Program Overview - What Makes Us Unique?
Clinical Training
- Outpatient Continuity Practice—Throughout the program, residents spend at least two half-days per week in their continuity practice sites. Residents are fully incorporated into regular team meetings where we focus on how to improve quality of care for the patients we serve.
- Adult Inpatient Medicine—A total of six months of inpatient medicine and two months of ICU. All medicine rotations supervised by our family physician faculty. Morning Report and Noon Conference (lunch provided) four days per week.
- Obstetrics—40-60 deliveries in the first two blocks of internship. Opportunity to train with obstetricians, family physicians and nurse midwives. Two family medicine Maternal and Child Health fellows per year add to the educational milieu.
- Pediatrics—Wide variety of experiences which include two months in a high volume pediatric emergency department, inpatient, outpatient and community-based programs. Total of five months of experience.
Tracks & Areas of Concentration
Global Health Track
Erin Lineman and Elizabeth Terragnoli in Honduras
Established in 2003, this track prepares highly motivated and accomplished residents to care for underserved populations anywhere in the world. Up to six interested residents per class are selected to enter the global health track. Each Fall and Spring trip usually has 7-8 residents traveling to work at the site. While further detail can be found on the global health page of this site we would like to highlight a few important features of this track:
- Didactic training occurs in the US to prepare residents for working in international sites.
- GHT residents make 2 trips during their residency to work in an underserved setting in Honduras, which is the primary overseas site.
- Travel expenses and insurance are covered by the Program for times spent overseas.
- Department faculty teaches the didactic sessions as well as travels to Honduras with the residents.
- Training is also available to residents who want to participate in an international experience but do not wish to commit to the full GHT program.
Maternal & Child Health Track
One of the long standing strengths of our program, maternal and child health, has remained an important focus with extensive obstetrical training for those residents who are particularly interested in including OB in their future practices. Some of the highlights of this track include:
- Obstetrics and Gynecology training occurs at Highland Hospital, a community hospital where residents generally accumulate experience with 40-60 deliveries in their required two blocks on service in the first year.
- Those who wish to pursue additional OB training have the opportunity to do another 2-3 blocks and can amass up to 100 or more deliveries, with 10-20 Caesarean sections as well as forceps and vacuum-extraction deliveries.
- OB track residents will take second call on the Labor and Delivery service, providing an opportunity to be involved in all complicated deliveries.
- OB/Gyn residents are usually scheduled for surgeries during the day, so it is primarily the Family Medicine residents who run the deck at that time. Both departments long ago realized the value of this interdependence.
- Certified Nurse-Midwives are a constant presence on the labor deck and add to the diversity of the maternity care experience managing routine and high-risk patients.
Political Advocacy & Leadership Track (PALT)
Congresswoman Louise Slaughter (D-NY) with
Family Medicine residents and
Residency Director Steve Schultz
This relatively new track supports resident who are interested in the policy making process that directs the delivery of health care in the U.S. There are usually two residents in each class who choose to participate in PALT, giving them opportunities to meet Senators and Congresspersons, such as Louise Slaughter, pictured left with University of Rochester Family Medicine residents as well as our program director, Steve Schultz. In addition, PALT residents:
- Learn about the legislative issues that affect patients, medical education and healthcare policy
- Develop an advocacy issue of personal interest
- Serve on a New York State Academy of Family Medicine commission
- Lobby in Albany, NY and Washington, D.C. to meet state senators and representatives as well as national leaders
- Supported by the residency to attend conferences
Community Hospital in a University Setting
The best of both worlds. It is such a trite term, and yet so perfectly describes Highland Hospital. Highland Hospital is a 270 bed hospital tucked into the edge of Highland Park, approximately one mile from the large university hospital, Strong Memorial. Highland is the oldest hospital in Rochester, founded in 1889 as a homeopathic hospital, and where insulin was first used in the United States.
