Family Medicine Residency: Rotation Schedule

Diverse Rotations with Multiple Elective Options

PGY-1 Rotations
1 1 1 3 1 1 2
Adult Medicine-Cardiology Care Unit Adult Medicine-Inpatient Emergency Medicine Family Medicine-Inpatient Family Medicine-Nursery Obstetrics Pediatrics
2 1 1 1 1-2 sessions weekly, all year
Pediatrics Psychiatry / Neurology Radiology / Community Medicine Surgery Continuity Clinic (Whittier)
Surgery Continuity Clinic (Whittier)
 
PGY-2 Rotations
1 1 1 1 1 1 1
Adult Medicine-Intensive Care Ambulatory Medicine Ambulatory Surgery (Whittier) Community Medicine Dermatology Elective Emergency Medicine
2 1 1 1 1 2-3 sessions weekly, all year
Family Medicine-Inpatient Family Medicine-Obstetrics Pediatrics Preventive Medicine Sports Medicine Continuity Clinic (Whittier)
 
PGY-3 Rotations
1 3 2 1 1 1
Ambulatory Pediatrics Elective Family Medicine--Inpatient Geriatrics Gynecology Medical Sub-specialties—Endocrinology, Rheumatology, Pulmonology
1 1 1 1 3-5 sessions weekly, all year
Orthopedics Pediatrics (Gillette) Practice Readiness: Medical Home

Surgical Sub-specialties-Urology, Ophthalmology, ENT, Oral Health

Continuity Clinic (Whittier)

About Our Rotations

PGY-1 and PGY-2

The first two years of the Family Medicine Residency prepare residents for inpatient medical and emergency care, including obstetrics and pediatrics, and set the groundwork for essential outpatient skills and practice. Our residents work collaboratively with other HCMC residents, building relationships and taking advantage of broad educational opportunities within our healthcare system. Family Medicine residents, particularly during PGY-2, also teach medical students.

Inpatient family medicine services include adult, pediatric, and obstetric patients from our own practice at Whittier Clinic, as well as patients from HCMC's other primary care community clinics.

PGY-1 orientation occurs weekly during the first two months of training. During this time, residents participate in team-building and skill-building activities, and learn essential skills for integration into the residency program.

PGY-2 residents take on more outpatient experiences at Whittier Clinic, and at HCMC’s specialty clinics. Our community medicine rotation highlights the year, where residents gain experience working with homeless patients and spend one week at the Hazelden Addiction Treatment Center.

During PGY-2, residents begin a longitudinal experience at Chateau Nursing, developing continuity relationships with geriatric patients.

Ambulatory experiences include work at the Whittier procedure clinic, where residents learn procedures common to family medicine.

Other rotations introduce the full range of dermatologic, orthopedic, and gynecologic procedures included as part of everyday practice.

Other opportunities include:

  • Outpatient services within family medical centers, including nutrition, sports medicine, and psychiatry;
  • A structured month of cardiology experience; and
  • Clinics in adult dermatology.

At the end of PGY-1, residents can opt for additional, specialized training in outside the core curriculum, using block or longitudinal elective time. Residents can choose one of our focus areas, or design their own elective.

Current focused training opportunities include:

A Global Health focus area is planned. Past residents have chosen focus areas including Hospitalist Medicine and Women’s Health.

PGY-3

Our third year focuses intensively on continuity clinic practice at the Whittier Clinic location. Residents build their knowledge and apply their skills to care and management of patients with complex healthcare needs.

Outpatient rotations take advantage of HCMC’s various specialty clinics to address common primary care problems, such as rheumatology, geriatrics, ENT, cardiology, gynecology and uro-gynecology, outpatient pediatrics, and adolescent medicine.

Specific third year experiences include:
  • Outpatient pediatrics, working with community pediatricians;
  • Outpatient procedures, including colposcopy, orthopedic, and gynecologic procedures;
  • Specialty clinics in geriatrics, palliative care, and long-term care;
  • Specialty clinics in urology, otolaryngology, and ophthalmology;
  • Longitudinal care of nursing home patients and home visit care; and
  • Advanced education seminars in behavioral medicine and practice management education.

Residents maintain their inpatient skills with two months as senior resident on the Family Medicine Service, with additional responsibilities for teaching and supervision of PGY-1 residents and medical students.

Family Medicine Programs

Geriatrics

Our longitudinal geriatric curriculum prepares our graduates to provide the highest quality care for older patients—an important skill, as more than 20 million adults over age 85 are estimated to need medical care by 2050. Through traditional coursework and direct patient care, residents learn to address the issues inherent in geriatric care.

