family medicine residency program CURRICULUM

A curriculum is much more than a rotation schedule.
Our curriculum is specifically designed to achieve educational goals and objectives that are ACGME competency-based and also reflect the educational values of the faculty and residents. All ACGME competencies are achieved by providing a variety of hands-on and didactic training in diverse settings. While our curriculum is competency-based, we continue our commitment to the personal and professional growth of each resident.  We do not take a “one size fits all” approach to education.  Upon graduation each resident must demonstrate sufficient professional ability to practice competently and independently.

Here are some of the highlights of our curriculum:
Behavioral Science- Interpersonal skills are of primary importance in family medicine.  It is likely that your patients will present you with a wide scope of problems ranging from depression, stress-related illness and marital or sexual difficulties.  In order for you to interact with sensitivity and to identify, evaluate, and initiate treatment for your patients, behavioral science training experiences are integrated into the program's three year curriculum.

A behavioral scientist is available to residents for consultation, co-precepting, and demonstration of therapeutic techniques for use with patients. A monthly Balint group will allow you to confidentially discuss your patients with peers and balint-trained faculty. Monthly core curriculum conferences are also included in didactics.

Videotape review of patient sessions is intended to provide constructive feedback on interviewing, counseling and problem-solving skills, nonverbal physician-patient/family interaction, and the efficiency with which you conduct office visits. Cameras are placed in specially equipped exam rooms.

Women’s Health (Gyn/OB) - The curriculum for obstetrics, gynecology, and preventative women's health care is multifaceted.  It is a longitudinal, rotational, didactic, and community-based curriculum. Residents spend a total of three months during the first year of residency on Obstetrics at Underwood Memorial Hospital and at the Hospital Prenatal Care Program on campus. The Prenatal Care Program averages about 300 deliveries a year. Residents are able to follow patients throughout their prenatal course and deliver them at Underwood-Memorial Hospital’s spacious LDRP unit.  During this time and throughout their training, residents are encouraged to interact with Obstetricians, nurses and other clinical staff in order to develop the skills needed for providing maternity care.

An advanced Obstetrics elective is available during third year for residents interested in further obstetrical training.

During training at the Family Medicine Center, residents learn many office gynecologic procedures such as endometrial biopsy, IUD insertion, implantable contraception, pessary fitting, and colposcopy.  Our residents also provide a high volume of women’s health screening and contraceptive counseling for their continuity patients as well as for women seeking care through the grant-funded Breast and Cervical Cancer screening program (CEED).

Residents also spend one month during their second year Gynecology rotation working with Gynecologic subspecialists in areas such as Urogynecology, Gynecology-Oncology and Fertility to further increase their competency in common Women’s Health issues.

Sports Medicine/Orthopaedics- Common orthopaedic problems and sports injuries are an everyday occurrence in family medicine. Residents will be taught how to evaluate and treat these injuries throughout their residency training. Exposure to sports medicine also occurs during Emergency Room rotations. They will also work with orthopedic surgeons.  Residents will work with faculty who serve as sideline team physicians and perform preparticipation exams on athletes of all ages for area schools in Gloucester County; this provides a longitudinal component to the sports medicine curriculum. Quarterly workshops and lectures on musculoskeletal topics are included in the didactic    component.

Community Medicine- Our commitment to improving the health of the community is maintained by having our faculty and residents provide valuable services.  These services include, but are not limited to performing health screenings for hypertension, prostate cancer, and diabetes within the community and office. The residents also spend time with a local hospice and with a local occupational medicine practice.  Community Medicine is a longitudinal experience occurring from PGY 1 to PGY 3.   Community Medicine also occurs on a daily basis in the Family Medicine Center.

Pediatrics- Management of ambulatory and hospitalized children is emphasized in the pediatrics curriculum. Pediatrics skills are acquired during all three years of residency. During the first year residents spend two months on the inpatient pediatric unit at SJ Healthcare System in Vineland, NJ. While at SJ Healthcare residents are able to work with pediatricians and neonatologists.

