conditions likely to be encountered in a typical family practice. The resident will also learn common musculoskeletal procedures.

Family Medicine Preceptorship: One month.
Experience in the “real world” of Family Medicine practice in a community setting. Although the options for supervising physician, location, and style are quite varied, each rotation will include experiences in office management, outpatient care, and balancing responsibilities in the practice of family medicine. There will be opportunities to evaluate scheduling and billing practices, computers in medical practice, and management of office staff and ancillary personnel in the office practice of medicine. Residents will become familiar with the variety of medical conditions encountered in office practice, and their management in a time-efficient manner.

Cardiology: One month.
Working with cardiologists in the community and in the hospital, the resident will learn the diagnosis and management of common cardiac conditions. Emphasis will be on outpatient management, including appropriate indications and procedures for referral.

Emergency Medicine: One month.
Done under the supervision of Emergency Room attending physicians, the rotation will enable the resident to gain experience in the diagnosis and management of common urgent and emergent medical and surgical disorders. The resident will learn common emergency procedures and initial management of emergencies, as well as appropriate utilization of other medical specialists in the care of the emergency patient.

Pulmonary Medicine: One month.
Develop an understanding of the management of respiratory disorders that family physicians are likely to encounter in practice. Although the resident will spend time both in the inpatient and outpatient setting, emphasis will be placed on learning outpatient diagnosis and management.

Surgery (Outpatient): One month.
Attending surgeons will provide instruction in the diagnosis and management of common surgical disorders. The resident will gain competence in evaluation of the outpatient surgical patient, indication and contraindication for a variety of outpatient surgical procedures, and surgical techniques employed in the management of outpatient surgical disorders.

Practice Management: One half day a month.
A longitudinal experience over the second and third years in the areas of running a medical practice, including talks from a variety of experts in the field of business and management.

Office Hours: The resident will spend on average of two half days a week seeing patients in the Family Health Center, but the number of patient encounters will increase.

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Program Year #3
 

Family Medicine: Two months.
Develop experience as a senior member of the inpatient team, including supervision of intern level residents and medical students. The resident will gain experience with the common responsibilities of a Family Physician as they relate to inpatient medicine, including coordination of care, dealing with patient and hospital telephone calls, and interacting with the many health care team members involved in the care of the hospitalized patient. Emphasis will be on adult patients, but the rotation may include experience with hospitalized children and the care of newborns in the hospital.

Gynecology: One month.
The residents will be supervised by an attending Gynecologist in the Ambulatory Care Center at St Elizabeth Heath Center. There, they will learn the appropriate diagnosis and management of common gynecologic issues that present in the outpatient setting. Common in-office gynecologic procedures are also taught.

Dermatology: One month.
Working with an attending Dermatologist, the resident will gain an outpatient perspective on commonly encountered skin conditions. Emphasis is placed on the appropriate evaluation, treatment and referral of patients in a capacity that translates well into primary care.

ENT: Two weeks.
During the required rotation in otolaryngology (ENT), the resident will learn the diagnosis and management of common otolaryngologic conditions. Emphasis will be on outpatient management, including appropriate indications and procedures for referral

Radiology: Two weeks.
The resident will develop basic interpretative skills for common radiographic examinations as well as the ability to recognize the appropriate testing for individual patients and learn the various radiographic and interventional techniques available to assist the family physician in the diagnosis and care of patients.

Urology: Two weeks.
Working with an attending Urologist, the resident will assist in the assessment and treatment of the patient with urologic conditions. Emphasis is placed on appropriate testing and referral in an ambulatory setting.

Ophthalmology: Two weeks.
Emphasis will be on outpatient management, Including appropriate indications and procedures for referral of common ophthalmologic problems seen in the outpatient setting. This rotation is performed under the supervision of attending Ophthalmologists.

Psychiatry: One month.
Under the supervision of licensed mental health professionals, this rotation is an intensive experience with the diagnosis and treatment of common mental health disorders. It is designed to supplement the longitudinal experience in Human Behavior and Mental Health obtained throughout the residency.

Electives: Four months.
Residents may choose from any other medical specialty for one-month rotations. Some of these areas include Gastroenterology, Nephrology, Endocrinology, Hematology, Oncology, Physical Medicine and Rehabilitation. The resident may also create his or her own experience, subject to approval from the Program Director.

Practice Management: One half day a month.
A longitudinal experience over the second and third years in the areas of running a medical practice, including talks from a variety of experts in the field of business and management

Office Hours: The resident will spend on average of three to four half days a week seeing patients in the Family Health Center.


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Didactics and Educational Activities
 

Our formal didactics program provides residents with traditional instruction on a comprehensive collection of Family Medicine topics. Didactics are held weekly on Wednesday mornings in the library of our Family Health Center. Topics are organized within a monthly theme that addresses one of the many facets of our specialty, and this monthly schedule repeats every eighteen months. Current faculty as well as primary care physicians and specialists from our community serve as speakers. Generally, the first Wednesday of each month is dedicated to core Family Medicine topics. During the second week, our PGY-2 and -3 residents attend a practice management series, while PGY-1 residents participate in community medicine training. The third week of the month consists of resident lectures, Morbidity & Mortality conferences, and Journal Club. During the fourth week, we generally attend Pediatrics Grand Rounds and core content lectures, and we then hold board review sessions and Obstetrics chart reviews. Additionally, training time is regularly allocated to common primary care procedures, including casting and splinting, tympanometry, joint injection and arthrocentesis, spirometry, and circumcision.

Our Wednesday morning didactics are supplemented by several other standard educational activities. We have Graduate Medical Education Grand Rounds regularly and Joint Primary Care Grand Rounds on a monthly basis, usually addressing new medical or surgical innovations or a topic of recent research. During our daily Morning Report sessions, the residents rotating with our inpatient service provide a brief topic of discussion or clinical “pearls”, and Friday Morning Report sessions are dedicated to EKG readings and instruction as a group. On a monthly basis, the residents collectively read several articles from the AFP Journal and then complete a quiz and discussion on important learning points. Further, our rotation curricula outline pertinent readings to enhance the residents’ rotation experiences and knowledge.

Overall, our didactics program and educational activities are an effective complement to each resident’s knowledge base and individual studying efforts. Additionally, our weekly Wednesday morning format provides an excellent opportunity for the residents to come together as a group for discussion, support, and camaraderie.


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