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Educational Program

 Curriculum Philosophy | Longitudinal Threads | Rotations | Areas of Emphasis | Elective Time

Curriculum Philosophy

The focus of the curriculum is to allow the graduate the potential to practice the full range of family medicine, including obstetrics should they so choose. This is accomplished through a combination of longitudinal threads and block rotations. Evaluation and feedback are given on a regular basis through a variety of means. Our First Year offers an emphasis on hospital care, our second year offers a mix and our third year is more focused on ambulatory training. Throughout is the FMC with the following longitudinal threads.

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Longitudinal Threads

Longitudinal activities in the Family Medicine Center are focused on ambulatory care of the patients.

Procedures that the resident learns in the FMC include:

  • Anoscopy
  • Arthrocentesis (large and small joint)
  • Biopsy of skin lesions
  • Casting of simple, non-displaced fractureFamily Medicine at USACW 1 400.jpg
  • Cryo/chemical destruction of benign lesions
  • Endometrial biopsy
  • Excision of ingrown toenail
  • Excision of benign lesions
  • Fluorescein exam of eye
  • I&D of abscess
  • Trigger point injection
  • Limited obstetrical ultrasound

The chronic conditions emphasized in the practice include:

  • Diabetes mellitus
  • Hypertension
  • Hyperlipidemia with risk factors
  • Asthma/COPD
  • Congestive heart failure
  • Attention deficit disorder
  • Major depression
  • Coronary artery disease

We also offer in depth experience in Geriatrics including lectures on common geriatric conditions and care of geriatric patients in the office, long term care, and home setting.

In the longitudinal Community Medicine training we emphasize population based medicine, knowledge and use of community resources, delivery of preventive services, occupational medicine, migrant worker health, and care of battered and abused women.

The Behavioral Medicine curriculum encompasses the principles of professionalism and exceptional communication as well as the traditional counseling training.

With regards to Medical Informatics the learner is assessed on entry into the program. Upon completion you will obtain clinical information from the internet, give a presentation using slides, use a word processor, and obtain information using a hand-held device.

We also offer in depth training in Practice Management.

 Geriatrics:

Our curriculum is one of longitudinal training throughout the second two years of training as well as a month block rotation in the 2nd year. Instruction includes lectures on common geriatric conditions, care of geriatric patients in the office, long term care, and home setting.

Community Medicine:

Our longitudinal training in community medicine begins in the first month of the internship and carries on throughout the three years. Emphasis is on population based medicine, knowledge and use of community resources, delivery of preventive services, occupational medicine, migrant worker health, and care of battered and abused women. Settings are in the FPC and in various community sites.

Behavioral Medicine:

Our behavioral medicine curriculum encompasses the principles of professionalism and exceptional communication as well as the traditional counseling training. Learners are observed by our behavioral medicine faculty and participate in co-counseling sessions. They also observe group counseling sessions and learn how to run group office visits for chronic disease management. This is all done in the FMC.

Medical Informatics:

The learner is assessed on entry into the program. Upon completion, the learner will be able to obtain clinical information from the internet, give a presentation using slides, use a word processor, and obtain information using a hand-held device.

Practice Management:

The resident will learn the necessary business, accounting, employment, and insurance principles necessary to enter into a variety of practice settings upon completion of training. Effective billing and the use of computer-based aids will be stressed. This material is taught in a longitudinal fashion over all three years.

Scholarly Activity:

The resident will learn the basic principles of medical research, including how research is conducted, evaluated, explained to patients, and applied to patient care. Training will include basic biostatistics and the interpretation of medical journal articles. This will culminate in the completion of a research project and the delivery a scholarly presentation during the third year.

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Rotations

First Year

The first year is a traditional internship with rotating clinical blocks focusing on the hospital experience. The FMC experience is 1-2 sessions per week. Unique aspects include a 1 month orientation which includes lecture sessions on common problems and procedure workshops, as well as an intensive clinical experience. The complete schedule is as follows:

Orientation - 1 month
Family Medicine Inpatient Service - 2 months
Internal Medicine Inpatient Service - 1 month
Pediatrics Inpatient Service - 2 months
OB - Labor & Delivery - 1 month
Emergency Room (Medical Center) - 1 month
General Surgery service - 1 month
Newborn Nursery - 1 month
Emergency Room (Children's and Women's Hospital) - 1 month
Community Medicine - 1 month
Intensive Care Unit - 1 month

Second Year

The second year is a transition year from an emphasis on the care of the hospitalized patient to the care of the patient in the setting most appropriate for the patient. Included are rotations in both inpatient and outpatient settings, community hospitals, and the outpatient experience is increased to 2 sessions per week. The FPS rotation emphasizes the total care of the patient in all settings, with management from pre-hospital through discharge. The complete schedule is as follows:

Family Medicine Inpatient service - 3 months
Geriatrics - 1 month
Cardiology consults - 1 month
GYN - 1 month
Population Health - 1 month
OB - Labor and Delivery - 1 month
Orthopedics/Sports Medicine - 1 month
Rural outpatient medicine - 1 month
ICU - 1 month
Community Medicine - 1 month

Third Year

The third year resident's time is focused in the FPC. This is accomplished with a 50 - 50 split on periods designated for Medical emphasis and Surgical emphasis. During the FPC Intensive months the time will be assigned 70% to the practice. During the Ward and Elective Intensive months the time will be assigned 30% to the practice. The resident may use these elective months for Away electives.

FPC Intensive - 2 months
Elective Intensive - 3 months
Medicine Emphasis - 3 months
Surgery Emphasis - 3 months
Hospital Emphasis - 1 months

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Areas of Emphasis

Medicine Emphasis

The medicine experience in the third year allows structured time for exposure to the subspecialties of medicine. This structured time complements the learning which has taken place in the office and ambulatory settings and allows further instruction leading to mastery of the management of the patient with certain chronic conditions. The time is shared with USA FM (50%) and elective time (20%). Emphases include:

  • endocrinological problems
  • pulmonary problems
  • gastrointestinal problems
  • allergy/immunology problems
  • rheumatological problems
  • nephrologic problems
  • neurology problems
  • geriatrics

Surgical Emphasis

The surgery experience in the third year allows structured time for exposure to the subspecialties of surgery. This structured time complements the learning which has taken place in the office and ambulatory settings and allows further instruction leading to mastery of the management of the patient with certain surgical conditions. The time is shared with USA FM (50%) and elective time (30%). Emphases include:

  • ophthalmologic problems
  • ENT problems
  • urologic problems
  • vascular problems

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Elective Time

The resident will have up to 170 elective sessions. The purpose of the elective time is to either round out the learner's experience or to allow the learner to achieve mastery of a certain technique or difficult concept.

Opportunities available are as follows:

Mastery - Completion of these electives will result in a special notation on the resident's final evaluation identifying the additional effort and documenting the specific achievements of the learner.

  • Obstetrics
  • Vasectomy
  • Exercise Stress Testing

Other potential areas for mastery that require the learner to identify a faculty mentor and develop (with guidance) a course of study include:

  • Allergy/Immunology
  • Community Medicine
  • Sports Medicine
  • Faculty Development
  • Research
  • Rural Medicine
  • Endoscopy
  • Enhancement of Clinical Skills
  • Enhancement of Non-Clinical Skills:
  • Computers
  • Practice Management
  • Board Review
  • Research
  • Professionalism
  • Skin Disorders
  • Radiology
  • Behavioral Medicine
  • Occupational Medicine

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