During the second and third year residents rotate through DuPont Children’s Health Program in Voorhees, NJ, where they are able to work with pediatric specialties that include pediatric cardiology, orthopedics, and pulmonary.  Also during the second year residents rotate through the Osborn Family Health Center in Camden NJ.  Residents also assess all potential pediatric admissions in the Underwood Memorial Hospital emergency department and discuss these cases with pediatricians, who are present in the hospital 24 hours per day.

Outpatient skills are also acquired in the Family Medicine Center which provides exposure to the whole scope of pediatrics required for family physicians, with emphasis on growth, development and anticipatory guidance.  Residents will see children for acute care, well-child checks with immunizations, chronic medical care, and a variety of medical examinations. Pediatric patients comprise thirty percent of all patients seen in the Family Medicine Center.

During orientation residents are required to take Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation (NRP) certifications.  Our residency also has a comprehensive pediatric lecture series, including monthly presentations given by Level III Intensive Care Nursery Neonatologists.

Family Practice Management- The Overall objective of the Family Practice Management rotation is to assure that residents are equipped with the knowledge, skills and attitudes essential for them to contribute to the day to day operations and management of the medical delivery system.  Scheduling of each item on the FPM “Task List” is individual by the resident. Each item must have a preceptor signature to assure completion. Upon successful completion of the Task List and completion of rotation objectives, (as determined by the Program Director) credit will be granted for this rotation. All rotations must be successfully completed to advance to the next PGY level. (Some tasks are longitudinal in nature). Residents are expected to give periodic updates on rotation progress to the Program Director or his designate.”

During the time spent at the listed offices on the Task List the resident should gain knowledge and exposure in the following areas:

• What services this agency/office offers?
• How to access these services and what constitutes an appropriate referral to this office.
• How can you as a physician best interact with this office to improve the health care system?
• Is there any project potential here regarding community based medicine or health education?

Procedures- Residents not only acquire the skills to perform procedures during specific rotations such as surgery and Obstetrics, but also on a longitudinal basis. Procedural skills occur under the direction of family medicine and specialty faculty. The curriculum consists of monthly lectures on various procedures appropriate to family medicine. Quarterly procedure workshops that are held but not limited to are:

• BATHE Technique
• Colopscopies
• Diabetic Testing Methods
• Endometrial Biopsy
• ENT Procedures
• Flexible Sigmoidoscopies
• Immunization Methods and Concepts
• Interviewing Skills/Agenda Setting
• IUD’S
• Knee/Shoulder Evaluations
• Nail Procedures
• Office Microscopy
• Parental Guidance
• Pessary Placement
• Skin procedures/knot tying and suturing
• Skin Procedures (I&D, Cysts etc.)
• Suicide Assessment and Screening                                                   
• Trigger/Joint Point/Tendon Injections
• Typanometry
• Vasectomy
• Well Child Exams
• Wood’s Lamp and Eye evaluations

Residents are required to log all procedures in a web-based residency management system (New Innovations).

Night Float (PGY 2 & 3)
Second and third year residents on Night Float work Sunday through Thursday from 5PM to 7AM. They are scheduled in the continuity clinic Friday morning and attend Morning Report.  We are confident that the combination of Night Float and, Night Call scheduling for the first year residents creates the best possible call schedule.

On-Call schedule- (PGY 1)
Call for first residents depends on the individual’s schedule. For example, if a resident is on Obstetrics for the month, the individual takes call every Wednesday, with no weekend calls. For all the other rotations (i.e. Surgery, Inpatient, Orthopedics, etc.) the individual is on call q3-4, which equates to at least one weekday call and at least one Saturday call per month.
Saturday and holiday call consists of 24 hour shifts from 8:30 am to 8:30 am.                              Monday through Friday call runs from 5 pm to 8 am.                                                                            Sunday Call runs from 8 am to 5 pm.

Synopsis of On-Call Duties and Responsibilities

• Admit FMC patients through the emergency department
• Admit patients without primary care physicians (unassigned) through the emergency department under the FMC service
• Manage patients in LDRP, and assist on c-sections with private practice obstetricians
• Respond to codes throughout the hospital
• Perform needed procedures for patients on inpatient service
• Answer outside calls and consultations