Family Medicine Residency Curriculum

Plan of Study
Conferences
Longitudinal Curricula in Geriatrics, Sports Medicine, Community Medicine, Addiction Medicine
Evaluations
Resident Support
Sample Call Schedule

Family Medicine Residency Plan of Study

Year 1	Year 2
8 weeks – Orientation 12 weeks – Family Medicine Inpatient 7 weeks – Adult Emergency Medicine 3 weeks – Surgery 4 weeks – Pediatric Outpatient 4 weeks – Obstetrics - Labor & Delivery 4 weeks – ICU 4 weeks – VA Rotation 4 weeks – Outpatient Office Medicine/Practice Management 2 weeks – Family Medicine Night Float	8 weeks – Family Medicine Inpatient 4 weeks – Family Medicine Inpatient Night Float 4 weeks – Gynecology/Women's Health 4 weeks – Sports Medicine 4 weeks – Palliative Medicine 4 weeks – Addiction Medicine/Behavioral Health 4 weeks – Elective 4 weeks – Peds Inpatient 4 weeks – Peds Emergency Medicine 4 weeks – Outpatient Office/Long-term Care 4 weeks – VA Rotation 2 weeks – Cardiology 2 weeks – Newborn Nursery Longitudinal – Community Medicine
Year 3
8 weeks – Elective 4 weeks – VA Rotation 4 weeks – Family Medicine Inpatient 4 weeks – Family Medicine Inpatient Night Float 4 weeks – Outpatient Office/Long-term Care 4 weeks – Obstetrics - Labor & Delivery 4 weeks – Orthopedics 4 weeks – Infectious Disease 4 weeks – Pediatric Outpatient 4 weeks – Dermatology 4 weeks – Selective 2 weeks – Community Medicine 2 weeks – Hematology Oncology

Family Medicine Residency Conferences

House Staff Work Rounds:

The clinical chief resident coordinates the team of residents and students assigned to the inpatient family medicine service. During work rounds residents provide clinical evaluation and diagnostic and therapeutic planning for their panel of patients. Consultative services are readily available at Chestnut Hill Hospital and our affiliated sites, and patient care decisions can be readily reviewed with the attending physician during work rounds or subsequent teaching rounds.

Attending Physician Teaching Rounds:

Inpatient medicine faculty are highly motivated educators who have come to Drexel from a diverse background of clinical education settings. Teaching rounds include bedside and formal didactic sessions.

Grand Rounds:

Speakers are selected from Drexel University College of Medicine faculty, Chestnut Hill Hospital and visiting lecturers. Grand rounds are teleconferenced to the Manayunk office site.

Morbidity and Mortality:

M&M conference is held monthly to review interesting or particularly difficult cases. This is a multidisciplinary conference focusing on appropriate approach, diagnosis and therapy in these cases. Family medicine upper-year residents present this conference with faculty members helping in the review of the case and format of the presentation.

Weekly Conferences:

Weekly family medicine didactic conferences are held on Friday mornings. Residents and Faculty are provided protected time away from rotations to attend. These didactic sessions are an incredible learning opportunity in which individuals within the Department of Family, Community & Preventive Medicine and guest speakers from other specialties and disciplines offer their expertise on various topics of relevance to family medicine. Residents also present at resident conference.

Journal Club is held monthly under the direct supervision of a department attending and Dr. Gracely, a statistician and expert in experimental design and statistical analysis. Typically led by an intern and upper year, emphasis is placed on the role of research and literature in shaping clinical practice.

Balint sessions are also held monthly, facilitated by Dr. Gelo, the department's behavioral health specialist. Balint affords residents an opportunity to discuss their patients and experiences within the program, in an effort to improve patient care and decrease fatigue and burn out.

Intern Return is a regularly scheduled PGY-1 group that offers another opportunity for residents to discuss both academic and life experiences, questions, and PGY-1 related didactics to further support the intern's transition, growth and development in the first (and typically most challenging) year of residency.

Quarterly sports medicine reviews are also held. With the help of Drexel's sports medicine faculty and fellows, a comprehensive overview of a specific joint or system is provided during each session. Pathophysiology, physical exam and clinical application are all reviewed in an integrative and interactive approach.

Scholarly Activity

There are extensive opportunities for family medicine residents to participate in scholarly activity with the Drexel faculty. Our faculty are involved in many different projects including writing book chapters and journal articles as well as presenting posters or didactic sessions at local, regional or national conferences. Residents interested in a detailed research project may request to utilize an elective block for research. By the conclusion of the residency training, all residence will have completed scholarly activity and a quality improvement project.

Longitudinal Curricula in Geriatrics, Sports Medicine, Community Medicine, Addiction Medicine

Geriatrics

We have a robust geriatrics curriculum. Upper-year residents spend time rounding in a community long-term care and subacute rehabilitation center and participate in the delivery of medical care to Philadelphia's elderly homebound population. Our residents have historically had the highest board performance in geriatric care and many are accepted into competitive geriatric fellowships.

