PGY-1 year consists of 13 blocks. Each intern will rotate through 2 blocks of Inpatient with our FM service, 2 blocks of Nights with our FM service, 1 block of ICU, 2 blocks of OB, 1 block of ER, 1 block of GI, 1 block of Peds at Hurley Medical Center, 1 block Geriatrics/Community Medicine, 1 block of Surgery and 1 block of Psych/Behavioral Science.
INPATIENT: A large part of any family physician’s practice is involved with the principles of general internal medicine. A thorough understanding of internal medicine will provide the foundation for the family physician’s practice. Residents will understand the pathophysiology and treatment of common problems in the adult population in the inpatient setting and the appropriate outpatient care following hospitalization. Residents will round and have a detailed understanding of their patients prior to attending rounds. Residents will write daily progress notes as well as H&P’s for new medicine admissions throughout they day. Residents will be responsible for discharge summaries for their assigned patients. Residents will be able to perform appropriate procedures with supervision and respond to floor calls in a prompt manner. During this month residents will spend one half day per week at the Family Health Center. The best part of inpatient is spending time with each other as a team and having potlucks!
NIGHTS: Family physicians require training that will enable them to provide comprehensive care for their patients. A large part of any family physician’s practice involves hospitalization and stabilization of acutely ill patients. On nights, residents are responsible primarily for admitting and stabilizing acutely ill patients that present to the ED or patients that decompensate on the general medical floors. Residents will hold the pager and respond to pages in a timely manner. During this month, residents will spend one half-day per week at the Family Health Center.
ICU: Family physicians require training that will enable them to provide comprehensive care for their patients. A large part of any family physician’s practice involves hospitalization and stabilization of acutely ill patients. A thorough understanding of critical care medicine will provide the foundation for the family physician’s hospital practice. This rotation provides the resident an opportunity to be responsible for diagnosing and managing the major acute illnesses that affect patients of all ages. Residents will get the opportunity to learn how to interpret EKG’s and ABG’s, manage ventilators, perform procedures including lumbar punctures, thoracentesis, intubations and central lines. During this month, residents will spend one half-day per week at the Family Health Center.
PEDS HURLEY: Our pediatric rotation during the first year will take place at Hurley Medical Center. Resident will learn to recognize those pediatric patients that should be managed in a hospital setting. Residents will diagnose and treat common pediatric and urgent medical problems encountered in pediatric patients. During this month, residents will spend one week on nights and three weeks on days. During this month, residents will spend one-half day per week at the Family Health Center.
OB: The overall goal for family medicine education in obstetrics will be that residents achieve competence in managing obstetrical encounters as appropriate for the family physician and that they achieve competence in recognizing obstetrical problems which require in-depth investigation and management and appropriate referral. Residents will be given ample opportunity to be active participants in labor and delivery. At the completion of the rotation, residents will be comfortable in providing high quality obstetrical care with a major emphasis on early detection and reduction of obstetrical risk, providing skillful management of labor and delivery, and recognizing and managing the family and social issues arising during this portion of the life cycle, including issues such as neonatal illness and death. Residents spend two separate months on OB. During each month you have two weeks of day shifts and two weeks of night shifts. During this month, residents will spend one full-day per week at the Family Health Center.
ER: Many family physicians work in acute or urgent care settings as well as providing emergency room coverage for many hospitals, providing care to the adult and pediatric population. The ability to promptly assess, intervene and treat are critical elements of the emergency medicine experience and these are frequently in the face of multiple simultaneous patient encounters. This rotation allows the resident to recognize and manage problems which require urgent or emergent treatment and understand the pathophysiology and treatment of common emergency medical problems. During this month, residents will spend one full-day per week at the Family Health Center.
GI: Residents will learn how to describe pathophysiology, diagnosis, and management of GI abnormalities, including, but not limited to, infectious enteric diseases, esophagus abnormalities, IBD, PUD, motility dysfunction (gastroparesis/IBS), anal and rectal abnormalities (fistula, fissure, perianal abscess, and hemorrhoids), liver disease, biliary tract disease, malabsorption syndromes, pancreatitis, and malignancy of GI tract, upper and lower GI bleeds. Residents will also observe and/or assist attending physicians/fellows with colonoscopies and upper endoscopies and be able to describe indications/risks for each procedure. During this month, residents will spend one full-day per week at the Family Health Center.
GERI/Community Medicine: During this rotation, residents will rotate through nursing homes and hospice centers. Residents will also get the opportunity to rotate with our amazing Palliative Care Team at the hospital. Residents will be active participants in family meetings. During this month, residents spend one full day and two half-days per week at the Family Health Center.
Surgery: All physicians require training that will enable them to provide comprehensive care for their patients. Surgical training during this rotation attempts to balance the need for procedural training, surgical knowledge and communication skills. In the first year one block is spent with Dr. Fares. The PGY1 FP resident acts as the first assistant on all surgeries with Dr. Fares and is responsible for all the pre- and post-op care of his private patients under their direct supervision. The patient population provides exposure to all common operations performed by general surgeons. During this month, residents will spend one full-day per week at the Family Health Center.
Psych/BS: The vast majority of the family physician’s time is spent in the outpatient setting. The ambulatory medicine block is designed to allow the resident to develop the skills and abilities to see patients in the outpatient setting. The resident will work in the Family Health Center on scheduled days for the entire 4-week block. Residents will also spend time in the behavioral clinic with the psychology team.