Highland is our hospital, the site of the third oldest family medicine program in the country, a hospital where family medicine has been part of the culture since 1969, when family medicine was first established as a specialty.
It is a hospital with a rich history of collaboration, where family physicians, internists, and subspecialists greet each other warmly and curbside consult each other over coffee at Primary Care Grand Rounds every Tuesday morning; where family physician attendings have C-section privileges, attend every resident continuity delivery, attend on the palliative care consult service, the geriatric inpatient service, the special care nursery, and our busy adult medicine inpatient service.
It is a hospital large enough to have excellent services, and yet small enough where you get to know all the cardiologists, nephrologists, OB/GYNs, and surgeons, and they get to know you. They become invested in your education, in you personally.
There are fellowships for family physicians in the Geriatrics and Maternal & Child Health and both of those fellowships have active clinical roles at Highland.
Emphasis on Psychosocial Medicine
This aspect of our training truly makes us unique. The goal of psychosocial medicine (PSM) is the development of personal and professional skills. The ability of Family Physicians to communicate with patients and to think on a systems level is what sets us apart and allows us to function as excellent clinicians. A few highlights of this 4-block rotation:
- 40% of residents’ time is spent in their outpatient practice, providing an opportunity to implement many of their PSM skills
- Residents participate in a Family Systems Medicine Practicum co-taught by a family physician and a family therapist
- Short-term primary care counseling, core seminars and educational experiences in alcoholism and chemical dependency, parent counseling, eating disorders, psychopharmacology, and child psychiatry
- Intensive small group experience with an analytically oriented psychiatrist, providing an opportunity for self-reflection and education about the dynamics of small groups.
In total, the Psychosocial Medicine rotation is generally considered pivotal in the development of every family physician. Read more detailed information.
Preparing the Personal Physician for Practice (P4)
Rochester p4 Video: Training to Teams from Gina Lamanna on Vimeo.
We were one of 14 family medicine residency programs in the country selected to participate in the AAFP TransforMED Preparing the Personal Physician for Practice (P4) demonstration project. The impetus of P4 has supported growth of resident QI projects and fuller participation of all clinical team members to enhance patient care. Read additional information.
Faculty
We are fortunate to have a large faculty of 28 family physicians (with 8 of them doing OB), 3 behavioral health providers, and an obstetrician. Their interests are far ranging from a clinical focus to research. Among the faculty we have:
- Providers who work primarily with refugees
- Nationally recognized researchers in healthcare disparities
- 2 family physicians with C-section privileges
- 2 family physicians who have completed sports medicine fellowships
- 1 family physician who is dually certified as a family therapist
Mindful Practice
We incoporate the techniques of Mindful Practice into training - this refers to our ability to be aware, in the moment, on purpose, with the goal of providing better care to patients and to take better care of ourselves. Being mindful is at the core of clinical competence. The purpose of this program is to improve quality of care and physician well-being by helping residents be more mindful during daily clinical practice, including:
- being responsive rather than reactive
- noticing things about oneself and situations even though they might be unpleasant;
- acting with awareness and intention (not being on “automatic pilot”), and
- focusing on experience, not the labels or judgments we apply to them (e.g. understanding patients and their problems rather than just categorizing or judging them).
Other Program Highlights
- One of only 14 Preparing the Personal Physician for Practice (P4) residency programs in the country: 3-year HRSA Title VII grant started in Fall 2009.
- Home of the biopsychosocial model.
- Blackboard website is home to all curricula, goals and objectives for all rotations.
- E*Value electronic evaluation system.
- Onsite, weekly faculty-supervised resident sessions for general procedures and for colposcopies.
- Diabetic and chronic pain group visits.
- On-site Behavioral Health Services.
- Opportunity to provide palliative care at two-bed hospice unit.
- All University of Rochester Medical Center (URMC) programs are free from pharmaceutical company representatives.
“I really miss the stimulation and academic diversity/open-mindedness that is so much a part of Rochester.” –Alumni Survey 2010