Palliative Care

Our residents gain a unique exposure to palliative medicine. We have a one-year fellowship program that helps to bolster our educational curriculum. Each of our residents spend one month on a palliative care rotation. The educational content includes end-of-life care, pain management and oncology.

Sports Medicine

Our residents gain a robust educational experience in sports medicine. Linked to our Sports Medicine Fellowship, residents have comprehensive instruction in musculoskeletal medicine by our primary care sports medicine faculty and fellows. Our curriculum longitudinal curriculum includes rotations through all 4 of our outpatient offices, college and high school training rooms, pre-participation sports physical exams and potential game coverage.

Community Medicine

From the time you start your residency training in your first year until you graduate you will participate community health as a part of our longitudinal curriculum. Under the department's Division of Community Health, serving the underserved is a strength and a passion of our program. The community medicine curriculum includes various service-learning activities, community outreach events (i.e., health fairs, health screening, patient education programs, etc.), lead nutrition and fitness program Move It with Mommy & Me to address childhood obesity, and are preceptors at our medical student-run clinics at Eliza Shirley Women & Children's Shelter, Salvation Army Drug & Alcohol Rehabilitation Center, Streetside Prevention Point Needle Exchange Program, and more. They also participate in a longitudinal curriculum and didactic lectures on various topics surrounding care of our most vulnerable populations here in Philadelphia including trauma informed care, immigrant health, refugee care. Lastly, throughout the three years, residents are required to research, plan, implement and evaluate their own community project or intervention and present it at a local, regional or national conference. Our residents have already developed amazing programs that remain functional and sustainable today. We look forward to your contributions when you come!

Substance Use Disorders/Chronic Pain

Our residents are privileged to participate in our newly designed longitudinal curriculum in addiction medicine which includes management of substance use disorder (SUD) and chronic pain. Residents actively manage opioid use disorder at both outpatient and inpatient medication-assisted treatment (MAT) centers, participate in integrative chronic pain management group visits focusing on alternative to medication modalities to treat pain, and shadow an acupuncturist who specializes pain and SUD. They participate in an interdisciplinary journal club dedicated to chronic pain. Didactics explore managing implicit bias, trauma-informed care, and evidence-based techniques for managing pain without medication. All residents complete buprenorphine waiver training and have the opportunity to obtain their DATA waiver by the end of residency. Residents learn to actively manage the initiation and maintenance of patients on medication assisted treatments for opiate use disorder in their continuity clinics.

Women’s Health

As part of this longitudinal curriculum residents learn about reproductive justice, state and federal policies, implicit bias, and patient-centered counseling techniques for contraception and managing unintended pregnancies. Residents are educated on procedures including insertion and removal of long-acting reversible contraception, endometrial biopsies, colposcopy. This curriculum also includes clinical experiences at a breast specialist clinic, a clinic that manages pregnant women with substance use disorder, and women and children's shelter.

Evaluations

Family medicine residents are evaluated and given feedback through multiple mechanisms. At the end of each block, the attending physician with whom they have been working completes an evaluation. Residents complete self-evaluation as well as receive a comprehensive review of ACGME Milestones from the Clinical Competency Committee. In addition, residents are evaluated by supervising family medicine faculty, continuity practice site staff, and our patients as part of our 360-degree evaluation process. An in-training exam is given annually. Residents meet with the program director twice annually to review their performance and progress on completion of program requirements.

Residents provide evaluations of their individual rotations at the conclusion of each rotation and evaluate teaching experiences with the family medicine faculty in the inpatient and outpatient setting on a quarterly basis.

Resident Support

Each incoming resident is paired with a faculty member adviser for general support and guidance throughout the three years of residency. Adviser-advisee meetings are held at least quarterly. Advisers review trainees' performance on in-training exams, rotation evaluations, and progress with scholarly activity. This is usually an informal time to also review professional, career and life goals and aspirations, as well as any concerns or issues that may have arisen. PGY-1 residents meet monthly as a group for intern support during Intern Return to assist in the transition into residency. PGY-2 and PGY-3 residents also select a faculty member to meet with for continued group support throughout their senior years of residency.

Family Medicine Residency Call Schedule

Our Family Medicine Residency program takes duty hours regulations and resident fatigue very seriously. We have the call system outlined below in place to maximize the benefit and education residents have when dealing with patient issues on-call/overnight and balance it with the benefit and education of the rotations. Systems are in place to handle residents who are too fatigued to work after overnight call responsibilities.

PGY-1

On various weekends throughout the year, interns have 12-hour call shifts on Saturday and Sunday during the day and Friday and Saturday during the night. Typically, the same intern will be on Saturday and Sunday during the day while another intern will be on Friday and Saturday overnight. These shifts still allow for appropriate continuity and transitions of care.

PGY-2 and 3

Upper-year residents share call responsibilities. During the week, a night float resident is in the hospital overnight Sunday through Thursday, fielding admissions and handling any patient care issues that may arise from the admitted patients on the family medicine service. This resident also manages phone calls from family medicine outpatient offices and affiliated nursing home. Over the weekends, rotating upper-year residents cover call responsibilities in shifts. A sign-out/transition of care system is in place to ensure excellent communication between the on-call resident and the rounding team.