Beginning in the Family Medicine outpatient clinic, residents care for their own panel of older patients, with faculty assistance. Geriatric patients also comprise a significant portion of inpatients on the Family Medicine Inpatient service. Residents see firsthand the issues for patients and families in caring for the elderly, including end-of-life decisions.

Residents also provide continuity care for patients at a local nursing home during PGY-2 and PGY-3. We complement these hands-on clinical experiences with interactive, small-group teaching sessions by our faculty members who are board-certified in geriatric care.

At the end of PGY-1, residents can opt for additional, focused training in Geriatrics outside the core curriculum, using a longitudinal approach during their PGY-2 and PGY-3 years. These residents take on additional geriatric rotations and gain experience in nursing home administration, hospice and palliative care, and the skills needed to provide care to ambulatory older patients.

Health Care Home

We deliver this structured curriculum in the principles of health care homes throughout the Family Medicine residency, using didactics and experiential learning for patients with complex care needs. Residents learn leadership skills, participate in multidisciplinary teams in both inpatient and outpatient settings, and train in complex care management.

Integrative Medicine

The demand for integrative primary care physicians today exceeds capacity—across the Twin Cities, the state of Minnesota, and the nation. The Family Medicine residency is one of the few training programs nationally that give residents practical experience in this discipline. Our Integrative Medicine curriculum prepares residents to practice basic integrative medicine, continue lifelong learning, and become integrative medicine leaders in their healthcare practices.

The entire Family Medicine curriculum incorporates principles of Integrative Medicine. Each resident participates in 200 hours of online training through the University of Arizona. Residents also participate in bi-monthly wellness and self-care lectures and experiences.

At the end of PGY-1, residents can opt for additional, focused training in Integrative Medicine outside the core curriculum, using several formats and modalities during their PGY-2 and PGY-3 years. These residents will spend three sessions in clinic each week caring for patients with trained integrative health faculty, 2-3 weekly sessions in personal study and self-care, and log five integrative health primary care encounters outside the focus area.

In-clinic sessions include:

  • Perform integrative medicine interviews with patients;
  • Populate functional timelines and matrix;
  • Formulate patient-centered integrative health treatment programs; and
  • Implement integrative medicine longitudinally in their primary patients.

Personal study and self-care experience include:

  • Utilizing Institute for Functional Medicine (IFM) core lectures and videos, taught by faculty;
  • Identifying a personal focus area to study, such as women’s health, herbal therapy, nutrition, or cardio-metabolic syndrome;
  • Self-evaluation throughout the rotation on diet, digestion, exercise, energy, sleep, stress, support—and making a self-care plan for improvement;
  • Observing and experiencing the treatments of Complementary and Alternative Medicine (CAM) practitioners who work at Whittier Clinic, such as chiropractic, acupuncture, physical therapy, and traditional healers;
  • Participating in the “Integrative Medicine 4 Us” and Pillsbury House for community service; and
  • Delivering a journal club lecture on an integrative health topic.

Obstetrics

Family Medicine residents gain valuable experience with low- and high-risk pregnancies during their rotations. Residents participate in two blocks of obstetrics training, with opportunities for managing obstetrics on 5-6 other blocks and during night call. Family Medicine faculty as well as hospital obstetricians supervise residents. Residents perform all OB procedures, including vacuum-assisted deliveries, and manage laboring patients with preeclampsia, preterm deliveries, and gestational diabetes.

All Family Medicine faculty practice obstetrics, and several serve on multi-disciplinary groups to help foster better communication and patient care. Five faculty members are Advanced Life Support in Obstetrics (ALSO) instructors, including one nationally recognized ALSO Advisory Faculty.

Each resident takes the ALSO course in PGY-1 and again in PGY-2 or PGY-3 to enhance their skill and improve confidence when handling labor and delivery emergencies. During each obstetrics rotation, residents review ALSO principles and teach other residents. Our residents have successfully managed dystocia and postpartum hemorrhage, and routinely cite the ALSO course as increasing their ability to manage these situations.

Another highlight is training in CenteringPregnancy. All residents have the opportunity to learn this group model of prenatal care that has proven effective in lowering pre-term birth rates.

Procedures

All residents rotate in the Whittier Clinic procedure clinic, held twice each week. Residents perform joint injections, basic and advanced skin procedures, vasectomies, and other procedures.

Sports Medicine

Within our sports medicine curriculum, residents learn from faculty with additional sports medicine training, and rotate in the sports medicine clinic at our Whittier Clinic location. During PGY-1, residents participate in a didactic course at the University of Minnesota. Residents also act as team physicians for local high schools.

Elective Rotations

Our residents can choose electives in international medicine in Tanzania, Costa Rica, and Jamaica.