The first year of the Family Medicine Residency Program focuses on inpatient care and introducing residents to the concept of a Patient-centered Medical Home. The inpatient component consists of experiences in Family Medicine, cardiology, gastroenterology, pediatrics, obstetrics, emergency medicine, and intensive care medicine. First year residents begin seeing patients in the Family Medicine Center 1-2 sessions per week and build a panel of patients that they will follow throughout their three years of residency.
The Patient-Centered Medical Home (PCMH) is taught in our Family Medicine Center/Longitudinal curriculum. First year residents spend one month in the Family Medicine Center as an introduction to the PCMH, in addition to their sessions in the Family Medicine Center that occur throughout the first year. The month takes place during the beginning of the residency to help orient residents to the PCMH early in their training. During this rotation, residents have the opportunity to work closely with faculty and senior residents in the office. One-to-one precepting sessions with faculty allow for personalized teaching and time to become comfortable with our electronic medical record. Residents also work with our Behavioral Scientist on interviewing skills during this time. Sessions are devoted to evidence based medicine, performance improvement, disease management, practice management, and radiology and laboratory skills. Time is also available to start independent work on computer-based courses as well as on long range research, practice management, and community medicine projects.
The inpatient rotations consist of two months on the Family Medicine Service, one month of pediatrics, two months of obstetrics, and one month each of cardiology (CCU), gastroenterology, surgery and emergency medicine. On the Family Medicine Service, residents care for patients admitted from our Family Medicine Center, including general medicine, pediatrics, gynecology, and intensive care unit patients. This rotation stresses the diagnosis and treatment of common medical problems using a team approach, with a senior resident and Family Medicine faculty following the patient through all degrees of illness. During the Cardiology/CCU rotation, residents learn how to care for common cardiology illnesses such as congestive heart failure and coronary artery disease and follow critical care unit patients with the private cardiologists and perform procedures related to these patients. With the gastroenterologists, residents are able to learn GI procedures including flexible sigmoidoscopy. In emergency medicine, residents work with full-time Emergency Department attendings to learn how to assess and stabilize acutely ill patients in JFK’s new state of the art Emergency Department.
The pediatric experience occurs on the pediatrics floor at JFK. The resident spends six weeks working with the Pediatric faculty which includes pediatric intensivists. The residents care for pediatric patients and learn the fundamentals of inpatient pediatric care through a combination of bedside teaching and didactics. The Family Medicine resident admits and follows a caseload of patients with pediatric attendings, participates in daily rounds and attends conferences. Residents spend two weeks in the new pediatric Emergency room at JFK working with Pediatric ED attendings in assessment of the acutely ill pediatric patient.
Obstetrics training consists of a six-week block at JFK. The residents care for our Family Medicine Center obstetrical patients – managing prenatal care, labor and delivery, post-partum care and follow-up. They also follow newborns in the nursery. The residents are supervised by both Family Medicine faculty and attendings in the Family Medicine obstetrical group, who provide 24-hour coverage as well as didactic lectures to the obstetrics resident.
The surgical rotation consists of four weeks under the assignment of JFK general surgery attending physicians. The residents evaluate and diagnose surgical patients, assist the surgeon intra-operatively and post-operatively, and learn appropriate surgical referral.
First year residents do a total of six weeks of night float during the year. Two weeks are done in the first four months of the year, with another month occurring later in the year. Residents work five shifts a week at night (Friday and Saturday off) with duties including covering our Family Medicine inpatients and obstetric patients and working together with senior residents assessing and admitting patients in the emergency room.